Hospital Pharmacy Funen, Odense University Hospital, Odense C, Denmark.
Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.
Basic Clin Pharmacol Toxicol. 2024 Jan;134(1):97-106. doi: 10.1111/bcpt.13952. Epub 2023 Oct 30.
Understanding the patient perspective is a significant part of the deprescribing process. This study aimed to explore the attitudes of older patients with psychiatric disorders towards deprescribing. A total of 72 of psychiatric outpatients (68% women; median age 76 years) completed the validated Danish version of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire. Patients used a median of eight medications (interquartile range 6-12), with 88%, 49% and 24% using antidepressants, antipsychotics and anxiolytics, respectively. Fifty-one percent of patients reported an intrinsic desire to stop one of their medications, while 92% would be willing to stop one on their physician's advice. Seventy-five percent of patients would be worried about missing out on future benefits following deprescribing and 37% had previous bad deprescribing experiences. Use of ≥8 regular medications was associated with more concerns about stopping medication and greater perceived burden of using medication, while use of antipsychotics was not associated with any differences in rPATD factor scores. It is crucial for health care professionals to be aware of patients' specific concerns and past experiences to promote a patient-centred deprescribing approach that takes into account the needs and preferences of older patients with psychiatric disorders.
了解患者的观点是减少用药过程中的一个重要部分。本研究旨在探讨老年精神障碍患者对减少用药的态度。共有 72 名精神科门诊患者（68%为女性；中位年龄 76 岁）完成了经过验证的丹麦版修订后的患者对减少用药的态度（rPATD）问卷。患者使用的药物中位数为 8 种（四分位间距 6-12），分别有 88%、49%和 24%的患者使用抗抑郁药、抗精神病药和抗焦虑药。51%的患者报告有内在的愿望停止使用其中一种药物，而 92%的患者愿意根据医生的建议停止使用一种药物。75%的患者担心减少用药后会错过未来的益处，37%的患者有过不良的减少用药经历。使用≥8 种常规药物与对停止用药的更多担忧以及对使用药物的更大感知负担相关，而使用抗精神病药与 rPATD 因子评分的任何差异均无关。卫生保健专业人员必须了解患者的具体关注点和过去的经历，以促进以患者为中心的减少用药方法，该方法需考虑到老年精神障碍患者的需求和偏好。
