Background
Knowledge of decision-making preference of patients and caregivers is needed to facilitate deprescribing. This study aimed to assess the perspectives of caregivers and older adults towards deprescribing in an Asian population. Secondary objectives were to identify and compare characteristics associated with these attitudes and beliefs.
Method
A cross-sectional survey of two groups of participants was conducted using the Revised Patients’ Attitudes Towards Deprescribing questionnaire. Descriptive results were reported for participants’ characteristics and questionnaire responses from four factors (belief in medication inappropriateness, medication burden, concerns about stopping, and involvement) and two global questions. Correlation between participant characteristics and their responses was analyzed.
Results
A total of 1,057 (615 older adults; 442 caregivers) participants were recruited from 10 institutions in Singapore. In which 511 (83.0%) older adults and 385 (87.1%) caregivers reported that they would be willing to stop one or more of their medications if their doctor said it was possible, especially among older adults recruited from acute-care hospitals (85.3%) compared with older adults in community pharmacies (73.6%). Individuals who take more than five medications and those with higher education were correlated with greater agreement in inappropriateness and involvement, respectively.
Conclusions
Clinicians should consider discussing deprescribing with older adults and caregivers in their regular clinical practice, especially when polypharmacy is present. Further research is needed into how to engage older adults and caregivers in shared decision making based on their attitudes toward deprescribing.
As of December 31, 2015, a total of 8,387 liver transplants have been performed in 67 institutions in Japan. There were 8,066 living-donor transplants and 321 cadaveric-donor transplants 318 from heart-beating donor and 3 from non-heart-beating donor. The annual total of liver transplants in 2015 was 448. The number of liver transplants from living-donor decreased to 391, from 419, in 2014, whereas the number of liver transplants from deceaseddonor exceeded 50 for the first time. The most frequent indication was cholestatic disease, followed by neoplastic disease. As for the graft liver in living-donor cases, right-lobe graft was the most popular 35% .
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