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Geriatric medicine
Research
Older patients’ perception of deprescribing in resource-limited settings: a cross-sectional study in an Ethiopia university hospital
  1. Henok Getachew Tegegn1,
  2. Yonas Getaye Tefera1,
  3. Daniel Asfaw Erku1,
  4. Kaleab Taye Haile2,
  5. Tamrat Befekadu Abebe1,3,
  6. Fasil Chekol1,
  7. Yonas Azanaw1,
  8. Asnakew Achaw Ayele1
  1. 1 Department of Clinical Pharmacy, University of Gondar, Gondar, Ethiopia
  2. 2 Department of Pharmaceutics and Social Pharmacy, University of Gondar, Gondar, Ethiopia
  3. 3 Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institute, Solna, Sweden
  1. Correspondence to Henok Getachew Tegegn; heniget{at}gmail.com

Abstract

Objective To assess older patients’ attitude towards deprescribing of inappropriate medications.

Design This was an institutional-based, quantitative, cross-sectional survey.

Setting Outpatient clinics of the University of Gondar Referral and Teaching Hospital in Ethiopia.

Participants Patients aged 65 or older with at least one medication were enrolled in the study from 1 March to 30 June 2017. Excluded patients were those who had severe physical or psychological problems and who refused to participate.

Main outcome measures Older patients’ attitude towards deprescribing was measured using a validated instrument, ‘the revised Patients’ Attitudes towards Deprescribing’ (rPATD) tool for older patients. Data were collected on sociodemographic characteristics and clinical data such as comorbidity and polypharmacy, and the main outcome was older patients’ willingness to deprescribe inappropriate medications.

Results Of the 351 eligible participants, 316 patients completed the survey. Of the 316 patients, 54.7% were men and were taking a median of 3 (IQR: 2–4) medications daily. Overall, most of the participants (92.1%; 95% CI 89% to 95%) were satisfied with the medications they were taking; however, still a significant number of participants (81.6%; 95% CI 77% to 86%) were willing to stop one or more of their medications if possible and agreed by their doctors. This willingness was correlated with seven items of the rPATD, including a strong correlation with the overall satisfaction of patients with the medications taken.

Conclusion Many older patients have shown their willingness to reduce one or more of their medications if their doctors said it was possible. Healthcare providers should be proactive in discussing and evaluating potentially inappropriate medications for better clinical decision making.

  • attitude
  • medication discontinuation
  • deprescribing
  • polypharmacy
  • elderly
  • rpatd

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-020590

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    Footnotes

    • Contributors HGT has contributed to the conception and study design, prepared the study protocol, and drafted the manuscript. YGT and DAE performed the literature review, carried out statistical analyses and interpreted the results. FC and YA acquired and managed the data. KTH, TBA and AAA wrote the manuscript and reviewed the manuscript for critical revisions. All authors approved the final manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval This study was approved by the Ethical Committee of the School of Pharmacy, University of Gondar, with the approval number UoG-SoP-131/2017.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.