Abstract
To the Editor: We read with interest the results presented by Major and colleagues1 on the attitudes of older adults receiving home medication management support about deprescribing. These results provide further confirmation of the willingness of older adults to have medication deprescribed.
Major and colleagues administered the revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire as part of a pilot project (n=66) exploring a model of care to optimize medication use.1 The participants of this study were likely more complex (higher number of medications as well as needing support for medication management) with lower health literacy than the participants of our study using the rPATD in Australian older adults.2 Deprescribing may be more complicated while at the same time be potentially more beneficial in complex older adults. These results offer reassurance that clinicians should not be fearful about broaching the topic of deprescribing with populations with complex medication regimens.
In earlier Australian studies using the original PATD in a complex hospital outpatient population, we found a high level of agreement to willingness to deprescribe if their doctor said it was possible (92%),3 although in a residential aged care facility (nursing home) population, the proportion of agreement was slightly lower (79%).4 Similar patterns were reported internationally.5, 6 Further research is required into factors that may influence the willingness of older adults to have their medications deprescribed, such as number of medications, complexity of medication regimens, and health literacy. Studies have produced inconsistent results regarding characteristics that are influential (such as age, number of medications), and there is currently little understanding of the clinical significance of these associations.2
As highlighted by the intervention by Major and colleagues,1 the rPATD has potential in clinical practice to enhance conversations about deprescribing.7 Different models of care to enhance deprescribing, such as those that enable shared decision making, are currently being investigated.8, 9 These models have great potential to optimize medication use and in turn reduce adverse drug reactions and drug-related harms (such as hospitalizations and mortality), as well as reduce burden on individuals.
Major and colleagues administered the revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire as part of a pilot project (n=66) exploring a model of care to optimize medication use.1 The participants of this study were likely more complex (higher number of medications as well as needing support for medication management) with lower health literacy than the participants of our study using the rPATD in Australian older adults.2 Deprescribing may be more complicated while at the same time be potentially more beneficial in complex older adults. These results offer reassurance that clinicians should not be fearful about broaching the topic of deprescribing with populations with complex medication regimens.
In earlier Australian studies using the original PATD in a complex hospital outpatient population, we found a high level of agreement to willingness to deprescribe if their doctor said it was possible (92%),3 although in a residential aged care facility (nursing home) population, the proportion of agreement was slightly lower (79%).4 Similar patterns were reported internationally.5, 6 Further research is required into factors that may influence the willingness of older adults to have their medications deprescribed, such as number of medications, complexity of medication regimens, and health literacy. Studies have produced inconsistent results regarding characteristics that are influential (such as age, number of medications), and there is currently little understanding of the clinical significance of these associations.2
As highlighted by the intervention by Major and colleagues,1 the rPATD has potential in clinical practice to enhance conversations about deprescribing.7 Different models of care to enhance deprescribing, such as those that enable shared decision making, are currently being investigated.8, 9 These models have great potential to optimize medication use and in turn reduce adverse drug reactions and drug-related harms (such as hospitalizations and mortality), as well as reduce burden on individuals.
| Original language | English |
|---|---|
| Pages (from-to) | 1757-1758 |
| Number of pages | 2 |
| Journal | Journal of the American Geriatrics Society |
| Volume | 67 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Aug 2019 |
| Externally published | Yes |