Patient preference and adherence最新文献

{"title":"Best Evidence Summary of Home Enteral Tube Feeding Care Management in the Elderly.","authors":"Huiya Zhu, Aihua Liu, Zhongyan Han, Yanling Yang, Xiao Ma, Haiyan Shi","doi":"10.2147/PPA.S498890","DOIUrl":"10.2147/PPA.S498890","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and summarize the best evidence of home enteral tube feeding (HETF) care management in the elderly to provide an evidence-based basis for caregivers to implement care interventions.</p><p><strong>Patients and methods: </strong>Evidence on HETF care management in the elderly was retrieved from Chinese and international databases, guidelines, and websites of professional associations, including systematic reviews and expert consensuses, using the keywords of home enteral nutrition, home tube feeding, old, elder, home care, etc. The literature considered in this study was published from April 2019 to April 2024. Two trained researchers independently evaluated the quality of the included literature, graded the literature using the JBI evidence pre-grading system, classified and summarized the extracted evidence.</p><p><strong>Results: </strong>A total of 15 articles were included, including 1 clinical decision, 1 guideline, 3 best evidence summaries, 4 systematic reviews, 2 randomized controlled trials, and 4 quasi-experimental studies. 18 pieces of the best evidence were summarized in 3 aspects, including the NST administration, education of caregivers, and selection of nutrition formulas.</p><p><strong>Conclusion: </strong>This study comprehensively summarized the best evidence of home enteral tube feeding care management in the elderly and provided a scientific basis for caregivers to implement care interventions. In home care settings, using evidence-based practices requires developing a comprehensive care management system based on the trinity of hospital, community and home, in order to reduce the incidence of HETF-related complications, improve the quality of life of the elderly with HETF, and provide a practical reference for NST members and caregivers.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"49-63"},"PeriodicalIF":2.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review Uncovering Modifiable Influences on Statin Adherence.","authors":"Javiera Rosenberg, Smaragda Lampridou, Amelia Moores, Sara Garfield, David Wingfield, Gaby Judah","doi":"10.2147/PPA.S502645","DOIUrl":"https://doi.org/10.2147/PPA.S502645","url":null,"abstract":"<p><p>Statins are effective in reducing cardiovascular disease (CVD) risk, but adherence rates remain low globally. Understanding and addressing modifiable influences on adherence is key to improving outcomes. Existing reviews have methodological limitations, often failing to integrate qualitative and quantitative data or consider specific barriers to statin adherence. This systematic review aimed to identify modifiable barriers and facilitators to statin adherence using the Theoretical Domains Framework (TDF). A comprehensive search of Embase, MEDLINE, PsycINFO, and CINAHL was conducted, covering studies from January 1998 to November 2023. Data were coded to TDF domains and synthesized to identify specific influences on adherence. The nature of the evidence (qualitative or quantitative) was recorded for each influence, and variations among patient groups were noted. Seventy studies from 20 countries were included, with only one focused on ethnic minorities. The most commonly identified domains affecting adherence were \"Beliefs about Consequences\", \"Knowledge\", 'Environmental Context and Resources', and \"Social Influences\". Key factors included knowledge of disease, perceived disease threat, perceived benefits of statins, and patient-provider communication and trust. While side effects had inconsistent associations with adherence, forgetfulness was mainly addressed in quantitative studies, and social influences were highlighted in qualitative research. This review identified modifiable factors that could improve statin adherence. Future research should focus on addressing barriers faced by underrepresented groups to create more inclusive and effective interventions that enhance patient support and communication for better health outcomes.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"19 ","pages":"29-48"},"PeriodicalIF":2.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participation and Compliance in a Multimodal Prehabilitation Program for Colorectal Cancer (PACE): A Qualitative Study.","authors":"Misha A T Sier, Maud P P J Cox, Thaís T T T Tweed, Nick Servaas, Jan Willem M Greve, Jan H M B Stoot","doi":"10.2147/PPA.S481567","DOIUrl":"https://doi.org/10.2147/PPA.S481567","url":null,"abstract":"<p><strong>Purpose: </strong>Interest in prehabilitation, the preoperative enhancement of patients' condition, is rising in the surgical field. Challenging factors appear to be patients' motivation to participate in and their compliance with prehabilitation programs. The aim of this qualitative study was to study the real-life experience of prehabilitation by assessing the lived experience and perceptions of participants in a multimodal prehabilitation program and to explore factors that influence participation and compliance during prehabilitation.