Polypharmacy and medication deprescribing: A survey among multimorbid older adults in Denmark

TY - JOUR

T1 - Polypharmacy and medication deprescribing

T2 - A survey among multimorbid older adults in Denmark

AU - Schiøtz, Michaela L

AU - Frølich, Anne

AU - Jensen, Anette K

AU - Reuther, Lene

AU - Perrild, Hans

AU - Petersen, Tonny S

AU - Kornholt, Jonatan

AU - Christensen, Mikkel B

PY - 2018/12

Y1 - 2018/12

N2 - Polypharmacy is common among multimorbid adults and associated with increased morbidity and mortality. Excessive polypharmacy (ie, ≥10 medicine) is strongly associated with inappropriate medication use, but little is known about attitudes toward deprescribing in patients with excessive polypharmacy. We surveyed 100 Danish individuals aged 65 years and above with ≥10 prescribed medications, using the validated Patients' Attitudes Towards Deprescribing (PATD) instrument. Most participants (81, 81%) thought they took a large number of medications, and 79 (79%) believed that their medications were necessary. Even so, 85 (85%) reported that they would be willing to stop taking one or more of their regular medications if their doctor told them they could, and 11 (11%) felt that they took at least one regular medication that they no longer needed. When presented with visual presentation of various amounts of tablets and capsules, 62 (62%) of participants reported that they would be comfortable taking fewer medications than they did. Forty-two (42%) participants had experience with stopping a regular medication. Almost all participants (92%) wanted to receive follow-up by various means if a medication was discontinued. Forty-one (41%) participants were interested in a consultation at an outpatient clinic specializing in polypharmacy. Overall, the answers to the PATD questionnaire suggest that our cohort of Danish, multimorbid outpatients with extensive polypharmacy have a high confidence in their healthcare providers for medication-related decisions, even though some feel that they are taking more medications than they would like to and feel that some medications may be unnecessary. Our results underline the need for healthcare providers to offer medication reviews in patients with multimorbidity.

AB - Polypharmacy is common among multimorbid adults and associated with increased morbidity and mortality. Excessive polypharmacy (ie, ≥10 medicine) is strongly associated with inappropriate medication use, but little is known about attitudes toward deprescribing in patients with excessive polypharmacy. We surveyed 100 Danish individuals aged 65 years and above with ≥10 prescribed medications, using the validated Patients' Attitudes Towards Deprescribing (PATD) instrument. Most participants (81, 81%) thought they took a large number of medications, and 79 (79%) believed that their medications were necessary. Even so, 85 (85%) reported that they would be willing to stop taking one or more of their regular medications if their doctor told them they could, and 11 (11%) felt that they took at least one regular medication that they no longer needed. When presented with visual presentation of various amounts of tablets and capsules, 62 (62%) of participants reported that they would be comfortable taking fewer medications than they did. Forty-two (42%) participants had experience with stopping a regular medication. Almost all participants (92%) wanted to receive follow-up by various means if a medication was discontinued. Forty-one (41%) participants were interested in a consultation at an outpatient clinic specializing in polypharmacy. Overall, the answers to the PATD questionnaire suggest that our cohort of Danish, multimorbid outpatients with extensive polypharmacy have a high confidence in their healthcare providers for medication-related decisions, even though some feel that they are taking more medications than they would like to and feel that some medications may be unnecessary. Our results underline the need for healthcare providers to offer medication reviews in patients with multimorbidity.

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Cohort Studies

KW - Denmark

KW - Deprescriptions

KW - Drug Prescriptions/statistics & numerical data

KW - Female

KW - Health Services Needs and Demand/statistics & numerical data

KW - Humans

KW - Male

KW - Medication Adherence/statistics & numerical data

KW - Multimorbidity

KW - Surveys and Questionnaires

U2 - 10.1002/prp2.431

DO - 10.1002/prp2.431

M3 - Journal article

C2 - 30386624

SN - 2052-1707

VL - 6

JO - Pharmacology Research & Perspectives

JF - Pharmacology Research & Perspectives

IS - 6

M1 - e00431

ER -