Justin P Turner1, Philippe Martin2, Yi Zhi Zhang3, Cara Tannenbaum4. 1. Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada. Electronic address: justin.turner@criugm.qc.ca. 2. Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada. 3. Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada. 4. Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
Abstract
BACKGROUND: The ability of questionnaires such as the Patients' Attitudes Towards Deprescribing (PATD) or the Beliefs about Medicines Questionnaire (Specific section) (BMQ-Specific) to successfully identify patients who will deprescribe remains unknown. OBJECTIVE: To determine if screening questionnaires assessing patients' attitudes and beliefs towards medications and deprescribing can predict deprescribing outcomes. METHODS: This is a post-hoc secondary analysis of the D-PRESCRIBE trial. 489 community-dwelling adults (≥65 years) who were chronic users (≥3 months) of a potentially inappropriate medication were randomized to a pharmacist-led educational intervention or usual care. Association between baseline responses to PATD and BMQ-Specific items and successful deprescribing was calculated. To determine predictive ability of questionnaire items, receiver operating characteristic curves (ROC) were constructed and area under the curve was calculated. RESULTS: At baseline, 86% of participants (95% confidence interval [CI] 83-89%) indicated a willingness to deprescribe, yet only 41% (95%CI 37-46%) successfully deprescribed. Six items were associated with deprescribing success, however, no PATD or BMQ-Specific item - either independently or in combination - meaningfully distinguished which participants succeeded or failed deprescribing attempts at 6-months (AUC < 0.7). CONCLUSION: Current tools to assess patient's attitudes and beliefs towards medication use and/or deprescribing have low predictive validity for successful deprescribing.
RCT Entities:
BACKGROUND: The ability of questionnaires such as the Patients' Attitudes Towards Deprescribing (PATD) or the Beliefs about Medicines Questionnaire (Specific section) (BMQ-Specific) to successfully identify patients who will deprescribe remains unknown. OBJECTIVE: To determine if screening questionnaires assessing patients' attitudes and beliefs towards medications and deprescribing can predict deprescribing outcomes. METHODS: This is a post-hoc secondary analysis of the D-PRESCRIBE trial. 489 community-dwelling adults (≥65 years) who were chronic users (≥3 months) of a potentially inappropriate medication were randomized to a pharmacist-led educational intervention or usual care. Association between baseline responses to PATD and BMQ-Specific items and successful deprescribing was calculated. To determine predictive ability of questionnaire items, receiver operating characteristic curves (ROC) were constructed and area under the curve was calculated. RESULTS: At baseline, 86% of participants (95% confidence interval [CI] 83-89%) indicated a willingness to deprescribe, yet only 41% (95%CI 37-46%) successfully deprescribed. Six items were associated with deprescribing success, however, no PATD or BMQ-Specific item - either independently or in combination - meaningfully distinguished which participants succeeded or failed deprescribing attempts at 6-months (AUC < 0.7). CONCLUSION: Current tools to assess patient's attitudes and beliefs towards medication use and/or deprescribing have low predictive validity for successful deprescribing.
Authors: Matthew E Growdon; Edie Espejo; Bocheng Jing; W John Boscardin; Andrew R Zullo; Kristine Yaffe; Kenneth S Boockvar; Michael A Steinman Journal: J Am Geriatr Soc Date: 2022-03-10 Impact factor: 7.538
Authors: Kristie Rebecca Weir; Nagham J Ailabouni; Carl R Schneider; Sarah N Hilmer; Emily Reeve Journal: J Gerontol A Biol Sci Med Sci Date: 2022-05-05 Impact factor: 6.591
Authors: Jose Ignacio de Juan-Roldán; Marcos Castillo-Jimena; Alba González-Hevilla; Clara Sánchez-Sánchez; Antonio J García-Ruiz; Enrique Gavilán-Moral Journal: BMJ Open Date: 2022-04-21 Impact factor: 3.006
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