Skip to main content
Erschienen in: International Journal of Clinical Pharmacy 2/2019

05.02.2019 | Research Article

Factors associated with patient preferences towards deprescribing: a survey of adult patients on prescribed medications

Erschienen in: International Journal of Clinical Pharmacy | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Abstract

Background Deprescribing is a patient-centered intervention with inherent uncertainties and requires shared decision making and patient involvement. Objective In the present study, we aimed to investigate factors associated with patient preferences toward deprescribing in a representative sample in Japan. Methods We conducted a nationwide cross-sectional survey and used a quota sampling method to select representative samples of the Japanese general population. We collected data on participant demographic and clinical factors including the number of chronic health conditions and the number of regular prescription medications. Patients’ willingness to deprescribe was assessed using the patients’ attitudes towards deprescribing questionnaire. Multivariable logistic regression analyses were conducted to determine factors associated with the outcome measure. Results Data were analyzed for 1483 adult outpatients. The proportion of patients having willingness to deprescribe was 67.8%. After adjustment for age and gender, multimorbidity was significantly positively associated with patients’ willingness to deprescribe [adjusted odds ratio (aOR) 1.35; 95% confidence interval (CI) 1.06–1.72]. A similar association was found with polypharmacy (aOR 1.43; 95% CI 1.08–1.88). The number of visits to medical institutions and increasing age were also found to be associated with patients’ willingness to deprescribe. Conclusion Our study indicated that patient preferences towards deprescribing are consistent with the established clinical evidence regarding the efficacy of deprescribing for patients with multimorbidity and polypharmacy. These findings may be beneficial for health care providers to implement shared decision making regarding deprescribing effectively.
Literatur
1.
Zurück zum Zitat Reeve E, Thompson W, Farrell B. Deprescribing: a narrative review of the evidence and practical recommendations for recognizing opportunities and taking action. Eur J Intern Med. 2017;38:3–11.CrossRefPubMed Reeve E, Thompson W, Farrell B. Deprescribing: a narrative review of the evidence and practical recommendations for recognizing opportunities and taking action. Eur J Intern Med. 2017;38:3–11.CrossRefPubMed
2.
Zurück zum Zitat Reeve E, Gnjidic D, Long J, Hilmer S. A systematic review of the emerging definition of “deprescribing” with network analysis: implications for future research and clinical practice. Br J Clin Pharmacol. 2015;80(6):1254–68.CrossRefPubMedPubMedCentral Reeve E, Gnjidic D, Long J, Hilmer S. A systematic review of the emerging definition of “deprescribing” with network analysis: implications for future research and clinical practice. Br J Clin Pharmacol. 2015;80(6):1254–68.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Calderón-Larrañaga A, Poblador-Plou B, González-Rubio F, Gimeno-Feliu LA, Abad-Díez JM, Prados-Torres A. Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well? Br J Gen Pract. 2012;62(605):e821–6.CrossRefPubMedPubMedCentral Calderón-Larrañaga A, Poblador-Plou B, González-Rubio F, Gimeno-Feliu LA, Abad-Díez JM, Prados-Torres A. Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well? Br J Gen Pract. 2012;62(605):e821–6.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Olsson IN, Runnamo R, Engfeldt P. Medication quality and quality of life in the elderly, a cohort study. Heal Qual Life Outcomes. 2011;9:95.CrossRef Olsson IN, Runnamo R, Engfeldt P. Medication quality and quality of life in the elderly, a cohort study. Heal Qual Life Outcomes. 2011;9:95.CrossRef
5.