</p><p><strong>Methods: </strong>Patients who underwent surgery for colorectal cancer and who had participated in the 4-week multimodal prehabilitation program \"BEFORE\" feasibility study were recruited. Their lived experiences were collected through semi-structured, individual, in-depth interviews. Interviews were transcribed verbatim and analyzed using a thematical approach. As no new information emerged after the interviews, data were considered saturated.</p><p><strong>Results: </strong>Six patients were interviewed. Seven main themes were discussed during the interviews, including information provision, motivation for participation, and content of the program. The results of this study emphasize the importance of adequate patient education, in-hospital exercise with the supervision of physiotherapists, and a patient-centered program. Logistical problems and the impact of cancer diagnosis were most frequently reported as barriers to participation.</p><p><strong>Conclusion: </strong>Participation could be improved by providing adequate information and solving logistical issues. Patient-centeredness of the program is an important feature in improving adherence.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"2709-2720"},"PeriodicalIF":2.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Trade Names on the Misuse of Some Over-The-Counter Drugs and Assessment of Community Knowledge and Attitudes in Alkarak, Jordan.","authors":"Mariam I Shaqfeh, Ahmad R Alsayed, Luai Z Hasoun, Heba A Khader, Malek A Zihlif","doi":"10.2147/PPA.S490277","DOIUrl":"10.2147/PPA.S490277","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the knowledge and attitudes of the community toward the brand names of the most commonly used over-the-counter (OTC) analgesics in Alkarak, Jordan, as well as to assess community's self-medication behaviors that may lead to misuse of OTC drugs.</p><p><strong>Patients and methods: </strong>This is a questionnaire-based cross-sectional study performed between 7 September and 1 October 2023. The total number of recruited participants was 730 adults from Alkarak, Jordan. One-way ANOVA was used to determine the statistical differences among the means of independent groups. The reliability of each question was evaluated using Cronbach's alpha. The Cronbach's alpha was within the accepted range for all questionnaire items (0.7-0.9).</p><p><strong>Results: </strong>Most participants were male (60.3%), with an average age equal to 38 ± 11.06 years, having a bachelor's degree (61.0%) from humanity colleges (43.6%). The highest proportion of the participants were reported to be without chronic diseases and not under chronic medications (57.1%). This study revealed a low knowledge score regarding OTC drug brand names (2.86 ± 0.99 out of five) and unfavorable attitudes toward OTC medicines (2.68 ±1.04 out of five). However, the study finds a significant relationship between the level of education and knowledge and attitude toward OTC drug brand names (p-value < 0.001). Bachelor's holder participants had the lowest knowledge of OTC drug brand names, whereas the worst attitude was reported among below diploma participants. Many participants held misconceptions about OTC drug brand names that lead to consumption of the same drugs under different brand names at the same time; especially OTC analgesics.</p><p><strong>Conclusion: </strong>Low levels of knowledge and unfavorable attitudes regarding OTC drug use from different brand names were reported. Increasing the awareness of the community and enhancing the role of physicians and pharmacists in OTC drug consumption may lead to decrease the misuse of these drugs.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"2697-2708"},"PeriodicalIF":2.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Study on the Real Experiences of Patients with Meige Syndrome Based on the Individual and Family Self-Management Theory.","authors":"Meng Li, Qingmiao Li, Junfan Wei, Yanhong Li, Feng Liu, Shen Li, Ning Zhang, Ruipeng Song, Qiong Li, Jing Cao","doi":"10.2147/PPA.S484296","DOIUrl":"10.2147/PPA.S484296","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the real experiences of patients with Meige Syndrome, which is an idiopathic dystonia, during the perioperative period and to explore the practical application and effectiveness of Individual and Family Self-Management Theory (IFSMT) in improving patient experiences.</p><p><strong>Methods: </strong>A qualitative descriptive research methodology was employed to elucidate the intricate psychological and social experiences encountered by patients with Meige Syndrome throughout the perioperative phase. This study conduct face-to-face, one-on-one, semi-structured interviews with 16 Meige Syndrome patients to gain an in-depth understanding of the patients' true feelings and needs. Interview data were organized and analyzed using Colaizzi's method, and themes were refined in conjunction with IFSMT to reveal patients' self-management practices and influencing factors.