Barbara Roux1, Bianca Rakheja2, Caroline Sirois3,4,5, Anne Niquille6,7, Catherine Pétein8, Nicole Ouellet9, Anne Spinewine8,10, François-Xavier Sibille11,12, Marie-Laure Laroche13,14. 1. Centre of Pharmacovigilance and Pharmacoepidemiology, Department of Pharmacology-Toxicology and Centre of Pharmacovigilance, University Hospital of Limoges, Limoges, France. 2. Faculty of Medicine, Laval University, Quebec, Canada. 3. Faculty of Pharmacy, Laval University, Quebec, Canada. 4. Centre of Excellence On Aging of Quebec, Quebec, Canada. 5. Centre de recherche sur les soins et les Services de premieres lignes de l'Université Laval, Quebec, Canada. 6. Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland. 7. Community Pharmacy, Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland. 8. Clinical Pharmacy Research Group, Louvain Drug Research Institute, UCLouvain, Brussels, Belgium. 9. Department of Health, University of Quebec at Rimouski, Rimouski, Canada. 10. Pharmacy Department, CHU UCL Namur, Yvoir, Belgium. 11. Department of Geriatric Medicine, CHU UCL Namur, Yvoir, Belgium. 12. Institute of Health and Society, UCLouvain, Brussels, Belgium. 13. Centre of Pharmacovigilance and Pharmacoepidemiology, Department of Pharmacology-Toxicology and Centre of Pharmacovigilance, University Hospital of Limoges, Limoges, France. marie-laure.laroche@chu-limoges.fr. 14. Unité VIESANTE - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France. marie-laure.laroche@chu-limoges.fr.
Abstract
PURPOSE: Successful deprescribing requires understanding the attitudes of older adults and caregivers towards this process. This study aimed to capture these attitudes in four French-speaking countries and to investigate associated factors. METHODS: A multicenter cross-sectional study was conducted by administrating the French version of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire in Belgium, Canada, France, and Switzerland. Community-dwelling or nursing home older adults ≥ 65 years taking ≥ 1 prescribed medications and caregivers of older adults with similar characteristics were included. Multivariate logistic regressions were carried out to examine factors associated with willingness to deprescribe. RESULTS: A total of 367 older adults (79.3 ± 8.7 years, 63% community-dwelling, 54% ≥ 5 medications) and 255 unrelated caregivers (64.4 ± 12.6 years) of care recipients (83.4 ± 7.9 years, 52% community-dwelling, 69% ≥ 5 medications) answered the questionnaire. Among them, 87.5% older adults and 75.6% caregivers would be willing to stop medications if the physician said it was possible. Reluctance to stop a medication taken for a long time was expressed by 46% of both older adults and caregivers. A low score for the factor "concerns about stopping" (older adults: aOR: 0.21; 95% CI: 0.07-0.59), and a high score for the factor "involvement" (older adults: aOR: 2.66; 95% CI: 1.01-7.07; caregivers: aOR: 11.28; 95% CI: 1.48-85.91) were associated with willingness to deprescribe. CONCLUSIONS: A significant proportion of older adults and caregivers of French-speaking countries are open to deprescribing. Despite this apparent willingness, deprescribing conversations in clinical practice remains marginal, emphasizing the importance of optimizing the integration of existing tools such as rPATD.
PURPOSE: Successful deprescribing requires understanding the attitudes of older adults and caregivers towards this process. This study aimed to capture these attitudes in four French-speaking countries and to investigate associated factors. METHODS: A multicenter cross-sectional study was conducted by administrating the French version of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire in Belgium, Canada, France, and Switzerland. Community-dwelling or nursing home older adults ≥ 65 years taking ≥ 1 prescribed medications and caregivers of older adults with similar characteristics were included. Multivariate logistic regressions were carried out to examine factors associated with willingness to deprescribe. RESULTS: A total of 367 older adults (79.3 ± 8.7 years, 63% community-dwelling, 54% ≥ 5 medications) and 255 unrelated caregivers (64.4 ± 12.6 years) of care recipients (83.4 ± 7.9 years, 52% community-dwelling, 69% ≥ 5 medications) answered the questionnaire. Among them, 87.5% older adults and 75.6% caregivers would be willing to stop medications if the physician said it was possible. Reluctance to stop a medication taken for a long time was expressed by 46% of both older adults and caregivers. A low score for the factor "concerns about stopping" (older adults: aOR: 0.21; 95% CI: 0.07-0.59), and a high score for the factor "involvement" (older adults: aOR: 2.66; 95% CI: 1.01-7.07; caregivers: aOR: 11.28; 95% CI: 1.48-85.91) were associated with willingness to deprescribe. CONCLUSIONS: A significant proportion of older adults and caregivers of French-speaking countries are open to deprescribing. Despite this apparent willingness, deprescribing conversations in clinical practice remains marginal, emphasizing the importance of optimizing the integration of existing tools such as rPATD.
Authors: Laura Hellemans; Shauni Nuyts; Julie Hias; Marjan van den Akker; Gijs Van Pottelbergh; Xavier Rygaert; Isabel Spriet; Bert Vaes; Jos Tournoy; Lorenz Van der Linden Journal: Int J Clin Pract Date: 2021-01-03 Impact factor: 2.503
Authors: Pauline M S Anrys; Goedele C Strauven; Veerle Foulon; Jean-Marie Degryse; Séverine Henrard; Anne Spinewine Journal: J Am Med Dir Assoc Date: 2018-07-25 Impact factor: 4.669
Authors: Laurie E Davies; Gemma Spiers; Andrew Kingston; Adam Todd; Joy Adamson; Barbara Hanratty Journal: J Am Med Dir Assoc Date: 2020-01-08 Impact factor: 4.669