Association between older adults' socioeconomic status and their healthcare experiences, preferences, and attitudes towards deprescribing: a cross-sectional study in 14 countries.

IF 3.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Archives of Public Health Pub Date : 2025-10-06 DOI:10.1186/s13690-025-01700-6

Renata Vidonscky Lüthold, Esther Kleijer-Werkman, Katharina Tabea Jungo, Zsofia Rozsnyai, Limor Adler, Radost Assenova, Eloísa Rogero-Blanco, Markus Bleckwenn, Thomas Frese, Gilles Henrard, Aisling A Jennings, Donata Kurpas, Vanja Lazic, Heidrun Lingner, Stina Mannheimer, Anne Centeno Neelen, Anabela Pereira, Ferdinando Petrazzuoli, Rosalinde K E Poortvliet, Ágnes Szélvári, Dorothea M G Wild, Sven Streit, Enriqueta Vallejo-Yagüe

{"title":"Association between older adults' socioeconomic status and their healthcare experiences, preferences, and attitudes towards deprescribing: a cross-sectional study in 14 countries.","authors":"Renata Vidonscky Lüthold, Esther Kleijer-Werkman, Katharina Tabea Jungo, Zsofia Rozsnyai, Limor Adler, Radost Assenova, Eloísa Rogero-Blanco, Markus Bleckwenn, Thomas Frese, Gilles Henrard, Aisling A Jennings, Donata Kurpas, Vanja Lazic, Heidrun Lingner, Stina Mannheimer, Anne Centeno Neelen, Anabela Pereira, Ferdinando Petrazzuoli, Rosalinde K E Poortvliet, Ágnes Szélvári, Dorothea M G Wild, Sven Streit, Enriqueta Vallejo-Yagüe","doi":"10.1186/s13690-025-01700-6","DOIUrl":null,"url":null,"abstract":"Background: Socioeconomic status (SES) can influence health outcomes. Both SES and older age are associated with polypharmacy, health literacy, and quality of care. Understanding how SES influences healthcare experiences of older adults with polypharmacy can serve to inform future interventions aiming at optimising patient care. Therefore, we investigated the association between older patients' SES and their i) attitudes towards deprescribing, ii) satisfaction with medications, iii) self-rated health, iv) health literacy, and v) trust in their general practitioner (GP).Methods: In this cross-sectional study, older patients with polypharmacy from 14 countries completed a survey on their attitudes towards deprescribing, healthcare experiences, and sociodemographic characteristics. We compared patients' responses across high (reference), middle, and low SES groups (defined by education and financial status), and performed multilevel logistic regressions adjusted for clustering at the country level to assess the association between patients' SES and the outcomes.Results: Among 1,320 older adults, compared to those with high SES, patients with low SES were more likely to want a medication deprescribed (ORlowSES 1.76, 95%CI 1.20-2.57). Those with medium SES were less likely to trust their GP (ORmediumSES 0.70, 95%CI 0.52-0.94). Both low and medium SES groups were less likely to be satisfied with their current medications (ORlowSES 0.45, 95%CI 0.29-0.71; ORmediumSES 0.63, 95%CI 0.44-0.92), less likely to report good health (ORlowSES 0.22, 95%CI 0.14-0.34; ORmediumSES 0.49, 95%CI 0.37-0.65), and had lower health literacy (ORlowSES 0.10, 95%CI 0.07-0.16; ORmediumSES 0.31, 95%CI 0.24- 0.41).Conclusion: Older adults with lower SES expressed greater interest in deprescribing, lower satisfaction with medications, lower self-rated health, and lower health literacy. Our findings suggest key aspects to consider when optimising care of older adults with low SES.","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"237"},"PeriodicalIF":3.2000,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502375/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Public Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13690-025-01700-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Socioeconomic status (SES) can influence health outcomes. Both SES and older age are associated with polypharmacy, health literacy, and quality of care. Understanding how SES influences healthcare experiences of older adults with polypharmacy can serve to inform future interventions aiming at optimising patient care. Therefore, we investigated the association between older patients' SES and their i) attitudes towards deprescribing, ii) satisfaction with medications, iii) self-rated health, iv) health literacy, and v) trust in their general practitioner (GP).

