Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Basic Clin Pharmacol Toxicol. 2024 Jan;134(1):39-50. doi: 10.1111/bcpt.13911. Epub 2023 Jul 3.
This study aimed to test the adequacy of a quantitative measure of our qualitatively developed Patient Typology-categories of older adults' attitudes towards medicines and medicine decision-making-and identify characteristics associated with each Typology. We conducted secondary data analyses of a subset of survey item measures of adults (≥65 years) who were members of online survey panels in Australia, the United Kingdom, the United States and the Netherlands (n = 4688). Multinomial logistic regression analyses assessed associations between demographic, psychosocial and medication-related measures. Mean age was 71.5 (5), and 47.5% of participants were female. Factors associated with an increased likelihood of identifying with Typology 1 'Attached to medicines' over Typology 2 'Open to deprescribing' were higher positive attitude towards polypharmacy (RRR = 1.12, p = <0.001) and higher need for certainty (RRR = 1.11, p = 0.039). Factors associated with an increased likelihood of identifying with Typology 3 'Defers (medication decision-making) to others' over Typology 2 were older age (RRR = 1.47 per 10-year age increase, p = <0.001) and a decreased likelihood of prior deprescribing experience (RRR = 0.73, p = 0.033). This study provides validation of the Typology with large samples from four countries, with the quantitatively-measured typologies generally aligning with the qualitatively derived categories. Our Patient Typology measure provides a succinct way researchers can assess attitudes towards deprescribing.
本研究旨在测试我们定性开发的患者分类法（老年人对药物的态度和药物决策的类别）的定量衡量标准的充分性，并确定与每个分类法相关的特征。我们对澳大利亚、英国、美国和荷兰在线调查小组的成年人（≥65 岁）的调查项目措施的子集进行了二次数据分析（n=4688）。多项逻辑回归分析评估了人口统计学、心理社会和与药物相关的措施之间的关联。平均年龄为 71.5（5），47.5%的参与者为女性。与 Typology 1“依恋药物”相比，更有可能认同 Typology 2“开放减药”的因素包括对多药治疗的积极态度更高（RRR=1.12，p<0.001）和对确定性的需求更高（RRR=1.11，p=0.039）。与 Typology 3“将（药物决策）推迟给他人”相比，更有可能认同 Typology 2 的因素包括年龄较大（RRR=每增加 10 岁增加 1.47，p<0.001）和减少减药经验的可能性（RRR=0.73，p=0.033）。本研究使用来自四个国家的大量样本验证了该分类法，定量测量的分类法通常与定性得出的类别一致。我们的患者分类法测量为研究人员评估减药态度提供了一种简洁的方法。
