Ashley I Martinez1, Joshua Spencer1, Mairead Moloney2, Christal Badour3, Emily Reeve4, Daniela C Moga5. 1. University of Kentucky College of Pharmacy, Department of Pharmacy Practice and Science, 789 South Limestone Avenue, Lexington, KY, 40536, USA. 2. University of Kentucky College of Arts and Sciences, Department of Sociology, 120 Patterson Drive, Lexington, KY, 40506, USA. 3. University of Kentucky College of Arts and Sciences, Department of Psychology, 171 Funkhouser Drive, Lexington, KY, 40506, USA. 4. Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia; Geriatric Medicine Research, Faculty of Medicine, College of Pharmacy, Dalhousie University and Nova Scotia Health Authority, Halifax, NS, Canada. 5. University of Kentucky College of Pharmacy, Department of Pharmacy Practice and Science, 789 South Limestone Avenue, Lexington, KY, 40536, USA; University of Kentucky College of Public Health, Department of Epidemiology, 111 Washington Avenue, Lexington, KY, 40536, USA; Sanders-Brown Center on Aging, 800 South Limestone, Lexington, KY, 40536, USA; Institute for Pharmaceutical Outcomes and Policy, 789 South Limestone Avenue, Lexington, KY, 40536, USA. Electronic address: daniela.moga@uky.edu.
Abstract
BACKGROUND: Patients' attitudes toward deprescribing are crucial to understand before developing interventions, but no such data exists in the medically underserved, health disparities population of rural Appalachian United States. OBJECTIVE(S): Assess Appalachian women's openness to deprescribing medications and determine if polypharmacy influenced their attitudes toward deprescribing. METHODS: Before and after a cognitive behavioral therapy intervention, middle-aged Appalachian women self-reported medication use and completed the revised Patients' Attitudes Toward Deprescribing Questionnaire (rPATD). Responses were described, stratified by presence of polypharmacy. RESULTS: 30 women completed the rPATD pre- and post-intervention (mean [SD] age 55.8 [6.6] years; 96.7% white). Those with polypharmacy (n = 16) had higher burden and involvement scores (median 2.8 vs 2.0, p = 0.01; 4.9 vs 4.6, p = 0.06), and lower appropriateness scores (3.4 vs 3.9, p = 0.04). Burden, concerns about stopping, and involvement factor scores were similar before and after the intervention (p = 0.08, 0.86, and 0.41 respectively). ≥90% of participants were satisfied with their current medications yet would be willing to stop one or more. CONCLUSIONS: Middle-aged women in rural Appalachian United States are open to deprescribing; polypharmacy is associated with lower belief in the appropriateness of medications. Larger studies are needed to inform future deprescribing interventions for this and other similarly disadvantaged populations.
BACKGROUND:Patients' attitudes toward deprescribing are crucial to understand before developing interventions, but no such data exists in the medically underserved, health disparities population of rural Appalachian United States. OBJECTIVE(S): Assess Appalachian women's openness to deprescribing medications and determine if polypharmacy influenced their attitudes toward deprescribing. METHODS: Before and after a cognitive behavioral therapy intervention, middle-aged Appalachian women self-reported medication use and completed the revised Patients' Attitudes Toward Deprescribing Questionnaire (rPATD). Responses were described, stratified by presence of polypharmacy. RESULTS: 30 women completed the rPATD pre- and post-intervention (mean [SD] age 55.8 [6.6] years; 96.7% white). Those with polypharmacy (n = 16) had higher burden and involvement scores (median 2.8 vs 2.0, p = 0.01; 4.9 vs 4.6, p = 0.06), and lower appropriateness scores (3.4 vs 3.9, p = 0.04). Burden, concerns about stopping, and involvement factor scores were similar before and after the intervention (p = 0.08, 0.86, and 0.41 respectively). ≥90% of participants were satisfied with their current medications yet would be willing to stop one or more. CONCLUSIONS: Middle-aged women in rural Appalachian United States are open to deprescribing; polypharmacy is associated with lower belief in the appropriateness of medications. Larger studies are needed to inform future deprescribing interventions for this and other similarly disadvantaged populations.
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