Methods: In this cross-sectional study, older patients with polypharmacy from 14 countries completed a survey on their attitudes towards deprescribing, healthcare experiences, and sociodemographic characteristics. We compared patients' responses across high (reference), middle, and low SES groups (defined by education and financial status), and performed multilevel logistic regressions adjusted for clustering at the country level to assess the association between patients' SES and the outcomes.

Results: Among 1,320 older adults, compared to those with high SES, patients with low SES were more likely to want a medication deprescribed (OR_lowSES 1.76, 95%CI 1.20-2.57). Those with medium SES were less likely to trust their GP (OR_mediumSES 0.70, 95%CI 0.52-0.94). Both low and medium SES groups were less likely to be satisfied with their current medications (OR_lowSES 0.45, 95%CI 0.29-0.71; OR_mediumSES 0.63, 95%CI 0.44-0.92), less likely to report good health (OR_lowSES 0.22, 95%CI 0.14-0.34; OR_mediumSES 0.49, 95%CI 0.37-0.65), and had lower health literacy (OR_lowSES 0.10, 95%CI 0.07-0.16; OR_mediumSES 0.31, 95%CI 0.24- 0.41).

Conclusion: Older adults with lower SES expressed greater interest in deprescribing, lower satisfaction with medications, lower self-rated health, and lower health literacy. Our findings suggest key aspects to consider when optimising care of older adults with low SES.

Abstract Image

查看原文本刊更多论文

老年人社会经济地位与他们的医疗保健经历、偏好和对处方的态度之间的关系：一项在14个国家进行的横断面研究

背景：社会经济地位（SES）可以影响健康结果。社会经济地位和年龄较大都与综合用药、健康素养和护理质量有关。了解社会经济地位如何影响多药老年人的医疗保健经历，可以为未来旨在优化患者护理的干预措施提供信息。因此，我们调查了老年患者的SES与以下因素之间的关系：1)对处方的态度，2)对药物的满意度，3)自评健康，4)健康素养，以及5)对全科医生的信任。方法：在这项横断面研究中，来自14个国家的老年多药患者完成了一项关于他们对处方的态度、医疗经历和社会人口特征的调查。我们比较了高（参考）、中等和低经济地位组（由教育和经济状况定义）患者的反应，并在国家一级进行了多水平逻辑回归调整，以评估患者经济地位与结果之间的关系。结果：在1320名老年人中，与高SES的患者相比，低SES的患者更有可能需要处方药物（ORlowSES为1.76,95%CI为1.20-2.57）。中等社会经济地位的人不太可能信任他们的家庭医生（ORmediumSES 0.70, 95%CI 0.52-0.94）。中低经济地位组对目前药物治疗的满意度较低（ORlowSES 0.45, 95%CI 0.29-0.71; ORmediumSES 0.63, 95%CI 0.44-0.92），报告健康状况良好的可能性较低（ORlowSES 0.22, 95%CI 0.14-0.34; ORmediumSES 0.49, 95%CI 0.37-0.65），健康素养较低（ORlowSES 0.10, 95%CI 0.07-0.16; ORmediumSES 0.31, 95%CI 0.24- 0.41）。结论：社会经济地位较低的老年人对处方的兴趣更大，对药物的满意度较低，自我评价健康水平较低，健康素养较低。我们的研究结果提出了在优化低社会经济地位老年人护理时需要考虑的关键方面。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Archives of Public Health Medicine-Public Health, Environmental and Occupational Health

CiteScore

4.80

自引率

3.00%

发文量

244

审稿时长

16 weeks

期刊介绍： rchives of Public Health is a broad scope public health journal, dedicated to publishing all sound science in the field of public health. The journal aims to better the understanding of the health of populations. The journal contributes to public health knowledge, enhances the interaction between research, policy and practice and stimulates public health monitoring and indicator development. The journal considers submissions on health outcomes and their determinants, with clear statements about the public health and policy implications. Archives of Public Health welcomes methodological papers (e.g., on study design and bias), papers on health services research, health economics, community interventions, and epidemiological studies dealing with international comparisons, the determinants of inequality in health, and the environmental, behavioural, social, demographic and occupational correlates of health and diseases.