Latent class analysis identifies four distinct Patient Deprescribing Typologies among older adults in four countries
Innovation in Aging,
Год журнала:
2025,
Номер
9(2)
Опубликована: Янв. 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.
Язык: Английский
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
Older adults’ attitudes towards deprescribing and medication changes: a longitudinal sub-study of a cluster randomised controlled trial
BMJ Open,
Год журнала:
2024,
Номер
14(1), С. e075325 - e075325
Опубликована: Янв. 1, 2024
Objective
To
investigate
the
association
between
older
patients’
willingness
to
have
one
or
more
medications
deprescribed
and:
(1)
change
in
medications,
(2)
appropriateness
of
and
(3)
implementation
prescribing
recommendations
generated
by
electronic
decision
support
system
tested
‘Optimising
PharmacoTherapy
In
Multimorbid
Elderly
Primary
CAre’
(OPTICA)
trial.
Design
A
longitudinal
sub-study
OPTICA
trial,
a
cluster
randomised
controlled
Setting
Swiss
primary
care
settings.
Participants
were
aged
≥65
years,
with
≥3
chronic
conditions
≥5
regular
recruited
from
43
general
practitioner
(GP)
practices.
Exposures
Patients’
was
assessed
using
three
questions
‘revised
Patient
Attitudes
Towards
Deprescribing’
(rPATD)
questionnaire
its
concerns
about
stopping
score.
Measures/analyses
Medication-related
outcomes
collected
at
1
year
follow-up.
Aim
outcome:
number
long-term
baseline
12
month
2
medication
(Medication
Appropriateness
Index).
3
binary
variable
on
whether
any
recommendation
during
review
implemented.
We
used
multilevel
linear
regression
analyses
(aim
aim
2)
logistic
3).
Models
adjusted
for
sociodemographic
variables
clustering
effect
GP
level.
Results
298
patients
completed
rPATD,
45%
women
78
years
median
age.
statistically
significant
found
score
over
time
(per
1-unit
increase
average
use
0.65
higher;
95%
CI:
0.08
1.22).
Other
than
that
we
did
not
find
evidence
associations
agreement
deprescribing
medication-related
outcomes.
Conclusions
an
most
measures
patient
year.
Trial
registration
NCT03724539
.
Язык: Английский
The Patient Typology about deprescribing and medication‐related decisions: A quantitative exploration
Basic & Clinical Pharmacology & Toxicology,
Год журнала:
2023,
Номер
134(1), С. 39 - 50
Опубликована: Июнь 10, 2023
Abstract
This
study
aimed
to
test
the
adequacy
of
a
quantitative
measure
our
qualitatively
developed
Patient
Typology—categories
older
adults'
attitudes
towards
medicines
and
medicine
decision‐making—and
identify
characteristics
associated
with
each
Typology.
We
conducted
secondary
data
analyses
subset
survey
item
measures
adults
(≥65
years)
who
were
members
online
panels
in
Australia,
United
Kingdom,
States
Netherlands
(
n
=
4688).
Multinomial
logistic
regression
assessed
associations
between
demographic,
psychosocial
medication‐related
measures.
Mean
age
was
71.5
(5),
47.5%
participants
female.
Factors
an
increased
likelihood
identifying
Typology
1
‘Attached
medicines’
over
2
‘Open
deprescribing’
higher
positive
attitude
polypharmacy
(RRR
1.12,
p
<0.001)
need
for
certainty
1.11,
0.039).
3
‘Defers
(medication
decision‐making)
others’
1.47
per
10‐year
increase,
decreased
prior
deprescribing
experience
0.73,
0.033).
provides
validation
large
samples
from
four
countries,
quantitatively‐measured
typologies
generally
aligning
derived
categories.
Our
succinct
way
researchers
can
assess
deprescribing.
Язык: Английский
Exploring GP and patient attitudes towards the use and deprescribing of dietary supplements: a survey study in Switzerland
BMC Primary Care,
Год журнала:
2024,
Номер
25(1)
Опубликована: Окт. 3, 2024
Язык: Английский
Attitude towards medication deprescribing among older patients attending the geriatric centre: a cross-sectional survey in Southwest Nigeria
BMJ Open,
Год журнала:
2023,
Номер
13(11), С. e078391 - e078391
Опубликована: Ноя. 1, 2023
Objectives
This
study
set
out
to
assess
older
people’s
perception
of
their
medications,
attitude
towards
medication
use
and
willingness
have
medications
deprescribed
in
a
geriatric
centre
Southwestern
Nigeria.
Design
setting
A
cross-sectional
was
conducted
at
the
Chief
Tony
Anenih
Geriatric
Centre,
University
Ibadan,
using
an
interviewer-administered
questionnaire.
The
questionnaire
used
revised
version
Patient’s
Attitude
Towards
Deprescribing
Questionnaire.
Descriptive
statistics,
multivariate
bivariate
analyses
were
performed
SPSS
V.23.
Statistical
significance
p<0.05.
Participants
415
patients
aged
≥60
years
who
attended
College
Hospital
Ibadan
between
April
July
2022.
Main
outcome
measure
primary
person
deprescribe
if
recommended
by
physician.
Results
mean
age
participants
69.6±6.4
years,
252
(60.7%)
female.
Overall,
positive
deprescribing
among
respondents
60.5%
89.7%,
respectively.
Factors
significantly
associated
with
financial
self-support
(p=0.021),
having
no
previous
hospital
admission
(p=0.009),
better-perceived
quality
health
relative
peers
(p<0.0001),
polypharmacy
(p=0.003),
domains
burden
(p=0.007),
appropriateness
concerns
about
stopping
(p<0.0001)
involvement
(p<0.0001).
predictive
factors
for
improved
direct
(OR=2.463;
95%
CI
1.501
4.043,
p<0.0001),
(OR=0.462;
0.254
0.838,
p=0.011)
(OR=2.031;
1.191
3.463,
p=0.009).
Conclusion
demonstrated
greater
physicians
it.
Predictive
that
may
influence
medications.
Язык: Английский