Musculoskeletal Science and Practice, Год журнала: 2023, Номер 67, С. 102856 - 102856
Опубликована: Сен. 6, 2023
Paracetamol is widely used for low back pain (LBP), but research questions its efficacy and safety. Patient education booklets have been explored promoting deprescribing, barriers facilitators specific to LBP deprescribing remain unexamined.
Язык: Английский
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
Процитировано
2
Drugs & Aging, Год журнала: 2022, Номер 39(3), С. 209 - 221
Опубликована: Фев. 21, 2022
Benefits and risks of preventive medication change over time for ageing patients deprescribing may be needed. Deprescribing cardiovascular antidiabetic drugs can challenging is not widely implemented in daily practice.The aim this study was to identify barriers enablers cardiometabolic as seen by healthcare providers (HCPs) different disciplines, explore their views on specific roles the process deprescribing.Three focus groups with five general practitioners, eight pharmacists, three nurse two geriatricians, elder care physicians were conducted cities The Netherlands. Interviews recorded transcribed verbatim. Directed content analysis performed basis Theoretical Domains Framework. Two researchers independently coded data.Most HCPs agreed that relevant but include lack evidence expertise, negative beliefs fears, poor communication collaboration between HCPs, resources. Having a guideline considered an enabler medication. Some feared consequences discontinuing or medication, while others motivated deprescribe when experienced no problems all disciplines stated adequate patient involving relatives decision making enables deprescribing. Barriers included use initiated specialists, exchange information, amount it takes uncertain about each other's responsibilities. A multidisciplinary approach including pharmacist practitioner best way support address related resources.HCPs recognized importance medical only made close cooperation patient. To successfully accomplish they strongly recommended approach.
Язык: Английский
Процитировано
37
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
Процитировано
37
Diabetic Medicine, Год журнала: 2022, Номер 39(7)
Опубликована: Фев. 4, 2022
Abstract Aim The aim of this systematic review is to explore the attitudes older adults (≥65 years old) and their carers towards de‐prescribing. Methods We identified relevant studies from three databases; MEDLINE, CINAHL Web Science. Two reviewers (MS, SS) independently extracted data each selected study using a standardised self‐developed extraction form. Main findings were summarised descriptively. Results A total 35 included in review. Of them, 19 questionnaire studies, 11 semi‐structured interviews, 4 focus groups 1 used nominal group technique approach. Most willing have medication de‐prescribed if told do so by healthcare professional (HCP). Other factors that increased willingness de‐prescribing included; trust HCP, side effects inconvenience medications as well prospect follow‐up monitoring during In contrast, perceived effectiveness, unawareness lack benefit, negative expectations ageing fear preventing Conclusion De‐prescribing an important concept people given harm associated with polypharmacy age group. Overall, are facilitated HCP. However, there remain few barriers which may need be addressed certain patients, through discussions between adults/their allow more effective.
Язык: Английский
Процитировано
25
European Geriatric Medicine, Год журнала: 2023, Номер 14(6), С. 1211 - 1222
Опубликована: Окт. 24, 2023
Язык: Английский
Процитировано
11
International Journal of Clinical Pharmacy, Год журнала: 2025, Номер unknown
Опубликована: Янв. 23, 2025
Язык: Английский
Процитировано
0
Health Policy, Год журнала: 2025, Номер 154, С. 105265 - 105265
Опубликована: Фев. 12, 2025
Unsustainably high numbers of patients attending emergency departments (ED) is a serious issue worldwide, with consequences for the quality and timeliness care. Avoidable visits, i.e. unnecessary or that should be dealt elsewhere, exacerbate this issue. Most studies focussed on avoidable attendances use clinical data collected by hospital staff, while study relies survey from asked to recall their last ED attendance reflect its necessity. We apply Recursive Bivariate Probit model quantify factors affecting patients' perception an visit being (or not), unveiling how it relates socio-demographic contextual factors. find who do not trust General Practitioner (GP) are less likely think was avoidable. The whether also associated symptoms experienced, ethnicity waiting time GP appointment.
Язык: Английский
Процитировано
0
Research in Social and Administrative Pharmacy, Год журнала: 2021, Номер 18(6), С. 2913 - 2921
Опубликована: Июль 16, 2021
Язык: Английский
Процитировано
24
BMJ Open, Год журнала: 2022, Номер 12(12), С. e061686 - e061686
Опубликована: Дек. 1, 2022
To synthesise the current knowledge on barriers and facilitators to deprescribing cardiovascular medications (CVMs) at levels of patients, informal caregivers healthcare providers (HCPs).We conducted a systematic review studies exploring/assessing patient, caregiver and/or HCP CVMs.Ovid/MEDLINE Embase from January 2003 November 2021.We performed deductive thematic analysis based framework specific CVMs created by Goyal et al. We added quantification occurrence categories themes in selected articles identify resounding that indicate greater impetus address future research.Most frequent for HCPs included uncertainty due lack evidence regarding CVM (in n=10 studies), fear negative consequences following (n=13) social influences (n=14). A frequently reported facilitator deprescribing, especially patients caregivers, was adverse drug events (n=7). Another were dislike (n=9). Necessity benefit seen as or similarly HCPs.The differences stress need ground discussions about beliefs preferences each stakeholder implicated decisions. Furthermore, highlights provide with tools enable sharing risks benefits ensure safe process.CRD42020221973.
Язык: Английский
Процитировано
18
Frontiers in Public Health, Год журнала: 2022, Номер 10
Опубликована: Фев. 11, 2022
Background Deprescribing requires patients' involvement and taking attitudes toward deprescribing into account. To understand the observed variation in these attitudes, influence of contextual-level factors, such as country or healthcare setting, should be taken Methods We conducted a systematic review studies using revised Patients' Attitudes Towards (rPATD) questionnaire among older adults. searched articles Medline Embase up to 30 June 2021. PRISMA guideline was used for search process reporting. summarized outcomes from rPATD compared at study population level between high low-middle-income countries, global regions, settings ANOVA testing. Correlations with mean age populations were tested. Associations individual patient extracted included summarized. Results Sixteen included. Percentages patients willing stop medication significantly lower countries (<70% Nepal Malaysia) high-income (>85% USA, Australia, European countries). No significant differences when results by region setting but willingness (>95%) seen two an inpatient population. A higher associated medication. At level, associations characteristics, including demographics education, showed inconsistent results. Conclusion Findings about are influenced contextual factors. Future research pay more attention system well culture on attitudes.
Язык: Английский
Процитировано
13