@article{2016aa84f70948958fb5519b0a9a057f,
title = "Attitudes of Older Adults and Caregivers in Australia toward Deprescribing",
abstract = "BACKGROUND/OBJECTIVES: Use of harmful and/or unnecessary medications in older adults is common. Understanding older adult and caregiver attitudes toward deprescribing will contribute to medication optimization in practice. The aims of this study were to capture the attitudes and beliefs of older adults and caregivers toward deprescribing and determine what participant characteristics and/or attitudes (if any) predicted reported willingness to have a medication deprescribed. DESIGN: Self-completed questionnaire. SETTING: Australia. PARTICIPANTS: Older adults (n = 386), 65 years or older, taking one or more regular prescription medications and caregivers of older adults (n = 205) who could self-complete a written questionnaire in English. MEASUREMENTS: Older adult and caregiver versions of the validated revised Patients{\textquoteright} Attitudes Towards Deprescribing (rPATD) questionnaire were completed. The rPATD includes two global questions and four factors: perceived burden of medications, belief in appropriateness of medications, concerns about stopping, and involvement in medication management. Participant characteristics, self-rated health, trust in physician, and health autonomy were also collected. RESULTS: Older adult participants had a median age of 74 years (interquartile range [IQR] = 70-81 y), and caregivers were aged 67 years (IQR = 59-76) and were caring for a person aged 81 years (IQR = 75-86.25 y). Most of both older adults (88%) and caregivers (84%) agreed or strongly agreed that they would be willing to stop one or more of their or their care recipient's medications if their or their care recipient's doctor said it was possible. In a binary logistic regression model, a low concern about stopping factor score was the strongest predictor of willingness to have a medication deprescribed in older adults (odds ratio [OR] = 0.12; 95% confidence interval [CI] = 0.04-0.34). Excellent/good rating of physical health was the strongest predictor in caregivers (OR = 3.71; 95% CI = 1.13-12.23). CONCLUSIONS: Most older adults and caregivers are willing to have one of their or their care recipient's medication deprescribed, although different predictors (characteristics/attitudes) of this willingness were identified in these two groups.",
keywords = "attitudes, caregivers, deprescribing, medication, older adults",
author = "Emily Reeve and Low, {Lee Fay} and Hilmer, {Sarah N.}",
note = "Funding Information: Sponsor{\textquoteright}s Role: This research was funded by the NHMRC Cognitive Decline Partnership Centre (CDPC). The CDPC receives support from the National Health and Medical Research Council (NHMRC) and funding partners including HammondCare, Alzheimer{\textquoteright}s Australia, Bright-water Care Group, and Helping Hand Aged Care. Project funding from the CDPC is delivered through the University of Sydney, Aging and Pharmacology group. The funding body had a role in study concept but no role in the collection, analysis or interpretation of the data, in the writing of the report, or the decision to submit the article for publication. Funding Information: We express our gratitude to all the participants who completed the questionnaires. We also appreciate the contribution of the organizations and many individuals who assisted with distribution and advertising of the questionnaires, in particular Tara Quirke, Catriona Lorang, and Jan van Emden. The revised Patients? Attitudes Towards Deprescribing (rPATD) was developed and validated by the authors of this article. Conflict of Interest: The authors have no conflicts of interest. Author Contributions: All authors contributed significantly to the publication. Emily Reeve contributed to concept and design, acquisition of data, analysis of data and interpretation of results; drafted and revised the manuscript; and approved the final version for publication. Lee-Fay Low contributed to concept and design (particularly the methodology) and supervised the analysis of data; revised the manuscript critically for important intellectual content; and approved the final version for publication. Sarah N. Hilmer contributed to concept and design, and interpretation of the results; revised the manuscript critically for important intellectual content; and approved the final version for publication. Sponsor's Role: This research was funded by the NHMRC Cognitive Decline Partnership Centre (CDPC). The CDPC receives support from the National Health and Medical Research Council (NHMRC) and funding partners including HammondCare, Alzheimer's Australia, Brightwater Care Group, and Helping Hand Aged Care. Project funding from the CDPC is delivered through the University of Sydney, Aging and Pharmacology group. The funding body had a role in study concept but no role in the collection, analysis or interpretation of the data, in the writing of the report, or the decision to submit the article for publication. Emily Reeve is an NHMRC-ARC Dementia Research Development Fellow. Lee-Fay Low is a Dementia Research Leadership Fellow. Publisher Copyright: {\textcopyright} 2019 The American Geriatrics Society",
year = "2019",
month = jun,
doi = "10.1111/jgs.15804",
language = "English",
volume = "67",
pages = "1204--1210",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "6",
}