Attitudes of Australian patients receiving inpatient mental health care towards deprescribing: a cross-sectional survey.

Background: Psychotropic polypharmacy is common, increasing, and associated with higher risks of adverse effects, hospitalisations and mortality. This study aimed to explore the attitudes and beliefs of people receiving inpatient mental health care toward deprescribing (discontinuing a medication when the current or potential risk outweighs the current or potential benefit) and determine any patient characteristics associated with these attitudes and beliefs.

Methods: A cross-sectional survey of patients admitted to two open acute psychiatric inpatient units was conducted over a 6-month period in the Australian metropolitan city of Adelaide. Individuals were eligible to participate regardless of their reason for admission, if they were at least 18 years old and able to converse, read and write in English, and provide informed consent. Participant characteristics and responses to the validated revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire were collected. The rPATD includes questions grouped into four factors: (i) perceived burden of medications, (ii) involvement in medication management, (iii) belief in appropriateness of medications, and (iv) concerns about stopping, plus two global questions. Participants were encouraged to think about medications that they use for their mental health conditions when completing the questionnaire.

Results: One hundred participants were recruited, with a mean age of 41.6 (SD = 13.7). 65% of participants agreed that they would be willing to stop one or more of their psychotropic medications if their doctor said it was possible. In a binary logistic regression model, willingness to have a medication deprescribed was mostly strongly predicted by Involvement factor score (odds ratio [OR] = 5.92, 95% confidence interval [CI] = 2.10-15-16.70, p < 0.001).

Conclusions: A majority of participants were open to having one or more medication deprescribed. When medically justified, mental health professionals should feel comfortable initiating conversations about deprescribing to understand patient attitudes and preferences, fostering shared decision-making for psychotropic medication management.

Clinical trial number: Not applicable.