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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Attitudes towards deprescribing and patient-related factors associated with willingness to stop medication among older patients with type 2 diabetes (T2D) in Indonesia: a cross-sectional survey study

BMC Geriatrics, Год журнала: 2023, Номер 23(1)

Опубликована: Янв. 12, 2023

Deprescribing of preventive medication is recommended in older patients with polypharmacy, including people type 2 diabetes (T2D). It seems that many low-middle-income countries are not willing to have their medicines deprescribed. This study aims assess attitudes Indonesian T2D towards deprescribing general and regarding specific cardiometabolic medicines, factors influencing willingness stop medicines.Primary care ≥60 years Indonesia completed the revised Patients' Attitudes Towards (rPATD) questionnaire. for were reported descriptively. Proportions one or more when by different healthcare professionals compared Chi-square test. Multiple regression analysis was used analyse influence between patient-related medicines.The survey 196 participants (median age 69 years, 73% female). The percentages 69, 67, 41%, practitioner (GP), specialist, pharmacist initiates process (p-value < 0.001). Higher perceived burden = 0.03) less concerns about stopping 0.001) associated a higher if proposed GP. Patients using multiple glucose-regulating 0.02). Using complementary alternative stop. If pharmacist, without substantial education than educated patients.Only two-thirds GP specialist this, even this. Attention should be given especially among glucose-lowering who may eligible but accept deprescribing.

Язык: Английский

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Attitudes of Australian patients receiving inpatient mental health care towards deprescribing: a cross-sectional survey

BMC Psychiatry, Год журнала: 2025, Номер 25(1)

Опубликована: Март 21, 2025

Abstract Background Psychotropic polypharmacy is common, increasing, and associated with higher risks of adverse effects, hospitalisations mortality. This study aimed to explore the attitudes beliefs people receiving inpatient mental health care toward deprescribing ( discontinuing a medication when current or potential risk outweighs benefit ) determine any patient characteristics these beliefs. Methods A cross-sectional survey patients admitted two open acute psychiatric units was conducted over 6-month period in Australian metropolitan city Adelaide. Individuals were eligible participate regardless their reason for admission, if they at least 18 years old able converse, read write English, provide informed consent. Participant responses validated revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire collected. The rPATD includes questions grouped into four factors: (i) perceived burden medications, (ii) involvement management, (iii) belief appropriateness (iv) concerns about stopping, plus global questions. Participants encouraged think medications that use conditions completing questionnaire. Results One hundred participants recruited, mean age 41.6 (SD = 13.7). 65% agreed would be willing stop one more psychotropic doctor said it possible. In binary logistic regression model, willingness have deprescribed mostly strongly predicted by Involvement factor score (odds ratio [OR] 5.92, 95% confidence interval [CI] 2.10-15-16.70, p < 0.001). Conclusions majority having deprescribed. When medically justified, professionals should feel comfortable initiating conversations understand preferences, fostering shared decision-making management. Clinical trial number Not applicable.

Язык: Английский

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Pharmacotherapy De-Escalation as a Critical Component of Lifestyle Medicine

Lifestyle Medicine, Год журнала: 2025, Номер unknown, С. 605 - 616

Опубликована: Янв. 1, 2025

Язык: Английский

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

Clinical Interventions in Aging, Год журнала: 2023, Номер Volume 18, С. 1129 - 1143

Опубликована: Июль 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

Язык: Английский

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Deprescribing: An umbrella review

