The Patient Typology about deprescribing and medication-related decisions: A quantitative exploration.
The Patient Typology about deprescribing and medication-related decisions: A quantitative exploration.
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关于取消处方和药物相关决策的患者类型学：定量探索。
DOI：
10.1111/bcpt.13911
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发表时间：
2024
影响因子：
3.1
通讯作者：
Jungo,KatharinaTabea
中科院分区：
文献类型：
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作者：
Weir,KristieRebecca;Scherer,AaronM;Vordenberg,SarahE;Streit,Sven;Jansen,Jesse;Jungo,KatharinaTabea
本研究旨在测试我们定性开发的患者类型的定量测量的充分性-老年人对药物和药物决策的态度类别-并确定与每个类型相关的特征。我们对澳大利亚、英国、美国和荷兰（n= 4688）在线调查小组成员中的成年人（≥65岁）的调查项目测量子集进行了二次数据分析。多项logistic回归分析评估了人口统计学、心理社会学和药物相关指标之间的相关性。平均年龄为71.5（5）岁，47.5%的参与者为女性。与类型1“依赖于药物”而非类型2“不依赖于处方”的认同可能性增加相关的因素是对多种药物的积极态度（RRR = 1.12，p = <0.001）和对确定性的更高需求（RRR = 1.11，p = 0.039）。与类型3“推迟（药物决策）到他人”的可能性增加相关的因素是年龄较大（RR = 1.47每10岁的年龄增长，p= <0.001）和先前取消处方经验的可能性降低（RR = 0.73，p = 0.033）。本研究使用来自四个国家的大样本验证了类型学，定量测量的类型学通常与定性分类相一致。我们的患者类型测量提供了一种简洁的方法，研究人员可以评估对取消处方的态度。
This study aimed to test the adequacy of a quantitative measure of our qualitatively developed Patient Typology—categories of older adults' attitudes towards medicines and medicine decision‐making—and identify characteristics associated with each Typology. We conducted secondary data analyses of a subset of survey item measures of adults (≥65 years) who were members of online survey panels in Australia, the United Kingdom, the United States and the Netherlands (n= 4688). Multinomial logistic regression analyses assessed associations between demographic, psychosocial and medication‐related measures. Mean age was 71.5 (5), and 47.5% of participants were female. Factors associated with an increased likelihood of identifying with Typology 1 ‘Attached to medicines’ over Typology 2 ‘Open to deprescribing’ were higher positive attitude towards polypharmacy (RRR = 1.12,p= <0.001) and higher need for certainty (RRR = 1.11,p= 0.039). Factors associated with an increased likelihood of identifying with Typology 3 ‘Defers (medication decision‐making) to others’ over Typology 2 were older age (RRR = 1.47 per 10‐year age increase,p= <0.001) and a decreased likelihood of prior deprescribing experience (RRR = 0.73,p= 0.033). This study provides validation of the Typology with large samples from four countries, with the quantitatively‐measured typologies generally aligning with the qualitatively derived categories. Our Patient Typology measure provides a succinct way researchers can assess attitudes towards deprescribing.