Consumer Attitudes Towards Deprescribing: A Systematic Review and Meta-Analysis

The Journals of Gerontology Series A, Год журнала: 2021, Номер 77(5), С. 1020 - 1034

Опубликована: Авг. 14, 2021

Abstract Background Harmful and/or unnecessary medication use in older adults is common. This indicates deprescribing (supervised withdrawal of inappropriate medicines) not happening as often it should. study aimed to synthesize the results Patients’ Attitudes Towards Deprescribing (PATD) questionnaire (and revised versions). Methods Databases were searched from January 2013 March 2020. Google Scholar was used for citation searching development and validation manuscripts identify original research using validated PATD, PATD (older adult caregiver versions), version people with cognitive impairment (rPATDcog). Two authors extracted data independently. A meta-analysis proportions (random-effects model) conducted subgroup meta-analyses setting population. The primary outcome question: “If my doctor said possible, I would be willing stop one or more medicines.” Secondary outcomes associations between participant characteristics other (r)PATD results. Results We included 46 articles describing 40 studies (n = 10,816 participants). found proportion participants who agreed strongly this statement 84% (95% CI 81%–88%) 80% 74%–86%) patients caregivers, respectively, significant heterogeneity (I2 95% 77%). Conclusion Consumers reported willingness have a deprescribed although should interpreted caution due heterogeneity. findings moves toward understanding attitudes deprescribing, which could increase discussion uptake recommendations clinical practice.

Язык: Английский

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Instruments for assessing healthcare professionals’ knowledge, attitudes and practices regarding deprescribing: a scoping review protocol

BMJ Open, Год журнала: 2025, Номер 15(1), С. e095584 - e095584

Опубликована: Янв. 1, 2025

Objective To map instruments for assessing healthcare professionals’ knowledge, attitudes and practices regarding deprescribing. Introduction Deprescribing is essential improving patient outcomes by managing polypharmacy, reducing fall risks decreasing medication costs. However, there a limited exploration of perspectives about Methods analysis Studies involving professionals directly involved in the use process (nurses, pharmacists physicians) will be included, while those which it not possible to identify professional excluded. Any definition deprescribing, as well any stage deprescribing process, without clear employing whether validated or not, included. focusing on algorithms setting Data presented absolute relative frequencies, world heatmap, heatmaps, bar plots word cloud when appropriate. Ethics dissemination The findings from this review discussed with stakeholders processes. Additionally, results disseminated through publications conference presentations. Protocol registration https://osf.io/tgjyc/

Язык: Английский

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Older Adults’ Attitudes Toward Deprescribing in 14 Countries

JAMA Network Open, Год журнала: 2025, Номер 8(2), С. e2457498 - e2457498

Опубликована: Фев. 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.

Язык: Английский

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What do older adults with multimorbidity and polypharmacy think about deprescribing? The LESS study - a primary care-based survey

BMC Geriatrics, Год журнала: 2020, Номер 20(1)

Опубликована: Окт. 31, 2020

Multimorbidity and polypharmacy are very common in older adults primary care. Ideally, general practitioners (GPs), should regularly review medication lists to identify inappropriate medication(s) and, where appropriate, deprescribe. However, it remains challenging deprescribe given time constraints few recommendations from guidelines. Further, patient related barriers enablers deprescribing have be accounted for. The aim of this study was as reported by with multimorbidity.We conducted a survey among participants aged ≥70 years, multimorbidity (≥3 chronic conditions) (≥5 medications). We invited Swiss GPs, recruit eligible patients who then completed paper-based on demographics, medications conditions. used the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire added twelve additional Likert scale questions two open-ended assess towards deprescribing, which we coded categorized into meaningful themes.Sixty four GPs consented 5-6 each returned 300 participant responses. Participants were 79.1 years (SD 5.7), 47% female, 34% lived alone, 86% managed their themselves. Sixty-seven percent took 5-9 regular medicines 24% ≥10 medicines. majority (77%) willing one or more if doctor said possible. There no association sex, age number willingness After adjustment for baseline characteristics, there strong positive between saying that because they good relationship GP, would feel safe OR 11.3 (95% CI: 4.64-27.3) agreeing new studies showed an avoidable risk 8.0 CI 3.79-16.9). From open questions, most mentioned feeling well current being convinced need all medicines.Most may able increase building trust communicating evidence about risks use.