Acta Pharmaceutica, Год журнала: 2024, Номер 74(2), С. 249 - 267

Опубликована: Май 30, 2024

Abstract This umbrella review examined systematic reviews of deprescribing studies by characteristics intervention, population, medicine, and setting. Clinical humanistic outcomes, barriers facilitators, tools for are presented. The Medline database was used. search limited to meta-analyses published in English up April 2022. Reviews reporting were included, while those where depre-scribing not planned supervised a healthcare professional excluded. A total 94 (23 meta--analyses) included. Most explored clinical or outcomes (70/94, 74 %); less attitudes, (17/94, 18 few focused on (8/94, 8.5 %). assessing divided into two groups: with intervention trials (39/70, 56 %; 16 reviewing specific interventions 23 broad medication optimisation interventions), cessation (31/70, 44 Deprescribing feasible resulted reduction inappropriate medications . Complex shown reduce hospitalisation, falls, mortality rates. In trials, higher frequency adverse drug withdrawal events underscores the importance prioritizing patient safety exercising caution when stopping medicines, particularly patients clear appropriate indications.

Язык: Английский

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Potentially Inappropriate Medications among Elderly with Frailty in a Tertiary Care Academic Medical Centre in Saudi Arabia

Healthcare, Год журнала: 2022, Номер 10(8), С. 1440 - 1440

Опубликована: Июль 31, 2022

This study aims to assess the prevalence of potentially inappropriate medications (PIMs) and analyze relationship between PIMs frailty among inpatient older adults aged 65 above in Saudi Arabia. A retrospective cross-sectional design was utilized during period April 2021 2022 all patients years admitted a public tertiary hospital Data on number use were assessed using Beers’ criteria while status “FRAIL Scale”. Of 358 patient files that reviewed, 52.2% males, 60.9% 65−74 years, 82% married. The robust, prefrail, frail 5%, 36.9%, 58.1%, respectively. According 2019 Beers criteria, total 45.8% (n = 164) participants identified as PIMs. Compared non-PIMs group, group demonstrated significant differences (p < 0.001), comorbidities 0.05), score 0.001). strongest predictor PIM comorbidities, recording an odds ratio 2.86, (95% CI 1.21−6.77, p 0.05). Our results show significantly associated with multiple polypharmacy. clear assessment evaluation tool may improve quality drug treatment adult population, particularly patients.

Язык: Английский

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Continue or not to continue? Attitudes towards deprescribing among community-dwelling older adults in China

BMC Geriatrics, Год журнала: 2022, Номер 22(1)

Опубликована: Июнь 8, 2022

Abstract Background Inappropriate prescribing of medications and polypharmacy among older adults are associated with a wide range adverse outcomes. It is critical to understand the attitudes towards deprescribing—reducing use potentially inappropriate (PIMs)—among this vulnerable group. Such information particularly lacking in low - middle-income countries. Methods In study, we examined Chinese community-dwelling adults’ deprescribing as well individual-level correlates. Through community-based health examination platform, performed cross-sectional study by personally interviews using revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire (version for adults) two communities located Suzhou, China. We recruited participants who were at least 65 years had one chronic condition prescribed medication. Results included 1,897 present study; mean age was 73.8 (SD = 6.2 years) 1,023 (53.9%) women. Most disease ( n 1,364 [71.9%]) took 1–2 regular drugs 1,483 [78.2%]). Half 947, 50%) indicated that they would be willing stop taking or more their medicines if doctor said it possible, 924 (48.7%) wanted cut down on number taking. did not find individual level characteristics correlated deprescribing. Conclusions The proportions participants’ willingness much lower than what prior investigations western populations reported. important identify factors influence develop patient-centered practical guideline suitable adults.

Язык: Английский

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

Patient Preference and Adherence, Год журнала: 2024, Номер Volume 18, С. 779 - 786

Опубликована: Март 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.

Язык: Английский

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Deprescribing in older adults in a French community: a questionnaire study on patients’ beliefs and attitudes

BMC Geriatrics, Год журнала: 2024, Номер 24(1)

Опубликована: Июнь 27, 2024

General practitioners (GPs) have a central role to play on reduction of polypharmacy and deprescribing. This study aimed assess beliefs attitudes towards deprescribing in patients, aged 65 years or older primary care, identify factors associated with their willingness stop medication.

Язык: Английский

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