Emily Reeve1,2,3, Lee-Fay Low4, Sarah N Hilmer1,5. 1. NHMRC Cognitive Decline Partnership Centre, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia. 2. Geriatric Medicine Research, Faculty of Medicine, Dalhousie University and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. 3. College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada. 4. University of Sydney, Sydney, New South Wales, Australia. 5. Departments of Aged Care and Clinical Pharmacology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Abstract
BACKGROUND/ OBJECTIVES: Use of harmful and/or unnecessary medications in older adults is common. Understanding older adult and caregiver attitudes toward deprescribing will contribute to medication optimization in practice. The aims of this study were to capture the attitudes and beliefs of older adults and caregivers toward deprescribing and determine what participant characteristics and/or attitudes (if any) predicted reported willingness to have a medication deprescribed. DESIGN: Self-completed questionnaire. SETTING: Australia. PARTICIPANTS: Older adults (n = 386), 65 years or older, taking one or more regular prescription medications and caregivers of older adults (n = 205) who could self-complete a written questionnaire in English. MEASUREMENTS: Older adult and caregiver versions of the validated revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire were completed. The rPATD includes two global questions and four factors: perceived burden of medications, belief in appropriateness of medications, concerns about stopping, and involvement in medication management. Participant characteristics, self-rated health, trust in physician, and health autonomy were also collected. RESULTS: Older adult participants had a median age of 74 years (interquartile range [IQR] = 70-81 y), and caregivers were aged 67 years (IQR = 59-76) and were caring for a person aged 81 years (IQR = 75-86.25 y). Most of both older adults (88%) and caregivers (84%) agreed or strongly agreed that they would be willing to stop one or more of their or their care recipient's medications if their or their care recipient's doctor said it was possible. In a binary logistic regression model, a low concern about stopping factor score was the strongest predictor of willingness to have a medication deprescribed in older adults (odds ratio [OR] = 0.12; 95% confidence interval [CI] = 0.04-0.34). Excellent/good rating of physical health was the strongest predictor in caregivers (OR = 3.71; 95% CI = 1.13-12.23). CONCLUSIONS: Most older adults and caregivers are willing to have one of their or their care recipient's medication deprescribed, although different predictors (characteristics/attitudes) of this willingness were identified in these two groups.
BACKGROUND/ OBJECTIVES: Use of harmful and/or unnecessary medications in older adults is common. Understanding older adult and caregiver attitudes toward deprescribing will contribute to medication optimization in practice. The aims of this study were to capture the attitudes and beliefs of older adults and caregivers toward deprescribing and determine what participant characteristics and/or attitudes (if any) predicted reported willingness to have a medication deprescribed. DESIGN: Self-completed questionnaire. SETTING: Australia. PARTICIPANTS: Older adults (n = 386), 65 years or older, taking one or more regular prescription medications and caregivers of older adults (n = 205) who could self-complete a written questionnaire in English. MEASUREMENTS: Older adult and caregiver versions of the validated revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire were completed. The rPATD includes two global questions and four factors: perceived burden of medications, belief in appropriateness of medications, concerns about stopping, and involvement in medication management. Participant characteristics, self-rated health, trust in physician, and health autonomy were also collected. RESULTS: Older adult participants had a median age of 74 years (interquartile range [IQR] = 70-81 y), and caregivers were aged 67 years (IQR = 59-76) and were caring for a person aged 81 years (IQR = 75-86.25 y). Most of both older adults (88%) and caregivers (84%) agreed or strongly agreed that they would be willing to stop one or more of their or their care recipient's medications if their or their care recipient's doctor said it was possible. In a binary logistic regression model, a low concern about stopping factor score was the strongest predictor of willingness to have a medication deprescribed in older adults (odds ratio [OR] = 0.12; 95% confidence interval [CI] = 0.04-0.34). Excellent/good rating of physical health was the strongest predictor in caregivers (OR = 3.71; 95% CI = 1.13-12.23). CONCLUSIONS: Most older adults and caregivers are willing to have one of their or their care recipient's medication deprescribed, although different predictors (characteristics/attitudes) of this willingness were identified in these two groups.
Authors: M H Duong; A J McLachlan; A A Bennett; N Jokanovic; D G Le Couteur; M T Baysari; D Gnjidic; F Blyth; S N Hilmer Journal: Drugs Aging Date: 2020-11-30 Impact factor: 3.923
Authors: Yee Lin Chock; Yuan Lin Wee; Su Lene Gan; Kah Woon Teoh; Khuen Yen Ng; Shaun Wen Huey Lee Journal: J Gen Intern Med Date: 2021-06-25 Impact factor: 5.128