Zurück zum Zitat Beer C, Hyde Z, Almeida OP, Norman P, Hankey GJ, Yeap BB, et al. Quality use of medicines and health outcomes among a cohort of community dwelling older men: an observational study. Br J Clin Pharmacol. 2011;71(4):592–9.CrossRefPubMedPubMedCentral Beer C, Hyde Z, Almeida OP, Norman P, Hankey GJ, Yeap BB, et al. Quality use of medicines and health outcomes among a cohort of community dwelling older men: an observational study. Br J Clin Pharmacol. 2011;71(4):592–9.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Scott IA, Hilmer SN, Reeve E, Potter K, Le Couteur D, Rigby D, et al. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern Med. 2015;175(5):827–34.CrossRefPubMed Scott IA, Hilmer SN, Reeve E, Potter K, Le Couteur D, Rigby D, et al. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern Med. 2015;175(5):827–34.CrossRefPubMed
7.
Zurück zum Zitat Jansen J, Naganathan V, Carter SM, McLachlan AJ, Nickel B, Irwig L, et al. Too much medicine in older people? Deprescribing through shared decision making. BMJ. 2016;353:1–6. Jansen J, Naganathan V, Carter SM, McLachlan AJ, Nickel B, Irwig L, et al. Too much medicine in older people? Deprescribing through shared decision making. BMJ. 2016;353:1–6.
8.
Zurück zum Zitat Elwyn G, Durand MA, Song J, Aarts J, Barr PJ, Berger Z, et al. A three-talk model for shared decision making: multistage consultation process. BMJ. 2017;359:j4891.CrossRefPubMedPubMedCentral Elwyn G, Durand MA, Song J, Aarts J, Barr PJ, Berger Z, et al. A three-talk model for shared decision making: multistage consultation process. BMJ. 2017;359:j4891.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Reeve E, Wiese MD, Hendrix I, Roberts MS, Shakib S. People’s attitudes, beliefs, and experiences regarding polypharmacy and willingness to deprescribe. J Am Geriatr Soc. 2013;61(9):1508–14.CrossRefPubMed Reeve E, Wiese MD, Hendrix I, Roberts MS, Shakib S. People’s attitudes, beliefs, and experiences regarding polypharmacy and willingness to deprescribe. J Am Geriatr Soc. 2013;61(9):1508–14.CrossRefPubMed
10.
Zurück zum Zitat Qi K, Reeve E, Hilmer SN, Pearson SA, Matthews S, Gnjidic D. Older peoples’ attitudes regarding polypharmacy, statin use and willingness to have statins deprescribed in Australia. Int J Clin Pharm. 2015;37(5):949–57.CrossRefPubMed Qi K, Reeve E, Hilmer SN, Pearson SA, Matthews S, Gnjidic D. Older peoples’ attitudes regarding polypharmacy, statin use and willingness to have statins deprescribed in Australia. Int J Clin Pharm. 2015;37(5):949–57.CrossRefPubMed
11.
Zurück zum Zitat Sirois C, Ouellet N, Reeve E. Community-dwelling older people’s attitudes towards deprescribing in Canada. Res Soc Adm Pharm. 2017;13(4):864–70.CrossRef Sirois C, Ouellet N, Reeve E. Community-dwelling older people’s attitudes towards deprescribing in Canada. Res Soc Adm Pharm. 2017;13(4):864–70.CrossRef
12.
Zurück zum Zitat Ng WL, Tan MZW, Koh EYL, Tan NC. Deprescribing: what are the views and factors influencing this concept among patients with chronic diseases in a developed Asian community? Proc Singap Healthc. 2017;26(3):172–9.CrossRef Ng WL, Tan MZW, Koh EYL, Tan NC. Deprescribing: what are the views and factors influencing this concept among patients with chronic diseases in a developed Asian community? Proc Singap Healthc. 2017;26(3):172–9.CrossRef
13.
Zurück zum Zitat Tran V-T, Harrington M, Montori VM, Barnes C, Wicks P, Ravaud P. Adaptation and validation of the Treatment Burden Questionnaire (TBQ) in English using an internet platform. BMC Med. 2014;12(1):109.CrossRefPubMedPubMedCentral Tran V-T, Harrington M, Montori VM, Barnes C, Wicks P, Ravaud P. Adaptation and validation of the Treatment Burden Questionnaire (TBQ) in English using an internet platform. BMC Med. 2014;12(1):109.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Aoki T, Yamamoto Y, Ikenoue T, Onishi Y, Fukuhara S. Multimorbidity patterns in relation to polypharmacy and dosage frequency: a nationwide, cross-sectional study in a Japanese population. Sci Rep. 2018;8(1):3806.CrossRefPubMedPubMedCentral Aoki T, Yamamoto Y, Ikenoue T, Onishi Y, Fukuhara S. Multimorbidity patterns in relation to polypharmacy and dosage frequency: a nationwide, cross-sectional study in a Japanese population. Sci Rep. 2018;8(1):3806.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Gnjidic D, Hilmer SN, Blyth FM, Naganathan V, Waite L, Seibel MJ, et al. Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol. 2012;65(9):989–95.CrossRef Gnjidic D, Hilmer SN, Blyth FM, Naganathan V, Waite L, Seibel MJ, et al. Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol. 2012;65(9):989–95.CrossRef
