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

被引:28
作者
Aoki, Takuya [1 ,2 ]
Yamamoto, Yosuke [1 ,2 ]
Ikenoue, Tatsuyoshi [2 ,3 ]
Fukuhara, Shunichi [1 ,4 ,5 ]
机构
[1] Kyoto Univ, Grad Sch Med, Sch Publ Hlth, Dept Healthcare Epidemiol,Sakyo Ku, Yoshida Konoe Cho, Kyoto 6068501, Japan
[2] iHope Int, Inst Hlth Outcomes & Proc Evaluat Res, Kyoto, Japan
[3] Kyoto Univ, Grad Sch Med, Human Hlth Sci, Kyoto, Japan
[4] Fukushima Med Univ, Shirakawa Satellite Teaching & Res STAR, Dept Gen Med, Fukushima, Japan
[5] Fukushima Med Univ, Ctr Innovat Res Communities & Clin Excellence CIR, Fukushima, Japan
关键词
Chronic disease; Decision making; Deprescribing; Japan; Multimorbidity; Patient preference; Polypharmacy; OLDER PEOPLES ATTITUDES; POLYPHARMACY; WILLINGNESS; VALIDATION; MEDICINES; OUTCOMES; QUALITY; MEN;
D O I
10.1007/s11096-019-00797-4
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
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.
引用
收藏
页码:531 / 537
页数:7
相关论文
共 23 条
[1]   Multimorbidity patterns in relation to polypharmacy and dosage frequency: a nationwide, cross-sectional study in a Japanese population [J].
Aoki, Takuya ;
Yamamoto, Yosuke ;
Ikenoue, Tatsuyoshi ;
Onishi, Yoshihiro ;
Fukuhara, Shunichi .
SCIENTIFIC REPORTS, 2018, 8
[2]   Quality use of medicines and health outcomes among a cohort of community dwelling older men: an observational study [J].
Beer, Christopher ;
Hyde, Zoe ;
Almeida, Osvaldo P. ;
Norman, Paul ;
Hankey, Graeme J. ;
Yeap, Bu B. ;
Flicker, Leon .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2011, 71 (04) :592-599
[3]   Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well? [J].
Calderon-Larranaga, Amaia ;
Poblador-Plou, Beatriz ;
Gonzalez-Rubio, Francisca ;
Andres Gimeno-Feliu, Luis ;
Maria Abad-Diez, Jose ;
Prados-Torres, Alexandra .
BRITISH JOURNAL OF GENERAL PRACTICE, 2012, 62 (605) :e821-e826
[4]   A three-talk model for shared decision making: multistage consultation process [J].
Elwyn, Glyn ;
Durand, Marie Anne ;
Song, Julia ;
Aarts, Johanna ;
Barr, Paul J. ;
Berger, Zackary ;
Cochran, Nan ;
Frosch, Dominick ;
Galasinski, Dariusz ;
Gulbrandsen, Pal ;
Han, Paul K. J. ;
Haerter, Martin ;
Kinnersley, Paul ;
Lloyd, Amy ;
Mishra, Manish ;
Perestelo-Perez, Lilisbeth ;
Scholl, Isabelle ;
Tomori, Kounosuke ;
Trevena, Lyndal ;
Witteman, Holly O. ;
Van der Weijden, Trudy .
BMJ-BRITISH MEDICAL JOURNAL, 2017, 359
[5]   Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan [J].
Fukuhara, S ;
Bito, S ;
Green, J ;
Hsiao, A ;
Kurokawa, K .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1998, 51 (11) :1037-1044
[6]   Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey [J].
Fukuhara, S ;
Ware, JE ;
Kosinski, M ;
Wada, S ;
Gandek, B .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1998, 51 (11) :1045-1053
[7]   Attitudes towards polypharmacy and medication withdrawal among older inpatients in Italy [J].
Galazzi, Alessandro ;
Lusignani, Maura ;
Chiarelli, Maria Teresa ;
Mannucci, Pier Mannuccio ;
Franchi, Carlotta ;
Tettamanti, Mauro ;
Reeve, Emily ;
Nobili, Alessandro .
INTERNATIONAL JOURNAL OF CLINICAL PHARMACY, 2016, 38 (02) :454-461
[8]   Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes [J].
Gnjidic, Danijela ;
Hilmer, Sarah N. ;
Blyth, Fiona M. ;
Naganathan, Vasi ;
Waite, Louise ;
Seibel, Markus J. ;
McLachlan, Andrew J. ;
Cumming, Robert G. ;
Handelsman, David J. ;
Le Couteur, David G. .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 2012, 65 (09) :989-995
[9]  
Jansen J, 2016, BMJ-BRIT MED J, V353, P1
[10]   Multimorbidity and polypharmacy in the elderly: lessons from REPOSI [J].
Mannucci, Pier Mannuccio ;
Nobili, Alessandro .
INTERNAL AND EMERGENCY MEDICINE, 2014, 9 (07) :723-734