Knowledge, Attitudes, and Practices of Primary Health Care Physicians Regarding Deprescribing in Older Adults

Background: Polypharmacy is highly prevalent among older adults and is associated with increased risks of adverse drug reactions, drug–drug interactions, and functional decline. Deprescribing has emerged as an important patient-safety strategy in primary care; however, its implementation largely depends on physicians’ knowledge, attitudes, and practices. Objective: To assess the knowledge, attitudes, and practices (KAP) of primary health care (PHC) physicians regarding deprescribing in older adults and to examine demographic factors associated with these domains. Methods: A cross-sectional survey was conducted among 200 PHC physicians working in Baghdad, Iraq. Data were collected using a structured, pretested electronic questionnaire covering knowledge, attitudes, practices, and perceived barriers and enablers related to deprescribing. Responses were scored and categorized into poor/fair and good levels. Results: More than half of participants demonstrated good knowledge of deprescribing (59.0%), while a higher proportion showed good attitudes (77.5%) and good practice (58.0%). Insufficient guidelines (40.5%) and lack of time (31.0%) were the most commonly reported barriers, whereas availability of better guidelines was the main enabler (75.0%). Gender was significantly associated with knowledge (p = 0.03), while practice was significantly associated with gender (p = 0.021) and years of experience (p = 0.002). Physicians with more than 10 years of experience were more likely to demonstrate good deprescribing practice. Conclusion: PHC physicians showed generally positive attitudes and acceptable knowledge toward deprescribing, but important gaps in practice remain. Targeted training, clearer guidelines, and practical decision-support tools are needed to strengthen deprescribing implementation and enhance medication safety in older adults.