Polypharmacy and deprescribing attitudes among stroke survivors: Opportunities for enhanced patient centered care

Objective

This study aimed to 1) describe the burden of polypharmacy among stroke survivors compared to older adults without a history of stroke and 2) assess their attitudes towards deprescribing.

Methods

This is a cross-sectional study of US Medicare Beneficiaries aged ≥65 who participated in the National Health and Aging Trends Study. Polypharmacy was defined by the number of regular medications reported (no polypharmacy, ≤5; moderate, 6-10; severe, >10). Deprescribing attitudes were elicited from the Medication Attitudes Module. Ordinal and logistic regression assessed the associations between polypharmacy, history of stroke, and deprescribing attitudes, adjusting for falls and comorbidities.

Results

Of the 2073 respondents, 253 reported a prior stroke. Compared to older adults without a history of stroke, stroke survivors were more likely to report polypharmacy (moderate: 39.4 % vs 29.8 %; severe: 22.6 % vs 9.8 %; p < 0.01). Most stroke survivors (87.1 %) and older adults without stroke (89.0 %) would be willing to stop one or more medications. Polypharmacy had the strongest association with favorable attitudes toward deprescribing.

Conclusion

Stroke survivors report greater polypharmacy than older adults without a history of stroke. Both groups overwhelmingly favor deprescribing. Stroke survivors represent a key population that would welcome and benefit from efforts to deprescribe.