Latent class analysis identifies four distinct Patient Deprescribing Typologies among older adults in four countries

Innovation in Aging, Journal Year: 2025, Volume and Issue: 9(2)

Published: Jan. 1, 2025

Polypharmacy, the concurrent use of multiple medicines, is a growing concern among older adults and those with chronic conditions. Deprescribing through dose reduction or discontinuing selected medicines strategy for reducing medicine-related harm. The Patient Typology was developed using qualitative methods to describe varying factors that are important when they consider deprescribing. objective this study quantitative define distinct classes via Typology. This used cross-sectional experimental design in which data collected an online survey from participants 65 years Australia, Netherlands, United Kingdom, States. A latent class analysis performed 4-item about beliefs importance how learn medicine decision-making preferences, attitudes towards stopping medicines. Older (n = 2,250) were median 70 2-thirds reported their highest level education associate's degree trade school less. We identified 4 classes: Class 1 "Trusts doctor" (41.6%), 2 "Makes own decisions" (30.2%), 3 "Avoids deprescribing" (15.5%), 'Medicines not important' (12.7%). report diverse perspectives deprescribing, emphasizing need tailored communication strategies clinical settings. Additional research needed examine adults' preferences real-world contexts refine improve deprescribing interventions. NCT04676282.

Language: Английский

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Older Adults’ Attitudes Toward Deprescribing in 14 Countries

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(2), P. e2457498 - e2457498

Published: Feb. 10, 2025

Importance Better understanding of patients’ attitudes toward deprescribing specific medications will inform future interventions. Objective To investigate older adults’ by investigating which they would like to have deprescribed, the reasons why, and patient factors associated with interest in deprescribing. Design, Setting, Participants This survey study was conducted from May 2022 December 2023 primary care settings 14 countries. Patients aged 65 years or taking 5 more were consecutively recruited their general practitioner (GP) completed questionnaire. Exposures Patient characteristics, including gender, number medications, GP education level, financial status, confidence completing medical forms, self-rated health, satisfaction trust GP, country. Main Outcomes Measures The outcomes as measured responses question, “Thinking about your current medication list, are there any that you stop reduce dose of?” Multilevel multivariable logistic regression analysis used, adjusted for clustering effect at country association between characteristics Results Of 1340 patients (mean [SD], 96 [47] per country), 736 (55%) women, 580 (44%) had secondary school highest level education, 1089 (82%) satisfied 589 expressed deprescribe 1 medications. varying levels, 79% (86 109 patients) Poland 23% (21 Bulgaria. 3 most reported deprescribed diuretics (111 1002 [11%]), lipid-modifying agents (109 acting on renin-angiotensin system (83 [8%]). odds naming least lower higher (odds ratio, 0.31; 95% CI, 0.21-0.47) 0.960; 0.930-0.998). Conclusions Relevance In this older, varied across countries, demonstrating interventions could be impactful when adapted contexts. These findings highlight importance patient-practitioner communication ensuring appropriate use.

Language: Английский

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Exploring GP and patient attitudes towards the use and deprescribing of dietary supplements: a survey study in Switzerland

BMC Primary Care, Journal Year: 2024, Volume and Issue: 25(1)

Published: Oct. 3, 2024

Language: Английский

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Healthcare provider-related perceptions toward deprescribing inappropriate medications among older adult outpatients

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(11), P. e0312762 - e0312762

Published: Nov. 12, 2024

Objectives To examine healthcare provider-related perceptions toward deprescribing inappropriate medications among older adults. Methods A cross-sectional, correlational study used a convenience sample of outpatient adults to measure their perception using Patient’s Perceptions Deprescribing (PPoD), which include 57 multiple-choice questions related patients’ sociodemographic data, health, medicines, providers, and experience care provided by the clinic. Data were collected graduate nursing student from one pharmacy in public hospital, five days per week, via in-person interviews. Results analyzed for 200 participants. The level patient collaboration with primary providers (PCPs) is linked trust PCPs, beliefs about medication use, PCP knowledge, concerns (p < .0001). Patient involvement decision-making also associated PCPs willingness stop Additionally, decision-making, general receiving conflicting information medicine = .010). Lastly, knowledge views on importance concerns, seeking help interactions clinical pharmacists, being advised pharmacist discontinue Conclusions found that adults’ PCP, deprescribing, are medicine-related factors. Therefore, should discuss benefits prevent long-term side effects. Future studies focus effectiveness evidence-based protocols

Language: Английский

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Low-value practices in primary care: a cross-sectional study comparing data between males and females in Spain

BMJ Open, Journal Year: 2024, Volume and Issue: 14(11), P. e089006 - e089006

Published: Nov. 1, 2024

Introduction Overuse of medical services is a challenge worldwide, posing threat to the quality care, patient safety and sustainability healthcare systems. Some data suggest that females receive more low-value practices (LVPs)—defined as interventions provide little or no benefit patients can even cause harm—than males. This study aims evaluate compare occurrence LVPs in primary care among both males females. Design A retrospective was conducted. Setting Primary Alicante province (Spain) during 2022. Participants Data were extracted from digital records 978 936 attended by 1125 family physicians across 262 centres province. Outcome measures on age, sex, diagnosis treatment extracted. The outcome measure frequency 12 selected prescribed male female patients. These expected be relatively frequent occurrences with potential harm. Results total 45 955 identified, which 28 148 (5.27% 534 603, CI95% 5.20–5.32) 17 807 (4.00% 444 333, 3.95–4.06) (x², p value <0.0001). most common prescribing for overactive bladder without excluding other pathologies may similar symptoms (30.87%), using hypnotics having previous aetiological difficulty maintaining sleep (14%) recommending analgesics (NSAIDs, paracetamol others) than 15 days per month headaches do not respond (13.33%). Conclusions Future clinical training, management research must consider biological differences those based gender factors when analysing causes LVP. Trial registration number NCT05233852 .

Language: Английский

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Exploring the association between intention and action in deprescribing

Journal of the American Geriatrics Society, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 10, 2024

The authors report no conflicts of interest. Dr. Mehta is supported by the National Institute on Aging (K01 AG070329). Boyd and analysis were (K24AG056578). Green (R01AG077011). Reeve an NHMRC Investigator Grant (APP1195460). co-authors a chapter multiple chronic conditions for UptoDate. All other interests.

Language: Английский

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