Clinical Interventions in Aging (Jul 2023)
Attitudes of Older Adult Patients and Caregivers Towards Deprescribing of Medications in Ethiopia
Abstract
Diriba Alemayehu Gadisa,1 Esayas Tadesse Gebremariam,1 Getnet Yimer,2,3 Efa Deresa Urgesa4 1Pharmacy Department, College of Medicine and Health Sciences, Ambo University, Ambo, Oromia, Ethiopia; 2Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 3Penn Center for Global Genomics & Health Equity, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 4Contract Director Management Department, Ethiopian Pharmaceutical Supply Service, Addis Ababa, EthiopiaCorrespondence: Diriba Alemayehu Gadisa, Email [email protected]; [email protected]: Deprescribing is essential for reducing inappropriate medication use and polypharmacy. For a holistic approach, it is essential to know how older adult patients and their caregivers perceive deprescribing.Objective: To assess the attitude of older adult patients and caregivers towards deprescribing medication at Ambo University Referral Hospital.Methodology: Institutional-based cross-sectional study was conducted using the revised Patients’ Attitude Towards Deprescribing tool (rPATD). The data was analyzed using the SPSS-25 software. Backward linear regression and logistic regression were used to measure association between outcome and determinant variables. The two-sided P-value ≤ 0.05 with 95% confidence interval was utilized for reporting significant factors.Results: One hundred fifty-six (81.3%) of the respondents (ie, 85.0% of older adult and 77.2% of caregivers) agreed to stop one or more of their regular medications if the physician said it was possible despite 98 (51.0%) of them (ie, 49.0% of older adult and 53.3% of caregivers) being satisfied with their/their care recipient’s medications. On the overall aggregate mean score, the respondents had a neutral position (2.6– 3.59) regarding the burden and concerns of stopping medications whereas the majority of them disagree (1.0– 2.59) with the inappropriateness of the medication they were taking and agreed (3.6– 5.0) with the need for their involvement in treatment decision making. Concerns about stopping medicine scores (AOR = 0.440, 95% CI = 0.262– 0.741, P = 0.035) and perceived levels of medication inappropriateness (AOR = 0.653, 95% CI = 0.456– 0.936, P = 0.020) was significantly associated with the willingness to discontinue and overall satisfaction with their medicine regimen respectively.Conclusion: The majority of older adult patients and caregivers would like to deprescribe if the physicians recommended it. The perceived concerns of stopping and inappropriateness of the medicines were associated with the willingness to deprescribe and overall satisfaction with their medicine respectively. Healthcare providers should prompt the deprescribing process with older adult patients and caregivers by addressing their concerns about stopping medications.Keywords: attitude, caregiver, deprescribing, older adult patients, Ethiopia
