A Comparison of Willingness to Deprescribe in Older People with Non-Communicable Diseases with Polypharmacy Between Drug Burden Group and Non-Drug Burden Group at Outpatient Clinic of Family Medicine Department, King Chulalongkorn Memorial Hospital
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Abstract
Background: Polypharmacy among older patients with non-communicable diseases has many significant negative impacts, including self-deprescribing.Limited data regarding willingness to deprescribe and associated factors in this population led to this study’s initiation. This study aim to compare willingness to deprescribe among non-communicable disease older patients with polypharmacy, among those burdened and not burdened by medication use.
Methods: A cross-sectional study was conducted in non-communicable disease older patients aged 60 and above who were using five or more medications at the Family Medicine Clinic, King Chulalongkorn Memorial Hospital, Bangkok, in January and February 2024. Data on personal information, health status, medication use, attitudes toward deprescribing, and reasons for deprescribing were collected. Inferential statistics were used to compare willingness to deprescribe in groups burdened and not burdened by medication use, while multivariate analysis identified associated factors.
Results: Of 264 participants, the majority were not burdened by medication use (154 participants, 58.3%), while the burdened group consisted of 110 participants (41.7%). In each group, the desire to deprescribe was 48.1% and 72.7%, respectively, with a significant difference (p < 0.001). Factors associated with the willingness to deprescribe included medication burden, education level, presence of other chronic diseases, and self-reported health status. Reasons for willingness to deprescribe include lack of indication for medication use and the type of medication, such as chronic disease medications.
Conclusions: Non-communicable disease older patients with polypharmacy, especially those burdened by medication use, have a strong willingness to deprescribe. Healthcare professionals should understand patient-related factors to collaboratively plan the most effective healthcare management.
Keywords: willingness to deprescribe, polypharmacy, older people, non-communicable disease, drug burden
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References
สำนักงานกองทุนสนับสนุนการสร้างเสริมสุขภาพ. สถาน-การณ์ผู้สูงอายุไทย พ.ศ. 2564. 2022.
Kuchel GA. Systems Physiology of Aging and Selected Disorders of Homeostasis. In: Halter JB, Ouslander JG, Studenski S, High KP, Asthana S, Supiano MA, et al., editors. Hazzard’s Geriatric Medicine and Gerontology. 8th ed. New York, NY: McGraw-Hill Education; 2022.
Nothelle S, Brancati F, Boyd C. Managing the Care of Patients with Multiple Chronic Conditions. In: Halter JB, Ouslander JG, Studenski S, High KP, Asthana S, Supiano MA, et al., editors. Hazzard’s Geriatric Medicine and Gerontology. 8th ed. New York, NY: McGraw-Hill Education; 2022.
พีรพัฒน์ ทรัพย์พฤทธิกุล, ทัดตา ศรีบุญเรือง, สมฤทัย วัชราวิวัฒน์. Geriatric Pharmacotherapy and Polypharmacy. ใน: เกื้อเกียรติ ประดิษฐ์พรศิลป์, พรทิพย์ ควรคิด, สมบัติ ตรีประเสริฐสุข, ภรเอก มนัสวานิช, ไอศวรรย์ เพชรล่อเหลียน, ไพโรจน์ ฉัตรานุกูลชัย, บรรณาธิการ. ตำราเวชศาสตร์ผู้สูงวัย. กรุงเทพมหานคร: คณะแพทยศาสตร์ โรงพยาบาลจุฬาลงกรณ์ สภากาชาดไทย; 2018. หน้า. 405-46.
Kaewsoothi T, Porruan R. Prevalence and factors associated with potentially inappropriate medications (PIMs) in elderly patient. Journal of Primary Care and Family Medicine (PCFM). 2021;4:69-80.
Pongchitsiri S. Prevalence and Associated Factors of Medication Non-adherence among Elderly Patients with Chronic Diseases in Primary Care Setting of Chachoengsao Province. J Prapokklao Hosp Clin Med Educat Center. 2021;38:97-104.
Ruangritchankul S, Krairit O, Putthipokin K, Chansirikarnjana S, Assavapokee T, Sraium S. Polypharmacy among Older Adults in Outpatient Clinic, Internal Medicine Department, Ramathibodi Hospital. Thai Journal of Toxicology. 2018;33:35-50.
Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychology & Health. 1999;14:1-24.
Gatt I, West LM, Calleja N, Briffa C, Cordina M. Psychometric properties of the Belief about Medicines Questionnaire (BMQ) in the Maltese language. Pharm Pract (Granada). 2017;15:886.
Hilmer SN, Mager DE, Simonsick EM, Cao Y, Ling SM, Windham BG, et al. A drug burden index to define the functional burden of medications in older people. Arch Intern Med. 2007;167:781-7.
Reeve E, Shakib S, Hendrix I, Roberts MS, Wiese MD. Development and validation of the patients’ attitudes towards deprescribing (PATD) questionnaire. Int J Clin Pharm. 2013;35:51-6.
Reeve E, Low LF, Shakib S, Hilmer SN. Development and Validation of the Revised Patients’ Attitudes Towards Deprescribing (rPATD) Questionnaire: Versions for Older Adults and Caregivers. Drugs Aging. 2016;33:913-28.
Freeman TR. McWhinney’s Textbook of Family Medicine: New York: Oxford University Press; 2016.
Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011;2:53-5.
Taber KS. The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Research in Science Education. 2018;48:1273-96.
Shrestha S, Giri R, Sapkota HP, Danai SS, Saleem A, Devkota S, et al. Attitudes of ambulatory care older Nepalese patients towards deprescribing and predictors of their willingness to deprescribe. Ther Adv Drug Saf. 2021;12:20420986211019309. PubMed PMID: 34211689
Reeve E, Low LF, Hilmer SN. Attitudes of Older Adults and Caregivers in Australia toward Deprescribing. J Am Geriatr Soc. 2019;67:1204-10.
Hanna V, Chahine B, Souheil FA. Attitudes of Lebanese community-dwelling older adults towards deprescribing using the rPATD tool. Arch Gerontol Geriatr. 2023;105:104840. PubMed PMID: 36343438
Crutzen S, Abou J, Smits SE, Baas G, Hugtenburg JG, Heringa M, et al. Older people’s attitudes towards deprescribing cardiometabolic medication. BMC Geriatr. 2021;21:366. PubMed PMID: 34134649
