Barriers and Enablers for Deprescribing Glucose-Lowering Treatment in Older Adults: A Systematic Review

Journal of the American Medical Directors Association, Journal Year: 2024, Volume and Issue: 25(3), P. 439 - 447.e18

Published: Jan. 15, 2024

Language: Английский

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Influence of chronic medical conditions on older patients’ willingness to deprescribe medications: a cross-sectional study

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

Published: April 4, 2024

Aging correlates with a heightened prevalence of chronic diseases, resulting in multimorbidity affecting 60% those aged 65 or older. Multimorbidity often leads to polypharmacy, elevating the risk potentially inappropriate medication (PIM) use and adverse health outcomes. To address these issues, deprescribing has emerged as patient-centered approach that considers patients' beliefs attitudes toward reduces polypharmacy older adults. Our study aims investigate whether certain medical conditions are associated willingness deprescribe medications.

Language: Английский

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Attitudes of Older Adult Patients and Caregivers Towards Deprescribing of Medications in Ethiopia

Clinical Interventions in Aging, Journal Year: 2023, Volume and Issue: Volume 18, P. 1129 - 1143

Published: July 1, 2023

Deprescribing is essential for reducing inappropriate medication use and polypharmacy. For a holistic approach, it to know how older adult patients their caregivers perceive deprescribing.To assess the attitude of towards deprescribing at Ambo University Referral Hospital.Institutional-based cross-sectional study was conducted using revised Patients' Attitude Towards tool (rPATD). The data analyzed SPSS-25 software. Backward linear regression logistic were used measure association between outcome determinant variables. two-sided P-value ≤0.05 with 95% confidence interval utilized reporting significant factors.One hundred fifty-six (81.3%) respondents (ie, 85.0% 77.2% caregivers) agreed stop one or more regular medications if physician said possible despite 98 (51.0%) them 49.0% 53.3% being satisfied their/their care recipient's medications. On overall aggregate mean score, had neutral position (2.6-3.59) regarding burden concerns stopping whereas majority disagree (1.0-2.59) inappropriateness they taking (3.6-5.0) need involvement in treatment decision making. Concerns about medicine scores (AOR = 0.440, CI 0.262-0.741, P 0.035) perceived levels 0.653, 0.456-0.936, 0.020) significantly associated willingness discontinue satisfaction regimen respectively.The would like deprescribe physicians recommended it. medicines respectively. Healthcare providers should prompt process by addressing

Language: Английский

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Perspectives on deprescribing in older people with type 2 diabetes and/or cardiovascular conditions: challenges from healthcare provider, patient and caregiver perspective and interventions to support a proactive approach

Expert Review of Clinical Pharmacology, Journal Year: 2024, Volume and Issue: 17(8), P. 637 - 654

Published: Aug. 2, 2024

For people with type 2 diabetes and/or cardiovascular conditions, deprescribing of glucose-lowering, blood pressure-lowering lipid-lowering medication is recommended when they age, and their health status deteriorates. So far, rates these so-called cardiometabolic medications are low. A review challenges interventions addressing in this population pertinent.

Language: Английский

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Are Saudi Arabian Patients Willing to Be Deprescribed Their Medications? An Exploratory Study

Patient Preference and Adherence, Journal Year: 2024, Volume and Issue: Volume 18, P. 779 - 786

Published: March 1, 2024

Purpose: Deprescribing is a complex process that requires active patient involvement, so the patient's attitude to deprescribing crucial its success.This study aimed assess predictors of Saudi Arabian patients' willingness deprescribe.Patients and Methods: In this cross-sectional study, adult patients from two hospitals in Riyadh completed self-administered questionnaire gathering data on demographic information Arabic revised Patients' Attitudes Towards (rPATD) questions.Descriptive analysis binary logistic regression were used analyze data.Results: A total 242 included (mean age 59.8 (SD 11.05) years, range 25-87 years; 40% 60-69 54.1% female).The majority (90%) participants willing have medications deprescribed.Willingness deprescribe was significantly associated with rPATD involvement factor (OR=1.866, 95% CI 1.177-2.958,p=0.008) perception their health status (OR=2.08,CI=1.058-4.119,p=0.034). Conclusion:The one or more deprescribed if recommended by doctors.Patient perceptions about own important predictive factors could shape counseling education strategies encourage deprescribing.

