Katie Qi1, Emily Reeve2,3, Sarah N Hilmer4,5, Sallie-Anne Pearson1,6, Slade Matthews4, Danijela Gnjidic1,4. 1. Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia. 2. Sydney Medical School, University of Sydney, Sydney, NSW, Australia. emily.reeve@sydney.edu.au. 3. Cognitive Decline Partnership Centre, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, Australia. emily.reeve@sydney.edu.au. 4. Sydney Medical School, University of Sydney, Sydney, NSW, Australia. 5. Cognitive Decline Partnership Centre, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, Australia. 6. Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
Abstract
BACKGROUND: Deprescribing is the process of medication withdrawal with the aims of reducing the harms of potentially inappropriate medication use and improving patient outcomes. Deprescribing of statins may be indicated for some older people, because the evidence for benefit in primary prevention of cardiovascular disease is limited and there is an increased risk of side effects in old age. OBJECTIVE: To determine older peoples' attitudes and beliefs regarding medication use and their willingness to have regular medications, particularly statins, deprescribed. Setting An Australian acute-care hospital. METHOD: A cross-sectional study of patients admitted to a teaching hospital in Sydney, Australia, aged ≥65 years and taking a statin was conducted. Attitudes and beliefs regarding medication use and willingness to have medications or statins deprescribed were captured using the validated Patients' Attitudes Towards Deprescribing questionnaire, supplemented with additional statin-specific questions. MAIN OUTCOME MEASURES: Older inpatients' attitudes and perspectives towards stopping medications, in particular statins. RESULTS: Overall, 180 participants were recruited, with a median age of 78 years, (interquartile range 71-85). Eighty-nine percent (95% CI 84.4-93.6) of participants reported that they would be willing to stop one or more of their regular medications if their doctor said it was possible. Ninety-five percent (95% CI 91.8-98.2) agreed that they would be willing to have a statin deprescribed. Moreover, 94% (95% CI 90.5-97.5) of participants expressed concern regarding the potential side effects of taking a statin. CONCLUSION: The majority of older inpatients using statins are willing to have one or more of their current medications, including statins, deprescribed. These findings can be used to inform clinical practice and interventional statin deprescribing studies to optimise medication use in older adults.
BACKGROUND: Deprescribing is the process of medication withdrawal with the aims of reducing the harms of potentially inappropriate medication use and improving patient outcomes. Deprescribing of statins may be indicated for some older people, because the evidence for benefit in primary prevention of cardiovascular disease is limited and there is an increased risk of side effects in old age. OBJECTIVE: To determine older peoples' attitudes and beliefs regarding medication use and their willingness to have regular medications, particularly statins, deprescribed. Setting An Australian acute-care hospital. METHOD: A cross-sectional study of patients admitted to a teaching hospital in Sydney, Australia, aged ≥65 years and taking a statin was conducted. Attitudes and beliefs regarding medication use and willingness to have medications or statins deprescribed were captured using the validated Patients' Attitudes Towards Deprescribing questionnaire, supplemented with additional statin-specific questions. MAIN OUTCOME MEASURES: Older inpatients' attitudes and perspectives towards stopping medications, in particular statins. RESULTS: Overall, 180 participants were recruited, with a median age of 78 years, (interquartile range 71-85). Eighty-nine percent (95% CI 84.4-93.6) of participants reported that they would be willing to stop one or more of their regular medications if their doctor said it was possible. Ninety-five percent (95% CI 91.8-98.2) agreed that they would be willing to have a statin deprescribed. Moreover, 94% (95% CI 90.5-97.5) of participants expressed concern regarding the potential side effects of taking a statin. CONCLUSION: The majority of older inpatients using statins are willing to have one or more of their current medications, including statins, deprescribed. These findings can be used to inform clinical practice and interventional statin deprescribing studies to optimise medication use in older adults.
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