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- The Elderly’s Thoughts and Attitudes about Polypharmacy and Deprescribing: A Qualitative Pilot Study in PortugalPublication . Simões, Pedro Augusto Gomes Rodrigues Marques; Foreman, Nicole; Xavier, Beatriz de Oliveira; Prazeres, Filipe; Maricoto, Tiago; Santiago, Luiz Miguel de Mendonça Soares; Simões, José Augusto RodriguesThe high prevalence of polypharmacy and potentially inappropriate medications in the elderly makes them a vulnerable group to adverse drug events. Deprescribing is the medication review plus cessation of potentially inappropriate medications with a health professional’s help. Several barriers and enablers influence it, and its knowledge can help health professionals. The objective of the study is to understand the Portuguese elderly’s attitudes and ideas about polypharmacy and deprescription. We made a qualitative approach through a focus group with elderly patients from an adult daycare center with transcription and codification into themes and subthemes based on previous frameworks. Eleven elderly patients participated in the focus group. The identified elderly’s ideas and attitudes could be clustered into five main barriers: appropriateness, process, influences, fear, and habit, and five main enablers: appropriateness, process, influences, dislike, and cost. Although the elderly’s strong beliefs regarding medication benefits and necessity prevail, contrary opinions regarding lack of benefit/necessity, drug interaction/side effects, and medication complexity/number may influence their willingness to deprescribe positively. The health professional’s influence and the patient’s trust in their doctors were perceived essential for decision-making as either a barrier or an enabler. The medication benefit was a big barrier, and side effects/drug interaction experiences are an important enabler.
- Elderly patients and the idea of having medication deprescribed: a mixed method study in Portuguese primary health carePublication . Simões, Pedro Augusto Gomes Rodrigues Marques; Santiago, Luiz Miguel de Mendonça Soares; Xavier, Beatriz de OliveiraIntroduction Deprescribing is the process of tapering or stopping medications aiming at improving patient outcomes and optimising current therapy. Some studies tried to identify which patients will have inappropriate medication deprescribed, but none found any association with sociodemographic and clinical characteristics, number of prescribed medications or time length. Our aim was to determine Portuguese elderly patients’ attitudes and beliefs regarding medication use and their willingness to have regular medications deprescribed. Material and methods We conducted a cross-sectional study in triangulation in primary care centres from mainland Portugal and its autonomous regions. We used a random sample of 386 polymedicated older adult patients that answered the questionnaire between October 2018 and February 2019. For the quantitative analysis, we used sociodemographic characteristics, clinical profile and medication. For the qualitative analysis, we studied an included open-question by coding participants’ answers, common codes were grouped together. Convergent mixed methods design was performed. Results 74.0% expressed the belief that medicines were generally beneficial. 19.9% reported a strong belief that medicines were harmful and 33.4% that they were overused. 61.8% were against the idea of deprescribing and 24.6% were in favour of deprescription. Those against the idea had lower education level (p=0.006) and a higher number of self-perceived morbidities (p=0.001) than those not against it. Conclusions Medication benefits were accepted by the majority of patients who also were against the idea of deprescribing. It is important that doctors are aware of this reality, namely in the primary care setting. Addressing the patients’ fears and beliefs and making the deprescribing process possible.