https://orcid.org/0000-0002-4140-8657
Abstract
Purpose
To explore how adult patients perceive deprescribing in a country with developing pharmaceutical care.
Patients and Methods
This was a multicenter cross-sectional study conducted in ten community pharmacies across Croatia. Community-dwelling adults 40 years and older, taking at least one prescription medication long term, were invited to participate. The revised and validated Patients’ Attitude Towards Deprescribing Questionnaire was used to investigate community-dwelling adults’ opinions on potential medication discontinuation. Questions regarding the patients’ perception of pharmacist competences and involvement as well as patients’ preferences in deprescribing were added. Collected data were analyzed using IBM SPSS Statistics using descriptive and inferential statistical analysis. Binary logistic regression was used to explore potential predictive factors of willingness to have medication deprescribed. All tests were performed as two-tailed and a p < 0.05 was considered statistically significant.
Results
A total of 315 adults aged 40 years and older completed the questionnaire. Majority of participants, 83.81% (95% CI, 79.72% to 87.90%) stated that they were satisfied with their medications, and 83.81% (95% CI, 79.72% to 87.90%) would be willing to deprescribe one or more medications. Participants expressed a positive attitude toward pharmacists’ competences (68.89%, 95% CI, 63.75% to 74.03%) and involvement in deprescribing (71.11%, 95% CI, 66.08% to 76.14%). Participants who stated specific medication as deprescribing preference were more likely show dissatisfaction with current medication and show greater willingness to have medication deprescribed. Three factors were found to be associated with a positive attitude towards deprescribing: low concerns about stopping factor score (aOR 0.54, 95% CU=0.35–0.84; p=0.006), low appropriateness factor score (aOR 0.62, 95% CI=0.39–0.98; p=0.039), and a positive opinion on pharmacist involvement (aOR 2.35, 95% CI=1.18–4.70; p= 0.016).
Conclusion
This study showed the patient’s willingness for deprescription as well as their positive attitude towards pharmacists being involved in the process. Results favour transition to a patient-centred care and shared-decision making model.
Abbreviations
rPATD, revised Patients’ Attitude towards Deprescribing Questionnaire; NSAID, nonsteroidal anti-inflammatory drug.
Acknowledgments
Tena Tarade, MPharm, Kristina Grgić Petrović, MPharm, Marina Šekerija, MPharm, and Magdalena Mašić, MPharm helped distribute and collect surveys across Croatia.
Author Contributions
Iva Bužančić: Conceptualization, Methodology, Software, Formal analysis, Investigation, Data Curation, Writing – Original Draft, Writing – Review & Editing, Visualization, Project administration. Patricia Dragović: Conceptualization, Investigation, Data Curation, Writing – Original Draft, Formal analysis. Tajana Iva Pejaković: Investigation, Data Curation, Writing – Original Draft. Luka Markulin: Investigation, Data Curation, Writing – Original Draft. Maja Ortner-Hadžiabdić: Conceptualization, Methodology, Resources, Writing – Original Draft, Writing – Review & Editing, Visualization, Supervision, Project administration. All authors contributed to data analysis, drafting, or revising the article, gave final approval of the version to be published, agreed to the submitted journal, and agreed to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.