Department of Education and Psychology of the University of Aveiro, Campus Universitário de Santiago, University of Aveiro, Aveiro, Portugal.
Center for Health Technology and Services Research at the Associate Laboratory RISE, Health Research Network (CINTESIS@RISE), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.
Basic Clin Pharmacol Toxicol. 2023 Dec;133(6):703-717. doi: 10.1111/bcpt.13874. Epub 2023 Apr 26.
Deprescribing is a complex process requiring a patient-centred approach. One frequently expressed deprescribing barrier is patients' attitudes and beliefs towards deprescribing. This study aimed to identify the predictors of patients' willingness to have medications deprescribed.
A cross-sectional study was conducted with community-dwelling patients aged ≥65 who are taking at least one regular medication. Data collection included patients' demographic and clinical characteristics and the Portuguese revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire. Descriptive statistics were used to present the patients' characteristics. Multiple binary logistic regression analysis was performed to identify the predictors of the patients' willingness to have medications deprescribed.
One hundred ninety-two participants (median age 72 years; 65.6% female) were included. Most (83.33%) were willing to have medications deprescribed, and the predictors were age (adjusted odds ratio [aOR] = 1.136; 95% CI 1.026, 1.258), female sex (aOR = 3.036; 95% CI 1.059, 8.708) and the rPATD concerns about stopping factor (aOR = 0.391; 95% CI 0.203, 0.754).
Most patients were willing to have their medications deprescribed if it is recommended by their doctors. Older age and female sex increased the odds of willingness to deprescribe; higher concerns about stopping medications decreased the odds. These findings suggest that addressing patients' concerns about stopping their medicines may contribute to deprescribing success.
药物减量是一个需要以患者为中心的复杂过程。一个经常被表达的药物减量障碍是患者对药物减量的态度和信念。本研究旨在确定患者愿意药物减量的预测因素。
本研究为横断面研究，纳入了年龄≥65 岁且正在服用至少一种常规药物的社区居住患者。数据收集包括患者的人口统计学和临床特征以及葡萄牙修订的患者对药物减量的态度问卷（rPATD）。采用描述性统计方法来描述患者的特征。采用多变量二项逻辑回归分析来确定患者愿意药物减量的预测因素。
共纳入 192 名参与者（中位年龄 72 岁；65.6%为女性）。大多数（83.33%）患者愿意药物减量，其预测因素为年龄（调整后的优势比[aOR] = 1.136；95%置信区间[CI] 1.026，1.258）、女性性别（aOR = 3.036；95%CI 1.059，8.708）和 rPATD 停止药物因素的担忧（aOR = 0.391；95%CI 0.203，0.754）。
如果医生建议，大多数患者愿意药物减量。年龄较大和女性性别增加了愿意药物减量的可能性；对停止药物的担忧越高，可能性就越低。这些发现表明，解决患者对停止用药的担忧可能有助于药物减量的成功。
