Mona J Kalogianis1, Barbara C Wimmer2, Justin P Turner1, Edwin C K Tan1, Tina Emery3, Leonie Robson3, Emily Reeve4, Sarah N Hilmer4, J Simon Bell5. 1. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, 3052 Melbourne, Australia. 2. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, 3052 Melbourne, Australia. Electronic address: barbara.wimmer@monash.edu. 3. Resthaven Incorporated, Adelaide, Australia. 4. NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Sydney, Australia; Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital & Kolling Institute of Medical Research, Sydney Medical School, University of Sydney, Sydney, Australia. 5. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, 3052 Melbourne, Australia; NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Sydney, Australia; Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
Abstract
PURPOSE: There has been recent interest in deprescribing, particularly among older people. No previous studies have assessed whether residents of aged care facilities are willing to have their medications deprescribed. Understanding residents' attitudes toward deprescribing is important for developing deprescribing interventions. OBJECTIVE: To investigate residents' willingness to have their medications deprescribed. METHODS: This was a cross-sectional survey of 232 residents aged ≥65 years from six residential aged care facilities (RACFs) across metropolitan and regional South Australia. Overall, 163 of the 232 residents (70.3%) took ≥9 regular medications. All participants completed the 10-item Patients' Attitudes Towards Deprescribing (PATD) questionnaire. RESULTS: Overall, 40.5% of residents reported a desire to stop taking one or more of their medications. If their doctor said it was possible, 78.9% of residents were willing to have one or more of their medications deprescribed. Residents taking ≥9 medications were more likely to feel that they were taking a large number of medications compared to residents taking <9 medications (50.3% vs 14.5%, P < 0.01), and were more likely to believe one or more of their medications was causing side effects (14.7% vs 10.1%, P = 0.02). However, residents taking ≥9 regular medications were not significantly more likely to want to reduce their number of medications than residents taking <9 medications. CONCLUSIONS: Deprescribing interventions are likely to be acceptable to residents' of RACFs, with a high willingness to discontinue medicines if doctors say it is possible. This highlights the importance of the proactive involvement of health care professionals in an individualized deprescribing process.
PURPOSE: There has been recent interest in deprescribing, particularly among older people. No previous studies have assessed whether residents of aged care facilities are willing to have their medications deprescribed. Understanding residents' attitudes toward deprescribing is important for developing deprescribing interventions. OBJECTIVE: To investigate residents' willingness to have their medications deprescribed. METHODS: This was a cross-sectional survey of 232 residents aged ≥65 years from six residential aged care facilities (RACFs) across metropolitan and regional South Australia. Overall, 163 of the 232 residents (70.3%) took ≥9 regular medications. All participants completed the 10-item Patients' Attitudes Towards Deprescribing (PATD) questionnaire. RESULTS: Overall, 40.5% of residents reported a desire to stop taking one or more of their medications. If their doctor said it was possible, 78.9% of residents were willing to have one or more of their medications deprescribed. Residents taking ≥9 medications were more likely to feel that they were taking a large number of medications compared to residents taking <9 medications (50.3% vs 14.5%, P < 0.01), and were more likely to believe one or more of their medications was causing side effects (14.7% vs 10.1%, P = 0.02). However, residents taking ≥9 regular medications were not significantly more likely to want to reduce their number of medications than residents taking <9 medications. CONCLUSIONS: Deprescribing interventions are likely to be acceptable to residents' of RACFs, with a high willingness to discontinue medicines if doctors say it is possible. This highlights the importance of the proactive involvement of health care professionals in an individualized deprescribing process.
Authors: Emily Reeve; Jennifer L Wolff; Maureen Skehan; Elizabeth A Bayliss; Sarah N Hilmer; Cynthia M Boyd Journal: JAMA Intern Med Date: 2018-12-01 Impact factor: 21.873
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