Tailoring the Patient Deprescribing Typology to prescribing decisions: diabetes-specific versus standard versions in an online survey

Background: Deprescribing is the process of reducing or stopping medicines that may no longer be needed or helpful. Effective deprescribing depends on understanding patients’ beliefs, concerns, and preferences, which influence how they participate in decisions about their medicines. Clear, patient-centered communication is important to make sure decisions about medicines are understood, supported, and safely implemented. The Patient Deprescribing Typology (PDT ) offers a novel, preference-based approach that categorizes patients into distinct groups based on their beliefs and preferences regarding medicine use and deprescribing. Aims: The PDT was adapted for this exploratory study to compare responses to a diabetes-specific version (administered to participants with diabetes) or a standard version (administered to all other participants). Methods: We surveyed adults aged 65 years and older in Australia and the United States (n = 2,199), and compared responses to standard versus diabetes-specific PDT questions. Results: Participants answering the diabetes-specific version perceived their medicine as more important, favored physician-led decision-making, and were less open to deprescribing compared to those receiving the general PDT . Preferences for starting or stopping a hypothetical diabetes medicine were associated with distinct attitudes and decision-making styles, suggesting the importance of aligning communication strategies with patients’ typologies. Discussion: This study represents a first step toward exploring how condition-specific versions of the PDT may better capture nuanced, medicine-specific patient attitudes and preferences.