Association between patient attitudes towards deprescribing and subsequent prescription changes |
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Authors: | Caroline McCarthy Michelle Flood Barbara Clyne Susan M. Smith Fiona Boland Emma Wallace Frank Moriarty |
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Affiliation: | 1. Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland;2. School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin 2, Ireland;3. Department of General Practice, University College Cork, Cork, Ireland |
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Abstract: | Deprescribing is an essential component of safe prescribing, especially for people with higher levels of polypharmacy. Identifying individuals prepared to consider medicine changes may facilitate deprescribing-orientated reviews. We aimed to explore the relationship between revised patients' attitudes towards deprescribing (rPATD) scores and medication changes in older people prescribed ≥15 medicines. A secondary analysis of rPATD scores and prescription data from a cluster randomised controlled trial of a GP-delivered, deprescribing-orientated medication review was conducted. The association between number of medicines stopped, started and changed and baseline rPATD scores was assessed using Poisson regression, adjusting for patient age, gender, study group allocation, baseline number of medicines and effects of clustering. Participants (n = 404) had a mean age of 76.4 years and were prescribed a mean of 17.1 medicines at baseline. Willingness to stop a medicine was associated with higher rates of both deprescribing (IRR: 1.40; 95% CI: 1.06–1.84) and initiating medicines (IRR: 1.43; 95% CI: 1.09–1.88). Satisfaction with current medicines was associated with a lower rate of deprescribing (IRR: 0.69; 95% CI: 0.57–0.85). The rPATD questionnaire could be used as part of a deprescribing intervention to identify participants who may be prepared to engage in deprescribing, enabling more efficient use of clinician time during complex consultations. |
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Keywords: | pharmacoepidemiology prescription of drugs rational pharmacotherapy |
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