16.
Zurück zum Zitat Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K. Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol. 1998;51(11):1037–44.CrossRefPubMed Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K. Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol. 1998;51(11):1037–44.CrossRefPubMed
17.
Zurück zum Zitat Fukuhara S, Ware JE, Kosinski M, Wada S, Gandek B. Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. J Clin Epidemiol. 1998;51(11):1045–53.CrossRefPubMed Fukuhara S, Ware JE, Kosinski M, Wada S, Gandek B. Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. J Clin Epidemiol. 1998;51(11):1045–53.CrossRefPubMed
18.
Zurück zum Zitat Reeve E, Shakib S, Hendrix I, Roberts MS, Wiese MD. Development and validation of the patients’ attitudes towards deprescribing (PATD) questionnaire. Int J Clin Pharm. 2013;35(1):51–6.CrossRefPubMed Reeve E, Shakib S, Hendrix I, Roberts MS, Wiese MD. Development and validation of the patients’ attitudes towards deprescribing (PATD) questionnaire. Int J Clin Pharm. 2013;35(1):51–6.CrossRefPubMed
19.
Zurück zum Zitat Reeve E, Low LF, Shakib S, Hilmer SN. Development and validation of the revised Patients’ Attitudes Towards Deprescribing (rPATD) Questionnaire: versions for older adults and caregivers. Drugs Aging. 2016;33(12):913–28.CrossRefPubMed Reeve E, Low LF, Shakib S, Hilmer SN. Development and validation of the revised Patients’ Attitudes Towards Deprescribing (rPATD) Questionnaire: versions for older adults and caregivers. Drugs Aging. 2016;33(12):913–28.CrossRefPubMed
20.
Zurück zum Zitat Galazzi A, Lusignani M, Chiarelli MT, Mannucci PM, Franchi C, Tettamanti M, et al. Attitudes towards polypharmacy and medication withdrawal among older inpatients in Italy. Int J Clin Pharm. 2016;38(2):1–8.CrossRef Galazzi A, Lusignani M, Chiarelli MT, Mannucci PM, Franchi C, Tettamanti M, et al. Attitudes towards polypharmacy and medication withdrawal among older inpatients in Italy. Int J Clin Pharm. 2016;38(2):1–8.CrossRef
21.
Zurück zum Zitat Nobili A, Garattini S, Mannucci P. Multiple diseases and polypharmacy in the elderly: challenges for the internist of the third millennium. J Comorbidity. 2011;1(1):28–44.CrossRef Nobili A, Garattini S, Mannucci P. Multiple diseases and polypharmacy in the elderly: challenges for the internist of the third millennium. J Comorbidity. 2011;1(1):28–44.CrossRef
22.
Zurück zum Zitat Mannucci PM, Nobili A, REPOSI Investigators. Multimorbidity and polypharmacy in the elderly: lessons from REPOSI. Intern Emerg Med. 2014;9(7):723–34.CrossRefPubMed Mannucci PM, Nobili A, REPOSI Investigators. Multimorbidity and polypharmacy in the elderly: lessons from REPOSI. Intern Emerg Med. 2014;9(7):723–34.CrossRefPubMed
23.
Zurück zum Zitat Steinman MA, Seth Landefeld C, Rosenthal GE, Berthenthal D, Sen S, Kaboli PJ. Polypharmacy and prescribing quality in older people. J Am Geriatr Soc. 2006;54(10):1516–23.CrossRefPubMed Steinman MA, Seth Landefeld C, Rosenthal GE, Berthenthal D, Sen S, Kaboli PJ. Polypharmacy and prescribing quality in older people. J Am Geriatr Soc. 2006;54(10):1516–23.CrossRefPubMed
Metadaten
Titel
Factors associated with patient preferences towards deprescribing: a survey of adult patients on prescribed medications
Publikationsdatum
05.02.2019
Erschienen in
International Journal of Clinical Pharmacy / Ausgabe 2/2019
Print ISSN: 2210-7703
Elektronische ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-019-00797-4

Weitere Artikel der Ausgabe 2/2019

International Journal of Clinical Pharmacy 2/2019 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.