Язык: Английский

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How Willing Are Patients or Their Caregivers to Deprescribe: a Systematic Review and Meta-analysis

Journal of General Internal Medicine, Год журнала: 2021, Номер 36(12), С. 3830 - 3840

Опубликована: Июнь 25, 2021

Язык: Английский

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Attitudes towards deprescribing among multi-ethnic community-dwelling older patients and caregivers in Malaysia: a cross-sectional questionnaire study

International Journal of Clinical Pharmacy, Год журнала: 2019, Номер 41(3), С. 793 - 803

Опубликована: Апрель 24, 2019

Язык: Английский

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Potentially inappropriate medication and attitudes of older adults towards deprescribing

PLoS ONE, Год журнала: 2020, Номер 15(10), С. e0240463 - e0240463

Опубликована: Окт. 26, 2020

Introduction Multimorbidity and polypharmacy are current challenges when caring for the older population. Both have led to an increase of potentially inappropriate medication (PIM), illustrating need assess patients' attitudes towards deprescribing. We aimed prevalence PIM use whether this was associated with patient factors willingness deprescribe. Method analysed data from LESS Study, a cross-sectional study on self-reported barriers enablers deprescribe (rPATD questionnaire). The survey conducted among multimorbid (≥3 chronic conditions) participants ≥70 years (≥5 long-term medications). A subset Beers 2019 criteria applied assessment appropriateness. Results Data 300 patients were analysed. mean age 79.1 (SD 5.7). 53% had at least one (men: 47.8%%, women: 60.4%%; p = 0.007). higher number medications (p 0.002). found high in both without PIM. Willingness not 0.25), nor PIMs 0.81). Conclusion adults deprescribing study. These results suggest that may be aware if they taking PIMs. This implies raising awareness about through education, especially females, order implement daily practice.

Язык: Английский

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Potentially inappropriate medications for the elderly: Incidence and impact on mortality in a cohort ten-year follow-up

PLoS ONE, Год журнала: 2020, Номер 15(10), С. e0240104 - e0240104

Опубликована: Окт. 28, 2020

Introduction Pharmacological therapy plays an important role in disease control the elderly; unfortunately, this comes with a high prevalence use of medications classified as potentially inappropriate. Objective To analyze incidence, risk factors, and survival elderly people using inappropriate (PIM). Method A ten-year follow-up assessment participants residing capital Central Brazil was conducted. The initial (baseline) included 418 people. Data were collected through home interviews guided by questionnaire covering socioeconomic, demographic, living conditions, health variables. medication information obtained comprised active ingredient, dosage, route, regimen for medications. PIMs according to 2019 Beers Criteria. analyses performed STATA 15.0. For analysis, Cox Regression respective Kaplan Meier curve. Results incidence PIM 44.1 cases (95% CI: 35.2–54.7) per 1,000 year. most used nifedipine, glibenclamide, sodium diclofenac. factors polypharmacy (aRR: 3.00; 95% 1.31–6.88) diabetes mellitus 1.57; 1.03–2.39). We identified no statistically significant association between PIM. Conclusion study highlights consumption among causing risks. Health professionals working drug treatment need be alert risks ensure rational prevent adverse reactions other problems.

Язык: Английский

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Medication-related experiences of patients with polypharmacy: a systematic review of qualitative studies

BMJ Open, Год журнала: 2020, Номер 10(9), С. e036158 - e036158

Опубликована: Сен. 1, 2020

Background We aimed to synthesise qualitative studies exploring medication-related experiences of polypharmacy among patients with multimorbidity. Methods systematically searched PubMed, Embase and Cumulative Index Nursing Allied Health Literature in February 2020 for primary, peer-reviewed about multimorbid patients’ polypharmacy, defined as the use four or more medications. Identified were appraised methodological quality by applying Critical Appraisal Skills Programme checklist research, data extracted synthesised meta-aggregation approach. Results included 13 studies, representing 499 a wide range chronic conditions. Overall, most items reported studies. 140 findings, these into 17 categories, developed five interrelated syntheses: (1) are heterogeneous group terms needing appraising medication information; (2) aware importance adherence, but it is difficult achieve; (3) decision-making medications complex; (4) multiple relational factors affect communication between physicians, can prevent from disclosing important (5) affects lives self-perception, challenges not limited practical issues medication-taking. Discussion Polypharmacy poses many patients, which have negative impact on life adherence. Thus, when dealing crucial that healthcare professionals actively solicit individual perspectives related polypharmacy. Based experiences, we recommend upscale communicative efforts involve social network an individualised basis facilitate shared treatment adherence multimorbidpatients

Язык: Английский

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Older people’s attitudes towards deprescribing cardiometabolic medication

BMC Geriatrics, Год журнала: 2021, Номер 21(1)

Опубликована: Июнь 16, 2021

Overtreatment with cardiometabolic medication in older patients can lead to major adverse events. Timely deprescribing of these medications is therefore essential. Self-reported willingness stop usually high among people, still overtreatment common and rarely initiated. An important barrier for reported by general practitioners the patients' unwillingness medication. More insights are needed into influence characteristics on their attitudes towards differences between groups.A survey people using revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire was performed. Participants completed rPATD an adapted version four groups. Linear ordinal logistic regression were used assess age, sex, therapeutic area number deprescribing. Univariate analysis compare sulfonylureas, insulins, antihypertensive statins.Overall, 314 out 1143 invited participants (median age 76 years, 54% female). Most (80%) satisfied willing if doctor said it possible (88%). Age, sex had no Taking more than ten medicines significantly associated a higher perceived burden. Antihypertensive insulin considered appropriate statins, sulfonylureas not favouring deprescribing.The majority one possible. Health care providers should take account that perceive some as other when discussing

Язык: Английский

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