Exploring Patients' Attitudes Toward Deprescribing and Their Perception of Pharmacist Involvement in a European Country: A Cross-Sectional Study.
Exploring Patients' Attitudes Toward Deprescribing and Their Perception of Pharmacist Involvement in a European Country: A Cross-Sectional Study.
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DOI：
10.2147/ppa.s323846
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发表时间：
2021
影响因子：
2.2
通讯作者：
Ortner-Hadžiabdić M
中科院分区：
文献类型：
--
作者：
Bužančić I;Dragović P;Pejaković TI;Markulin L;Ortner-Hadžiabdić M
探讨在发展药学服务的国家，成年患者如何看待取消处方。这是一项在克罗地亚10个社区药房进行的多中心横断面研究。40岁及以上的社区居民，长期服用至少一种处方药，被邀请参加。修订和验证的患者对停药的态度问卷被用来调查社区居民的成年人对潜在的停药的意见。增加了关于患者对药剂师能力和参与的看法以及患者在取消处方方面的偏好的问题。使用IBM SPSS Statistics使用描述性和推断性统计分析对收集的数据进行分析。二元逻辑回归分析被用来探索潜在的预测因素的意愿有药物处方。所有检验均作为双尾进行，p <0.05被认为是统计学显著的。共有315名40岁及以上的成年人完成了问卷调查。83.81%（95% CI，79.72%至87.90%）的大多数受试者表示他们对药物感到满意，83.81%（95% CI，79.72%至87.90%）的受试者愿意停用一种或多种药物。参与者对药师的能力（68.89%，95% CI，63.75%至74.03%）和参与取消处方（71.11%，95% CI，66.08%至76.14%）表示积极的态度。声明特定药物为取消处方偏好的参与者更有可能对当前药物表示不满，并表现出更大的意愿取消药物处方。三个因素被发现与对停药的积极态度有关：对停药因素评分的低关注（aOR 0.54，95% CU = 0.35 - 0.84; p = 0.006），适当性因子评分低（aOR 0.62，95% CI = 0.39 - 0.98; p = 0.039），以及对药剂师参与的积极看法（aOR 2.35，95% CI = 1.18 - 4.70; p = 0.016）。本研究显示病人愿意取消处方，以及他们的积极态度，药剂师参与的过程。结果有利于过渡到以病人为中心的护理和共享决策模式。
To explore how adult patients perceive deprescribing in a country with developing pharmaceutical care. 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. 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). 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.