PDF(Pubmed)
Abstract：
BACKGROUND: Aging correlates with a heightened prevalence of chronic diseases, resulting in multimorbidity affecting 60% of those aged 65 or older. Multimorbidity often leads to polypharmacy, elevating the risk of potentially inappropriate medication (PIM) use and adverse health outcomes. To address these issues, deprescribing has emerged as a patient-centered approach that considers patients\' beliefs and attitudes toward medication and reduces inappropriate polypharmacy in older adults. Our study aims to investigate whether certain chronic medical conditions are associated with older patients\' willingness to deprescribe medications.
METHODS: A cross-sectional study enrolled 192 community-dwelling individuals aged 65 or older taking at least one regular medication. Data included demographics, clinical characteristics, and responses to the Portuguese revised Patients\' Attitudes Towards Deprescribing (rPATD) questionnaire. Descriptive statistics characterized participants, while multiple binary logistic regression identified associations between chronic medical conditions and willingness to deprescribe.
RESULTS: Among the participants (median age: 72 years, 65.6% female), 91.6% had multimorbidity. The analysis revealed that willingness to deprescribe significantly increased with the presence of gastric disease (adjusted odds ratio [aOR] = 4.123; 95% CI 1.221, 13.915) and age (aOR = 1.121; 95% CI 1.009, 1.246). Conversely, prostatic pathology (aOR = 0.266; 95% CI 0.077, 0.916), higher scores in the rPATD appropriateness factor (aOR = 0.384; 95% CI 0.190, 0.773), and rPATD concerns about stopping factor (aOR = 0.450; 95% CI 0.229, 0.883) diminished patients\' willingness to deprescribe.
CONCLUSIONS: This study highlights the intricate relationship between older patients\' attitudes toward deprescribing and chronic medical conditions. We found that gastric disease was associated with an increased willingness to deprescribe medications, while prostate disease was associated with the opposite effect. Future research should explore how patients with specific diseases or groups of diseases perceive deprescribing of medications general and for specific medications, aiding in the development of targeted interventions.
METHODS: A cross-sectional study enrolled 192 community-dwelling individuals aged 65 or older taking at least one regular medication. Data included demographics, clinical characteristics, and responses to the Portuguese revised Patients\' Attitudes Towards Deprescribing (rPATD) questionnaire. Descriptive statistics characterized participants, while multiple binary logistic regression identified associations between chronic medical conditions and willingness to deprescribe.
RESULTS: Among the participants (median age: 72 years, 65.6% female), 91.6% had multimorbidity. The analysis revealed that willingness to deprescribe significantly increased with the presence of gastric disease (adjusted odds ratio [aOR] = 4.123; 95% CI 1.221, 13.915) and age (aOR = 1.121; 95% CI 1.009, 1.246). Conversely, prostatic pathology (aOR = 0.266; 95% CI 0.077, 0.916), higher scores in the rPATD appropriateness factor (aOR = 0.384; 95% CI 0.190, 0.773), and rPATD concerns about stopping factor (aOR = 0.450; 95% CI 0.229, 0.883) diminished patients\' willingness to deprescribe.
CONCLUSIONS: This study highlights the intricate relationship between older patients\' attitudes toward deprescribing and chronic medical conditions. We found that gastric disease was associated with an increased willingness to deprescribe medications, while prostate disease was associated with the opposite effect. Future research should explore how patients with specific diseases or groups of diseases perceive deprescribing of medications general and for specific medications, aiding in the development of targeted interventions.
摘要：
背景：老龄化与慢性疾病患病率升高相关，导致多发病率影响60％的65岁或以上的人。多症通常导致多药，提高潜在不适当药物（PIM）使用和不良健康结局的风险。为了解决这些问题,开处方已成为一种以患者为中心的方法，该方法考虑了患者对药物的信念和态度，并减少了老年人不适当的多重用药。我们的研究旨在调查某些慢性疾病是否与老年患者停用药物的意愿有关。
方法：一项横断面研究纳入192名65岁或以上的社区居民，至少服用一种常规药物。数据包括人口统计，临床特征,以及对葡萄牙修订的患者对处方无效的态度(rPATD)问卷的回应。描述性统计数据表征参与者，而多元二元逻辑回归确定了慢性疾病和放弃处方意愿之间的关联。
结果：在参与者中（平均年龄：72岁，65.6%女性)，91.6%具有多浊度。分析显示，随着胃病的存在（校正比值比[aOR]=4.123；95％CI1.221，13.915）和年龄（aOR=1.121；95％CI1.009，1.246），停用处方的意愿显着增加。相反，前列腺病理学（aOR=0.266；95%CI0.077，0.916），rPATD适当性因子得分较高(aOR=0.384；95%CI0.190，0.773)，rPATD对停药因素的担忧(aOR=0.450；95%CI0.229，0.883)降低了患者的处方意愿。
结论：这项研究强调了老年患者对开药的态度与慢性疾病之间的复杂关系。我们发现胃病与停用药物的意愿增加有关，而前列腺疾病与相反的效果有关。未来的研究应该探索特定疾病或疾病组的患者如何看待一般药物和特定药物的处方，帮助制定有针对性的干预措施。
方法：一项横断面研究纳入192名65岁或以上的社区居民，至少服用一种常规药物。数据包括人口统计，临床特征,以及对葡萄牙修订的患者对处方无效的态度(rPATD)问卷的回应。描述性统计数据表征参与者，而多元二元逻辑回归确定了慢性疾病和放弃处方意愿之间的关联。
结果：在参与者中（平均年龄：72岁，65.6%女性)，91.6%具有多浊度。分析显示，随着胃病的存在（校正比值比[aOR]=4.123；95％CI1.221，13.915）和年龄（aOR=1.121；95％CI1.009，1.246），停用处方的意愿显着增加。相反，前列腺病理学（aOR=0.266；95%CI0.077，0.916），rPATD适当性因子得分较高(aOR=0.384；95%CI0.190，0.773)，rPATD对停药因素的担忧(aOR=0.450；95%CI0.229，0.883)降低了患者的处方意愿。
结论：这项研究强调了老年患者对开药的态度与慢性疾病之间的复杂关系。我们发现胃病与停用药物的意愿增加有关，而前列腺疾病与相反的效果有关。未来的研究应该探索特定疾病或疾病组的患者如何看待一般药物和特定药物的处方，帮助制定有针对性的干预措施。
