Development and Validation of the Revised Patients’ Attitudes Towards Deprescribing (rPATD) Questionnaire: Versions for Older Adults and Caregivers

Reeve, Emily; Low, Lee‐Fay; Shakib, Sepehr; Hilmer, Sarah N.

doi:10.1007/s40266-016-0410-1

Cited by 141 publications

(232 citation statements)

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“…No identifying information was collected for participants (ie, the questionnaire was anonymous). This article reports a preplanned secondary analysis of the data used to inform the development and validation of the rPATD …”

Section: Methodsmentioning

confidence: 99%

“…Caregivers in this study were individuals who play any role in a family member or friend's management of health/medications in an informal or unpaid manner (individuals receiving financial support from the government for informal caregiving activities were still eligible). Returned questionnaires (by mail or submitted online) had to have at least 50% of the questions completed to be included in the analysis as per requirements for completing the validation process …”

Section: Methodsmentioning

confidence: 99%

“…Third, there was no version for caregivers who play a large role in the management of medications of older adults, especially for those living with dementia. As such, a revised PATD (rPATD) questionnaire was developed and validated in Australia to address these limitations (previously described) …”

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confidence: 99%

“…The rPATD contains two global questions and four factors in both the older adult and caregiver versions: perceived burden of medications, belief in appropriateness of medications, concerns about stopping, and involvement in medication management . These are the global questions: “If my doctor said it was possible I would be willing to stop one or more of my regular medicines” and “Overall, I am satisfied with my current medicines.” The factors closely align with qualitative investigations into the beliefs and attitudes of older adults and caregivers about medications and deprescribing .…”

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confidence: 99%

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Attitudes of Older Adults and Caregivers in Australia toward Deprescribing

Reeve

Low

Hilmer

2019

J American Geriatrics Society

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104

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BACKGROUND/OBJECTIVES Use of harmful and/or unnecessary medications in older adults is common. Understanding older adult and caregiver attitudes toward deprescribing will contribute to medication optimization in practice. The aims of this study were to capture the attitudes and beliefs of older adults and caregivers toward deprescribing and determine what participant characteristics and/or attitudes (if any) predicted reported willingness to have a medication deprescribed. DESIGN Self‐completed questionnaire. SETTING Australia. PARTICIPANTS Older adults (n = 386), 65 years or older, taking one or more regular prescription medications and caregivers of older adults (n = 205) who could self‐complete a written questionnaire in English. MEASUREMENTS Older adult and caregiver versions of the validated revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire were completed. The rPATD includes two global questions and four factors: perceived burden of medications, belief in appropriateness of medications, concerns about stopping, and involvement in medication management. Participant characteristics, self‐rated health, trust in physician, and health autonomy were also collected. RESULTS Older adult participants had a median age of 74 years (interquartile range [IQR] = 70‐81 y), and caregivers were aged 67 years (IQR = 59‐76) and were caring for a person aged 81 years (IQR = 75‐86.25 y). Most of both older adults (88%) and caregivers (84%) agreed or strongly agreed that they would be willing to stop one or more of their or their care recipient's medications if their or their care recipient's doctor said it was possible. In a binary logistic regression model, a low concern about stopping factor score was the strongest predictor of willingness to have a medication deprescribed in older adults (odds ratio [OR] = 0.12; 95% confidence interval [CI] = 0.04‐0.34). Excellent/good rating of physical health was the strongest predictor in caregivers (OR = 3.71; 95% CI = 1.13‐12.23). CONCLUSIONS Most older adults and caregivers are willing to have one of their or their care recipient's medication deprescribed, although different predictors (characteristics/attitudes) of this willingness were identified in these two groups.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Attitudes of Older Adults and Caregivers in Australia toward Deprescribing

Reeve

Low

Hilmer

2019

J American Geriatrics Society

Self Cite

104

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“…The results suggested that many older people would like to reduce the number of medicines they take and were less aware of reasons for medication 5. Key factors identified included perceived burden of medication taking, belief in appropriateness of medication use (harms and benefits), concerns about stopping the medication and level of involvement/knowledge of medications 6. Another study by Linsky et al identified four factors which include medication knowledge, concerns and importance as well as interest in stopping medication 7.…”

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confidence: 99%

Deprescribing one year on: challenging the first iatrogenic epidemic

Barnett

Garfinkel²

2018

Eur J Hosp Pharm

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Assessment of Attitudes Toward Deprescribing in Older Medicare Beneficiaries in the United States

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and/or unnecessary medications in older adults is prevalent. This can lead to avoidable harms such as adverse drug reactions, falls, hospitalization, and mortality. Primary care physicians report that patient resistance to discontinuing medication use is a significant barrier to deprescribing. OBJECTIVE To describe the attitudes of older adults toward deprescribing and to determine whether individual characteristics are associated with these attitudes. DESIGN, SETTING, AND PARTICIPANTS For this population-based survey study of US Medicare beneficiaries 65 years and older, data were obtained from the Medication Attitudes module fielded through in-person interviews in round 6 of the National Health and Aging Trends Study (weighted response rate of round 6 was 88.5%). The questions in this module were drawn from the Patients' Attitudes Towards Deprescribing questionnaire and its revised version. The Medication Attitudes module was fielded to a random one-third (n = 2124) of the National Health and Aging Trends Study participants (weighted response rate of this module was 94.8%). MAIN OUTCOMES AND MEASURES Responses to 2 statements ("If my doctor said it was possible, I would be willing to stop one or more of my regular medicines" and "I would like to reduce the number of medicines I am taking") were the main outcomes of interest. RESULTS Of the 1981 Medicare beneficiaries included in the study, 1149 (55.2%, weighted) were women, and the majority (n = 715 [54.6%, weighted]) were 65 to 74 years old. A total of 1752 (92.0%, weighted) older adults reported being willing to stop taking 1 or more of their medicines if their physician said it was possible, and 1241 (66.6%, weighted) older adults wanted to reduce the number of medicines that they were taking. Older adults taking 6 or more medications had greater odds than those taking fewer than 6 medications of being willing to stop taking 1 or more of their medicines (adjusted odds ratio, 2.90; 95% CI, 1.74-4.82) and wanting to reduce the number of medicines that they were taking (adjusted odds ratio, 2.31; 95% CI, 1.71-3.13). CONCLUSIONS AND RELEVANCE Physicians considering deprescribing as part of comprehensive, patient-centered care should be reassured that a majority of older Americans are open to having 1 or more of their medicines deprescribed if their physician says it is possible, and more than two-thirds want to reduce the number of medicines that they are taking.

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Development and Validation of the Revised Patients’ Attitudes Towards Deprescribing (rPATD) Questionnaire: Versions for Older Adults and Caregivers

Abstract: The revised PATD questionnaire had acceptable validity and reliability. This newly validated questionnaire may provide insight into individuals' willingness for/barriers to deprescribing, with applications in practice and research.

Cited by 141 publications

References 44 publications

Attitudes of Older Adults and Caregivers in Australia toward Deprescribing

Attitudes of Older Adults and Caregivers in Australia toward Deprescribing

Deprescribing one year on: challenging the first iatrogenic epidemic

Assessment of Attitudes Toward Deprescribing in Older Medicare Beneficiaries in the United States

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