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.

中文翻译：

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新加坡患者和护理人员对处方药的态度

摘要

背景

需要了解患者和护理人员的决策偏好，以促进开药。本研究旨在评估护理人员和老年人对亚洲人群中药物滥用的看法。次要目标是识别和比较与这些态度和信念相关的特征。

方法

使用修订后的患者对药物处方的态度问卷对两组参与者进行了横断面调查。报告了参与者特征的描述性结果和来自四个因素（对用药不当的信念、用药负担、对停药的担忧和参与）和两个全局问题的问卷答复。分析了参与者特征和他们的反应之间的相关性。

结果

从新加坡的 10 家机构共招募了 1,057 名（615 名老年人；442 名护理人员）参与者。其中 511 (83.0%) 名老年人和 385 (87.1%) 名护理人员报告说，如果他们的医生说有可能，他们愿意停止服用一种或多种药物，尤其是从急症护理医院招募的老年人 (85.3 %) 与社区药房的老年人 (73.6%) 相比。服用超过五种药物的人和受过高等教育的人分别与不适当和参与的更大一致性相关。

结论

临床医生应考虑在常规临床实践中与老年人和护理人员讨论取消处方的问题，尤其是在存在多种用药情况时。需要进一步研究如何根据老年人和护理人员对处方药的态度让他们参与共同决策。