Skip to main content
Top
Published in: BMC Geriatrics 1/2024

Open Access 01-12-2024 | Research

Influence of chronic medical conditions on older patients’ willingness to deprescribe medications: a cross-sectional study

Authors: Anabela Pereira, Manuel Veríssimo, Oscar Ribeiro

Published in: BMC Geriatrics | Issue 1/2024

Login to get access

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.
Appendix
Available only for authorised users
Literature
2.
go back to reference Eurostat. Ageing Europe - statistics on population developments. 2020. Eurostat. Ageing Europe - statistics on population developments. 2020.
8.
go back to reference Gallacher KI, Batty GD, McLean G, Mercer SW, Guthrie B, May CR, et al. Stroke, multimorbidity and polypharmacy in a nationally representative sample of 1,424,378 patients in Scotland: implications for treatment burden. BMC Med. 2014;12(1). https://doi.org/10.1186/s12916-014-0151-0 Gallacher KI, Batty GD, McLean G, Mercer SW, Guthrie B, May CR, et al. Stroke, multimorbidity and polypharmacy in a nationally representative sample of 1,424,378 patients in Scotland: implications for treatment burden. BMC Med. 2014;12(1). https://​doi.​org/​10.​1186/​s12916-014-0151-0
21.
go back to reference Page AT, Clifford RM, Potter K, Schwartz D, Etherton-Beer CD. The feasibility and effect of deprescribing in older adults on mortality and health: a systematic review and meta-analysis. Br J Clin Pharmacol. 2016:583–623. https://doi.org/10.1111/bcp.12975 Page AT, Clifford RM, Potter K, Schwartz D, Etherton-Beer CD. The feasibility and effect of deprescribing in older adults on mortality and health: a systematic review and meta-analysis. Br J Clin Pharmacol. 2016:583–623. https://​doi.​org/​10.​1111/​bcp.​12975
34.
38.
go back to reference Reeve E, Bayliss EA, Shetterly S, Maiyani M, Gleason KS, Norton JD, et al. Willingness of older people living with dementia and mild cognitive impairment and their caregivers to have medications deprescribed. Age Ageing. 2023;52(1). https://doi.org/10.1093/ageing/afac335 Reeve E, Bayliss EA, Shetterly S, Maiyani M, Gleason KS, Norton JD, et al. Willingness of older people living with dementia and mild cognitive impairment and their caregivers to have medications deprescribed. Age Ageing. 2023;52(1). https://​doi.​org/​10.​1093/​ageing/​afac335
39.
46.
go back to reference Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47(11):1245–51.CrossRefPubMed Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47(11):1245–51.CrossRefPubMed
52.
go back to reference Teillac P. [Benign prostatic hyperplasia: patients’ perception of medical treatment and their expectations. Results of a French survey involving patients treated with finasteride]. Therapie. 2002;57(5):473–83.PubMed Teillac P. [Benign prostatic hyperplasia: patients’ perception of medical treatment and their expectations. Results of a French survey involving patients treated with finasteride]. Therapie. 2002;57(5):473–83.PubMed
53.
go back to reference Weibl P, Klatte T, Laurinc P, Tomaškin R, Shariat SF, Helbich M, et al. Patient’s behavior and attitudes toward the management of benign prostatic hyperplasia among patients with the risk of disease progression: prospective study by prostate and expectations of treatment epidemiology research (PETER) study group. Wien Klin Wochenschr. 2015;127(9–10):363–8. https://doi.org/10.1007/s00508-014-0668-4CrossRefPubMed Weibl P, Klatte T, Laurinc P, Tomaškin R, Shariat SF, Helbich M, et al. Patient’s behavior and attitudes toward the management of benign prostatic hyperplasia among patients with the risk of disease progression: prospective study by prostate and expectations of treatment epidemiology research (PETER) study group. Wien Klin Wochenschr. 2015;127(9–10):363–8. https://​doi.​org/​10.​1007/​s00508-014-0668-4CrossRefPubMed
58.
go back to reference Oktora MP, Yuniar CT, Amalia L, Abdulah R, Hak E, Denig P. Attitudes towards deprescribing and patient-related factors associated with willingness to stop medication among older patients with type 2 diabetes (T2D) in Indonesia: a cross-sectional survey study. BMC Geriatr. 2023;23(1). https://doi.org/10.1186/s12877-022-03718-9 Oktora MP, Yuniar CT, Amalia L, Abdulah R, Hak E, Denig P. Attitudes towards deprescribing and patient-related factors associated with willingness to stop medication among older patients with type 2 diabetes (T2D) in Indonesia: a cross-sectional survey study. BMC Geriatr. 2023;23(1). https://​doi.​org/​10.​1186/​s12877-022-03718-9
Metadata
Title
Influence of chronic medical conditions on older patients’ willingness to deprescribe medications: a cross-sectional study
Authors
Anabela Pereira
Manuel Veríssimo
Oscar Ribeiro
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2024
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-024-04891-9

Other articles of this Issue 1/2024

BMC Geriatrics 1/2024 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine