Factors associated with family caregivers' attitudes toward deprescribing in long-term care facilities: a cross-sectional study in South Korea.

backgroundDeprescribing has emerged as an important strategy for addressing polypharmacy among older adults in long-term care facilities (LTCFs). Family caregivers often play a key role in medication-related decision-making, yet factors associated with caregivers' attitudes toward deprescribing remain insufficiently understood. This study aimed to identify the factors associated with caregivers' attitudes toward deprescribing among residents of LTCFs in South Korea.

methodsA cross-sectional online survey was conducted with 973 family caregivers of residents in LTCFs. Attitudes toward deprescribing were assessed using the Korean version of the revised Patients' Attitudes Towards Deprescribing questionnaire (K-rPATD). Multiple linear regression models examined the associations of 16 measured predictors, represented by 18 regression terms, with four K-rPATD subscale scores and two global items, entered simultaneously. Unadjusted and Benjamini-Hochberg false discovery rate (FDR)-adjusted p values were computed for all 108 coefficients.

resultsOf the 973 caregivers included, 56.0% were male, 88.0% had a college education or higher, and 73.0% reported dual-track prescriptions. Among the K-rPATD subscales, involvement showed the highest mean score (3.63 ± 0.61), followed by burden (3.61 ± 0.72) and concerns about stopping (3.33 ± 0.64), whereas the reverse-scored appropriateness subscale had the lowest mean (2.52 ± 0.68). Residents took an average of 5.6 ± 3.5 medications, and 16.3% had experienced adverse drug events. After FDR correction, eight associations remained significant: adverse drug events with higher burden and concerns about stopping and lower appropriateness; medication cost with higher burden and concerns about stopping; number of medications with higher burden; and number of chronic conditions with higher concerns about stopping and involvement. All other nominally significant associations did not survive FDR correction and are considered exploratory.

conclusionsAfter correction for multiple comparisons, family caregivers' attitudes toward deprescribing were associated with the resident's medication-related circumstances - adverse drug events, medication cost, number of medications, and number of chronic conditions - rather than with caregivers' own sociodemographic characteristics. These cross-sectional findings are hypothesis-generating, but they help identify the family caregivers with whom deprescribing is most likely to be a relevant topic of discussion.