Polypharmacy Prevalence and Perceptions of Deprescribing in Elderly Patients Among Community Primary Care Providers in Mid-Michigan Practices

Cureus, Journal Year: 2023, Volume and Issue: unknown

Published: May 23, 2023

Polypharmacy is common among the elderly and can predispose them to increased morbidity higher healthcare expenditures. Deprescribing an important aspect of preventative medicine minimize polypharmacy-related adverse effects. Mid-Michigan has historically been considered a medically underserved area. We sought describe polypharmacy prevalence primary care provider (PCP) perceptions deprescribing in at community practices region.Medicare Part D claims data from 2018 2020 were queried calculate polypharmacy, which defined as Medicare beneficiaries who concurrently prescribed least five medications. PCPs four adjacent counties mid-Michigan, including two high- low-prescribing practices, surveyed assess their deprescribing.The mid-Michigan was 44.0% 42.5%, similar Michigan's overall 40.7% (p = 0.720 0.844, respectively). Additionally, 27 survey responses received (response rate, 30.7%). Most respondents expressed confidence clinical standpoint (66.7%). Barriers included patient/family concerns (70.4%) lack time during office visits (37.0%). Facilitators patient readiness (18.5%), collaboration with case managers/pharmacists up-to-date medication lists (18.5%). An exploratory comparison showed no significant differences.These findings demonstrate high suggest that region are generally supportive deprescribing. Potential targets improve patients include addressing visit length, concerns, increasing interdisciplinary collaboration, reconciliation support.

Language: Английский

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Person-centred deprescribing for patients living with frailty: a qualitative interview study and proposal of a collaborative model

International Journal of Pharmacy Practice, Journal Year: 2023, Volume and Issue: 31(3), P. 282 - 289

Published: April 17, 2023

Abstract Objectives (1) Present deprescribing experiences of patients living with frailty, their informal carers and healthcare professionals; (2) interpret whether are reflective person-centred/collaborative care; (3) complement our findings existing evidence to present a model for person-centred based on previous collaborative care model. Methods Qualitative design in English primary (general practice). Semi-structured interviews were undertaken immediately post-deprescribing 5/6 weeks later nine aged 65+ frailty three frailty. Fourteen professionals experience also interviewed. In total, 38 conducted. A two-staged approach data analysis was undertaken. Key Three themes developed: attitudes, beliefs understanding medicines management responsibility; attributes collaborative, consultation; organisational factors support deprescribing. Based these complementary evidence, we offer Conclusions Previous models while, value, do not consider the contextual that govern implementation success practice. this paper, propose novel people own empirical findings, wider base.

Language: Английский

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Health communication and shared decision‐making between nurses and older adults in community setting: An integrative review

Journal of Clinical Nursing, Journal Year: 2024, Volume and Issue: 33(8), P. 2922 - 2935

Published: April 4, 2024

Abstract Aim To explore the role of health communication in Shared Decision‐Making (SDM) between nursing staff and older people community setting. Background Society healthcare services are marked by an exponentially ageing population, leading to a significant proportion patients being adults with highly demanding care needs. Scientific literature supports shared decision‐making as process that engages their care. However, increasing use technology consequences COVID‐19 pandemic have influenced how nurses communicate patients. Therefore, it is crucial understand develop reach effective, processes. Methods Whittemore Knafl's integrative review method, search comprised five databases: PubMed, CINALH, Web Science, Scopus PsycINFO. Results The 12 included studies were synthesised into three study patterns: (1) nurse–older patient relationship, (2) patients' perspectives (3) nontherapeutic end‐of‐life Conclusion This underscored effective shaping SDM dynamics Key elements transparent information exchange, establishing trust maintaining channels informal caregiving networks. actions aligned preserving people's autonomy, but challenges persisted, particularly situations. Advanced planning was recommended address these shortcomings improve among people, professionals families. Implications Implementing educational measures based on verbal nonverbal training could be beneficial. Nursing research continue refine specific strategies adapted social determinants for diverse clinical situations regarding Reporting Method authors adhered relevant EQUATOR guidelines through PRISMA 2020 checklist. No Patient or Public Contribution.

Language: Английский

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Considerations, barriers and enablers of deprescribing among healthcare professionals in Ogun State, Southwest, Nigeria: a cross-sectional survey

BMC Health Services Research, Journal Year: 2024, Volume and Issue: 24(1)

Published: May 24, 2024

Abstract Background Deprescribing is a clinical intervention aimed at managing polypharmacy and improving older adults’ health outcomes. However, evidence suggests that healthcare professionals (HCPs) may face challenges in implementing the intervention. This study to explore considerations, barriers enablers of deprescribing among HCPs Southwest Nigeria. Methods A quantitative cross-sectional survey was carried out consecutively sampled including physicians, pharmacists nurses two public tertiary hospitals Ogun State, Southwest, structured 43-item self-administered questionnaire used participants’ sociodemographics, HCPs’ experience, adults. The data were summarised using descriptive statistics frequency percentage. Kruskal–Wallis test determine differences perceptions groups on Likert scale. p -value < 0.05 considered significant. Results Overall, 453 copies analysed. Of participants 204 (45.0%) within age group 20–30 years; 173 (38.2%) claimed adults occasionally requested their medications. majority (417; 92.1%) patients’ quality life be very important deprescribing; 423 (93.4%) opined having care goal known members HCP team an enabler for while 308 (68.0%) disagreed or strongly lack incentives remuneration de-prescribe barrier deprescribing. There significant difference across professional assertion pressure from pharmaceutical companies ( = 0.037). Conclusions this had various considerations medication life. Having every involved patient not necessarily need regulations policies support identified reduce effective process.

Language: Английский

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Deprescribing in older adults in a French community: a questionnaire study on patients’ beliefs and attitudes

BMC Geriatrics, Journal Year: 2024, Volume and Issue: 24(1)

Published: June 27, 2024

General practitioners (GPs) have a central role to play on reduction of polypharmacy and deprescribing. This study aimed assess beliefs attitudes towards deprescribing in patients, aged 65 years or older primary care, identify factors associated with their willingness stop medication.

Language: Английский

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