Attitudes of Older Patients and Caregivers in Japan Towards Deprescribing: A Cross-Sectional Study

Deprescribing is essential for medication safety in older patients; however, its implementation is influenced by patient and caregiver attitudes. While these attitudes have been widely studied globally, the factors associated with willingness to deprescribe in Japan are unclear. This study aimed to identify characteristics and attitudes associated with willingness to deprescribe among older patients and caregivers in Japan.

A cross-sectional study was conducted using a postal survey of older patients at pharmacies and a web survey of caregivers from April to June 2025. The evaluation items were the Japanese version of the revised Patients' Attitudes Toward Deprescribing (rPATD), number of medications and diseases, physician Trust Scale, and patient characteristics. A binary logistic regression model was used to examine the associated factors.

The analysis included 326 older patients (median age, 75 years) and 216 caregivers (median age, 59 years). Willingness to deprescribe was reported by 61.7% of older patients and 31.5% of caregivers. Among older patients, higher willingness was significantly associated with lower Appropriateness (odds ratio [OR] 0.38; 95% confidence interval [CI] 0.21-0.68), but with higher Involvement (OR 1.99; 95% CI: 1.21-3.28). Among caregivers, higher willingness was significantly associated with higher Burden (OR 3.70; 95% CI: 1.45-9.43) and Involvement (OR 7.51; 95% CI: 3.16-17.82), but with lower Appropriateness (OR 0.19; 95% CI: 0.07-0.49) and Concerns about stopping (OR 0.38; 95% CI: 0.15-0.95).

Our findings suggest that Japanese older patients and caregivers have distinct attitudinal profiles. Perceived Appropriateness and Involvement were identified as key factors associated with the willingness to deprescribe in both groups.