Patient Attitudes and Factors Associated with Willingness to Deprescribe Prescribed Medications in Western Saudi...

Background: Deprescribing is a supervised, patient-centred process for reducing or stopping medicines when their burden, harm, or lack of continuing indication outweighs expected benefits. This study assessed attitudes toward deprescribing, examined the exploratory psychometric performance of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire, and identified factors associated with stated willingness to deprescribe among adults using prescribed medicines in western Saudi Arabia. Methods: An analytical cross-sectional survey was conducted from 15 February to 30 April 2025 in six community pharmacies and three outpatient clinics in Taif, Makkah, and Jeddah. Adults taking at least one prescribed medicine completed a paper-based Arabic rPATD questionnaire. Internal consistency, exploratory factor analysis, Spearman correlations, Mann-Whitney U tests, ordinal logistic regression, and a fully adjusted binary logistic regression sensitivity analysis were used. Results: Of 362 adults assessed, 320 were included in the final analysis. Overall, 254/320 (79.4%) agreed or strongly agreed that they would stop one or more medicines if their physician recommended it. Cronbach's alpha ranged from 0.77 to 0.84, and McDonald's omega ranged from 0.79 to 0.85. The four-factor exploration solution explained 61.4% of the variance. Greater involvement (adjusted odds ratio [aOR] 2.84, 95% confidence interval [CI] 1.98-4.06) and greater perceived medication inappropriateness (aOR 2.31, 95% CI 1.67-3.20) were associated with higher willingness, whereas concerns about stopping were associated with lower willingness (aOR 0.54, 95% CI 0.39-0.75). Medication burden was correlated with willingness but was not independently associated after adjustment (aOR 1.28, 95% CI 0.94-1.75; p = 0.112). Conclusions: Participants reported generally favourable stated willingness to deprescribe when advised by a physician. Involvement, perceived medication inappropriateness, and concerns about stopping were independently associated with willingness. These cross-sectional findings concern intention rather than actual deprescribing behaviour or clinical outcomes.