Chong-Han Kua1,2, Emily Reeve3,4, Doreen S Y Tan1,5, Tsingyi Koh1,6, Jie Lin Soong1,7, Marvin J L Sim1,8, Tracy Y Zhang1,9, Yi Rong Chen1,10, Vanassa Ratnasingam11, Vivienne S L Mak12, Shaun Wen Huey Lee2,13. 1. Pharmaceutical Society of Singapore (PSS) Deprescribing Workgroup, Singapore. 2. School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia. 3. Geriatric Medicine Research, Faculty of Medicine and College of Pharmacy, Dalhousie University and Nova Scotia Health Authority, Halifax, Canada. 4. College of Medicine, University of Saskatchewan, Saskatoon, Canada. 5. Khoo Teck Puat Hospital, Singapore. 6. National University Hospital, Singapore. 7. Singapore General Hospital, Singapore. 8. National Healthcare Group Pharmacy, Singapore. 9. Ang Mo Kio-Thye Hua Kwan Hospital, Singapore. 10. Tan Tock Seng Hospital, Singapore. 11. Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia. 12. Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia. 13. School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Selangor, Malaysia.
Abstract
BACKGROUND: Knowledge of decision-making preference of patients and caregivers is needed to facilitate deprescribing. This study aimed to assess the perspectives of caregivers and older adults towards deprescribing in an Asian population. Secondary objectives were to identify and compare characteristics associated with these attitudes and beliefs. METHOD: A cross-sectional survey of two groups of participants was conducted using the Revised Patients' Attitudes Towards Deprescribing questionnaire. Descriptive results were reported for participants' characteristics and questionnaire responses from four factors (belief in medication inappropriateness, medication burden, concerns about stopping, and involvement) and two global questions. Correlation between participant characteristics and their responses was analyzed. RESULTS: A total of 1,057 (615 older adults; 442 caregivers) participants were recruited from 10 institutions in Singapore. In which 511 (83.0%) older adults and 385 (87.1%) caregivers reported that they would be willing to stop one or more of their medications if their doctor said it was possible, especially among older adults recruited from acute-care hospitals (85.3%) compared with older adults in community pharmacies (73.6%). Individuals who take more than five medications and those with higher education were correlated with greater agreement in inappropriateness and involvement, respectively. CONCLUSIONS: Clinicians should consider discussing deprescribing with older adults and caregivers in their regular clinical practice, especially when polypharmacy is present. Further research is needed into how to engage older adults and caregivers in shared decision making based on their attitudes toward deprescribing.
BACKGROUND: Knowledge of decision-making preference of patients and caregivers is needed to facilitate deprescribing. This study aimed to assess the perspectives of caregivers and older adults towards deprescribing in an Asian population. Secondary objectives were to identify and compare characteristics associated with these attitudes and beliefs. METHOD: A cross-sectional survey of two groups of participants was conducted using the Revised Patients' Attitudes Towards Deprescribing questionnaire. Descriptive results were reported for participants' characteristics and questionnaire responses from four factors (belief in medication inappropriateness, medication burden, concerns about stopping, and involvement) and two global questions. Correlation between participant characteristics and their responses was analyzed. RESULTS: A total of 1,057 (615 older adults; 442 caregivers) participants were recruited from 10 institutions in Singapore. In which 511 (83.0%) older adults and 385 (87.1%) caregivers reported that they would be willing to stop one or more of their medications if their doctor said it was possible, especially among older adults recruited from acute-care hospitals (85.3%) compared with older adults in community pharmacies (73.6%). Individuals who take more than five medications and those with higher education were correlated with greater agreement in inappropriateness and involvement, respectively. CONCLUSIONS: Clinicians should consider discussing deprescribing with older adults and caregivers in their regular clinical practice, especially when polypharmacy is present. Further research is needed into how to engage older adults and caregivers in shared decision making based on their attitudes toward deprescribing.
Authors: Caroline de Godoi Rezende Costa Molino; Patricia O Chocano-Bedoya; Angélique Sadlon; Robert Theiler; John E Orav; Bruno Vellas; Rene Rizzoli; Reto W Kressig; John A Kanis; Sophie Guyonnet; Wei Lang; Andreas Egli; Heike A Bischoff-Ferrari Journal: BMJ Open Date: 2022-04-29 Impact factor: 3.006