Language: Английский

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Validation and Assessment of Patients' and Their Caregivers' Attitude Toward Medications Deprescribing in Qatar: A Cross-sectional study of Home Health Care Services in Qatar

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: May 20, 2024

Introduction: Polypharmacy remains a pressing concern among the elderly population, often leading to adverse drug reactions (ADRs), emergency department (ED) visits, and hospital admissions. Studies have underscored polypharmacy as robust predictor of potentially inappropriate medication use associated poor clinical outcomes in individuals aged 65 older. Despite decline medical treatment effectiveness with aging, patients caregivers express reluctance discontinue regular medications, necessitating deeper understanding their perceptions beliefs regarding deprescribing. Methods: This study aimed assess attitudes toward deprescribing medications Qatar. The first phase involved translating validating caregivers' version revised Patients’ Attitudes Toward Deprescribing (rPATD) tool. Subsequently, prospective cross-sectional was conducted, utilizing validated self-administered questionnaires both English Arabic. Results: significant proportion perceived burden inconvenient burdensome. While satisfaction current generally high, notable willingness under physician recommendation observed. Moreover, participants expressed strong desire be decision-making processes, highlighting culture person-centered care. this, concerns events, efficacy, necessity persisted respondents. Conclusion:this provides insights into surrounding Qatar, emphasizing importance tailored strategies shared practice.

Language: Английский

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A Pilot Study on the Views and Experiences of Healthcare Providers about Deprescribing Preventive Medications in Patients with Polypharmacy

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: July 11, 2024

Background Deprescribing is a process of tapering or stopping medications to achieve improved health outcomes. The widely recommended reduce the burden polypharmacy in older frail patients. Healthcare providers’ (HCPs) role has been reported be important when deprescribing clinical practice. Despite potential, little known about views and experiences HCPs Indonesia. Therefore, this study aims present preliminary results Indonesia patients with polypharmacy. Methods was carried out using semi-structured interviews three HCPs, comprising general practitioner (GP), internist, pharmacist, who were selected as informants. Interviews recorded transcribed verbatim, directed content analysis performed extract data. Results Themes HCPs’ knowledge, skills, experience, interaction between patients, patient families found. Although understood importance deprescribing, some challenges implementing admitted. These comprised lack specific guidelines, barriers communication building trust from insufficient time resources support decisions. closer collaboration good their may favorable conducting deprescribing. Conclusion This first exploration showed that there most likely knowledge gaps practices Indonesia, particularly regarding preventive Consequently, studies involving more help determine roles enablers implementation.

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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Predictors of medicine-related perceptions towards deprescribing inappropriate medications among older adult outpatients in Jordan: a cross-sectional study

BMJ Open, Journal Year: 2024, Volume and Issue: 14(11), P. e086207 - e086207

Published: Nov. 1, 2024

Objectives To examine the predictors of medicine-related perceptions towards deprescribing inappropriate medications among older adults in Jordan. Design A cross-sectional, correlational study. Setting Data were collected by a graduate nursing student from five outpatient clinics selected public hospital Jordan via inperson interviews 5 days week over period 4 months. Participants convenience sample 200 who regularly visited for regular check-ups during July 2023 recruited. Outcome measures Predictors patients’ perceived medication concerns, interest stopping medications, unimportance and beliefs about overuse examined. Results Increased concerns patients significantly associated with age (p=0.037), lower level self-rated general health (p=0.002), less care-provider knowledge (p=0.041), higher medicines (p=0.018), collaboration care providers (p=0.017), being seen clinical pharmacist (p<0.001) an increased number prescribed (p<0.001). was levels (p=0.029), involvement decision-making (p=0.013), (p=0.024) (p=0.001). Furthermore, more (p=0.007), (p=0.001) greater Moreover, (p=0.016), (p=0.038), having post-traumatic disorder (p=0.018) (p=0.038). Conclusions The current study examined adults. Care should discuss benefits their to prevent side effects long-term unnecessary use. Future studies on effectiveness evidence-based protocol minimising prescription are recommended.

Language: Английский

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Desprescrição de medicamentos: uma revisão sobre a melhora na qualidade de vida dos pacientes

Revista Eletrônica Acervo Saúde, Journal Year: 2023, Volume and Issue: 23(11), P. e14778 - e14778

Published: Nov. 11, 2023

Objetivo: Avaliar o fenômeno da utilização de medicamentos em idosos, uma perspectiva identificar possível efeito cascata das drogas terapêuticas nesta população e as suas reações adversas. Revisão bibliográfica: No Brasil, estima-se cerca 80% dos idosos façam uso ao menos um tipo medicamento. Além disso, observa-se, com frequência, a mais droga terapêutica, muitas vezes, forma indiscriminada. Doenças como hipertensão arterial, diabetes distúrbios respiratórios, deflagram condições patológicas prevalentes motivadoras para polifarmácia na qual, classe anti-hipertensivos, seguida por hipoglicemiantes orais antiagregantes plaquetários, foram maior presença no cotidiano idosa. Nessa polifarmácia, ou medicações potencialmente inadequadas, desprescrição surge processo retirada medicamento inadequado, supervisionado profissional saúde, finalidade reduzir efeitos adversos medicamentosos melhorar os resultados terapêuticos pacientes. Considerações finais: Dessa forma, 90% pacientes são receptivos à descontinuação desnecessários quando recomendados pelos profissionais contexto cuidados primários pode se tornar fácil médicos envolverem familiares.

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