Potentially inappropriate medication and attitudes of older adults towards deprescribing.
Alexandra B Achterhof, Zsofia Rozsnyai, Emily Reeve, Katharina Tabea Jungo, Carmen Floriani, Rosalinde K E Poortvliet, Nicolas Rodondi, Jacobijn Gussekloo, Sven Streit
Author Information
Alexandra B Achterhof: Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland.
Zsofia Rozsnyai: Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland.
Emily Reeve: Quality Use of Medicines and Pharmacy Research Centre, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.
Katharina Tabea Jungo: Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland. ORCID
Carmen Floriani: Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland.
Rosalinde K E Poortvliet: Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Nicolas Rodondi: Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland.
Jacobijn Gussekloo: Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Sven Streit: Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland. ORCID
INTRODUCTION: Multimorbidity and polypharmacy are current challenges when caring for the older population. Both have led to an increase of potentially inappropriate medication (PIM), illustrating the need to assess patients' attitudes towards deprescribing. We aimed to assess the prevalence of PIM use and whether this was associated with patient factors and willingness to deprescribe. METHOD: We analysed data from the LESS Study, a cross-sectional study on self-reported medication and on barriers and enablers towards the willingness to deprescribe (rPATD questionnaire). The survey was conducted among multimorbid (≥3 chronic conditions) participants ≥70 years with polypharmacy (≥5 long-term medications). A subset of the Beers 2019 criteria was applied for the assessment of medication appropriateness. RESULTS: Data from 300 patients were analysed. The mean age was 79.1 years (SD 5.7). 53% had at least one PIM (men: 47.8%%, women: 60.4%%; p = 0.007). A higher number of medications was associated with PIM use (p = 0.002). We found high willingness to deprescribe in both participants with and without PIM. Willingness to deprescribe was not associated with PIM use (p = 0.25), nor number of PIMs (p = 0.81). CONCLUSION: The willingness of older adults with polypharmacy towards deprescribing was not associated with PIM use in this study. These results suggest that patients may not be aware if they are taking PIMs. This implies the need for raising patients' awareness about PIMs through education, especially in females, in order to implement deprescribing in daily practice.
