Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.
USF Pulsar, ARS Centro, Coimbra, Portugal.
BMJ Open. 2018 Jul 17;8(7):e019542. doi: 10.1136/bmjopen-2017-019542.
Polypharmacy is commonly defined as the simultaneous taking of five or more drugs. Deprescribing is the process of tapering or stopping medications with the aim of improving patient outcomes and optimising current therapy, and there are several tools aiming at identifying potentially inappropriate medications, especially in the elderly. The direct involvement of patients and their caregivers in the choice and administration of drugs has long been known to be very important, but it is not usually applied. The aim of this study is to assess the knowledge of older adults about deprescription, the effect on willingness to have regular medications deprescribed and its quality-of-life outcome.
This study protocol comprises three phases. The first two phases will be nationwide and aim to evaluate the prevalence and patterns of polypharmacy and assess the barriers and facilitators of deprescribing perceived by older adults, as well as their willingness to have regular medications deprescribed and to self-medicate. The third and last phase will be a non-pharmacological randomised clinical study to measure older patients' acceptance to have regular medications deprescribed and related quality of life.
The study will be conducted in accordance with the principles expressed in the Declaration of Helsinki. It has been approved by the Ethics Committee of the University of Beira Interior and Portuguese National Data Protection Commission. Study results will be published in peer-reviewed journals and presented at national and international conferences. In short, no action will be taken without written consent from patients and doctors.
NCT03283735.
多种药物疗法通常被定义为同时服用五种或更多种药物。减药是指逐渐减少或停止用药的过程，目的是改善患者的预后并优化现有治疗方案，并且有几种工具旨在识别潜在的不适当药物，尤其是在老年人中。长期以来，患者及其护理人员直接参与药物的选择和管理非常重要，但通常并未得到应用。本研究旨在评估老年人对减药的了解程度，以及对其定期药物减药意愿及其生活质量的影响。
本研究方案包括三个阶段。前两个阶段将在全国范围内进行，旨在评估老年人中多种药物疗法的流行程度和模式，评估老年人对减药的障碍和促进因素的看法，以及他们对定期药物减药和自我用药的意愿。第三和最后一个阶段将是一项非药物随机临床试验，以衡量老年患者对定期药物减药的接受程度及其相关的生活质量。
本研究将遵循《赫尔辛基宣言》中表达的原则进行。它已经获得了贝拉伊内里奥大学伦理委员会和葡萄牙国家数据保护委员会的批准。研究结果将发表在同行评议的期刊上，并在国内和国际会议上进行展示。简而言之，在没有患者和医生书面同意的情况下，不会采取任何行动。
NCT03283735。
