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

Abstract

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

Methods: 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.

Results: 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).

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