Understanding older patients’ willingness to have medications deprescribed in primary care: a protocol for a cross-sectional survey study in nine European countries

BMC Geriatrics

Study Protocol

Anne-Kathrin Geier¹  Hans Thulesius²  Radost Assenova³  Donata Kurpas⁴  Heidrun Lingner⁵  Vanja Lazic⁶  Dorothea M. G. Wild⁷  Zsofia Rozsnyai⁸  Katharina Tabea Jungo⁸  Sven Streit⁸  Renata Vidonscky Lüthold⁹  Kristie Rebecca Weir^1,10  Beatrice Scholtes^1,11  Ferdinando Petrazzuoli^1,12  Rosalinde K. E. Poortvliet^1,13 

[1] Department of General Practice, Faculty of Medicine, Leipzig University, Leipzig, Germany;Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden;Department of Clinical Sciences, Lund University, Malmö, Sweden;Department of Urology and General Practice, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria;Family Medicine Department, Wrocław Medical University, Wrocław, Poland;Hannover Medical School, Center for Public Health and Healthcare, Hannover, Germany;Health center Zagreb – Centar, Zagreb, Croatia;Institute of Family Medicine and General Practice, University Hospital Bonn, Bonn University, Bonn, Germany;Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland;Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland;Graduate School for Health Sciences, University of Bern, Bern, Switzerland;Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland;Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia;Research Unit of Primary Care and Health, Department of General Medicine, Faculty of Medicine, University of Liège, Liège, Belgium;Sezione SNaMID Caserta, Caserta, Italy;Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden;University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands;Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands;

关键词: Deprescribing;    Polypharmacy;    Primary care;    Survey study;    Older adults;   

DOI  :  10.1186/s12877-022-03562-x

 received in 2022-05-27, accepted in 2022-10-25,  发布年份 2022

来源: Springer

【 摘 要 】

IntroductionTo reduce inappropriate polypharmacy, deprescribing should be part of patients’ regular care. Yet deprescribing is difficult to implement, as shown in several studies. Understanding patients’ attitudes towards deprescribing at the individual and country level may reveal effective ways to involve older adults in decisions about medications and help to implement deprescribing in primary care settings. In this study we aim to investigate older adults’ perceptions and views on deprescribing in different European countries. Specific objectives are to investigate the patients’ willingness to have medications deprescribed by medication type and to have herbal or dietary supplements reduced or stopped, the role of the Patient Typology (on medication perspectives), and the impact of the patient-GP relationship in these decisions.Methods and analysisThis cross-sectional survey study has two parts: Part A and Part B. Data collection for Part A will take place in nine countries, in which per country 10 GPs will recruit 10 older patients (≥65 years old) each (n = 900). Part B will be conducted in Switzerland only, in which an additional 35 GPs will recruit five patients each and respond to a questionnaire themselves, with questions about the patients’ medications, their willingness to deprescribe those, and their patient-provider relationship. For both Part A and part B, a questionnaire will be used to assess the willingness of older patients with polypharmacy to have medications deprescribed and other relevant information. For Part B, this same questionnaire will have additional questions on the use of herbal and dietary supplements.DiscussionThe international study design will allow comparisons of patient perspectives on deprescribing from different countries. We will collect information about willingness to have medications deprescribed by medication type and regarding herbal and dietary supplements, which adds important information to the literature on patients’ preferences. In addition, GPs in Switzerland will also be surveyed, allowing us to compare GPs’ and patients’ views and preferences on stopping or reducing specific medications. Our findings will help to understand patients’ attitudes towards deprescribing, contributing to improvements in the design and implementation of deprescribing interventions that are better tailored to patients’ preferences.

【 授权许可】

CC BY   
© The Author(s) 2022