Willingness to Participate in Deprescribing Trials: A Survey of Older Adults in Two Countries

This study investigates the willingness of older adults to participate in a hypothetical deprescribing clinical trial.

We conducted an online survey of adults aged 65+ years in Australia and the United States. Participants rated their willingness to enroll in a deprescribing trial, responding to the statement, "Research is conducted to assess the safety and effectiveness of stopping medicines. Imagine your doctor made you aware of a research trial aiming to help people stop one or more of their medicines. To what extent would you be willing to enroll in the study?" on a 6-point Likert scale with "Not at all willing (1)" and "Extremely willing (6)" as the scale anchors. Participants provided a brief free-text explanation. We dichotomized the outcome variable as willing (scores 4-6) and unwilling (scores 1-3) to enroll and conducted descriptive analyses, chi-square tests, and univariate and multivariate logistic regression models. Free-text responses were analyzed using content analysis, with descriptive statistics summarizing themes.

There were 2334 participants in the quantitative analysis and 2237 participants in the content analysis. Most were willing (n = 1705, 73%) rather than unwilling (n = 629, 27%) to enroll in a deprescribing trial (p < 0.001, 95% CI 0.712, 0.748). Over one-half of participants (n = 1252, 56%) expressed the "positive about deprescribing trials" domain, with Australian participants more likely to do so (AU 666 [60%] vs. US 586 [52%], p < 0.001). Participants (n = 1047, 47%) frequently reported at least one theme of the "concerns and hesitations" domain (n = 669, 30%) with US participants more frequently expressing negative views (US 273 [24%] vs. AU 211 [19%], p = 0.002) and reporting the "mistrust" theme (US 74 [7%] vs. AU 35 [3%], p < 0.001).

Older adults showed a willingness to engage in deprescribing trials, though concerns may affect enrollment. Clear communication of risks and benefits could support recruitment.