</p><p><strong>Results: </strong>Through in-depth analysis using Colaizzi's method and the application of IFSMT to the perioperative experiences of patients with Meige Syndrome, and reported according to COREQ standards, three core themes were identified: (1) Context Dimension (specific disease factors, physical and social environmental factors, personal and family factors), (2) Process Dimension (knowledge and beliefs, self-regulation and self-efficacy, social facilitation), and (3) Outcome Dimension (proximal and distal outcomes of self-management behaviors).</p><p><strong>Conclusion: </strong>This study demonstrates that IFSMT has significant application value in the perioperative experiences of patients with Meige Syndrome. Enhancing patients' knowledge, beliefs, self-regulation abilities, and social support can promote effective self-management behaviors, thereby improving their quality of life and health status. Additionally, the study reveals the complexity of self-management in perioperative patients, emphasizing the importance of interdisciplinary collaboration and comprehensive interventions in enhancing patient experiences. Future research can further explore how to apply these theories in clinical practice to optimize perioperative management and rehabilitation processes for patients with Meige Syndrome.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"2681-2696"},"PeriodicalIF":2.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to ADA Clinical Guidelines in Type 2 Diabetes Management in Public Health Clinics in Palestine.","authors":"Abdallah Damin Abukhalil, Sana Ali Muhanna, Misk Najih Madi, Ni'meh Al-Shami, Hani A Naseef, Abdullah K Rabba","doi":"10.2147/PPA.S494951","DOIUrl":"10.2147/PPA.S494951","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of type 2 diabetes is a significant global public health concern. Adherence to established guidelines is essential for effective management of this metabolic disease.</p><p><strong>Objective: </strong>This study aimed to evaluate the current practices of physicians in Palestine regarding their adherence to ADA guidelines for type 2 diabetes management.</p><p><strong>Methods: </strong>A retrospective, cross-sectional, multicenter study was conducted by reviewing patients' medical records. This study included 362 patients aged ≥ 18 years diagnosed with type 2 diabetes for at least one year and receiving treatment at multiple outpatient clinics in Palestine. Adherence to ADA guidelines was assessed by selecting an appropriate antidiabetic agent based on patient confounding factors and comorbidities, frequency of diabetes monitoring, screening, glycemic control, and optimization of hypertension and dyslipidemia medication.</p><p><strong>Results: </strong>Half of the participants were female. 53% of the participants did not achieve their A1c target goal. Adherence to ADA guidelines for selecting the preferred antidiabetic medication was only 32.22%. Very low adherence to prescribing GLP1 agonists (0.5%) and SGLT2 inhibitors (7%) when indicated. Biguanides were the most prescribed medications (83.1%), followed by sulfonylurea (35.1%), and insulin (28.2%). Only 43% and 66% of the patients were on appropriate lipid and hypertension medications, respectively, as recommended by ADA guidelines. Foot assessment and eye examinations were performed in only 27% and 55% of the patients, respectively. Age, atherosclerotic cardiovascular disease, and sulfonylurea use were significantly associated with lower glycemic control.</p><p><strong>Conclusion: </strong>This study demonstrated that Adherence to ADA guidelines for diabetes management is suboptimal in selecting appropriate antidiabetic medication based on patient confounding factors, potentially contributing to the high prevalence of complications and comorbidities observed in patients with diabetes in Palestine. Medical associations and health institutions must adopt programs to increase professional education and awareness of the current guidelines to improve outcomes.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"2667-2680"},"PeriodicalIF":2.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Psychological Insulin Resistance and Dyadic Coping on Insulin Medication Adherence in Elderly Diabetes Patients and Their Spouses: A Latent Profile Analysis.","authors":"Yuanhong Wu, Huijing Xu, Yuxin Wang, Xiaohui Wang, Shanyu Wu","doi":"10.2147/PPA.S489408","DOIUrl":"10.2147/PPA.S489408","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the characteristics of psychological insulin resistance and dyadic coping in elderly diabetic patients and their spouses, and their association with insulin medication adherence.</p><p><strong>Design: </strong>Observational, cross-sectional study.</p><p><strong>Methods: </strong>A convenience sampling method selected 300 elderly diabetic patient-spouse pairs from a community. Data were collected using general information questionnaires, the My Views on Insulin questionnaire, Dyadic Coping questionnaire, and ARMS refill and medication adherence questionnaire. Latent Profile Analysis (LPA) was used to categorize the \"psychological-coping\" patterns of psychological insulin resistance and dyadic coping among these pairs. Multiple linear regression analysis identified factors influencing insulin medication adherence.</p><p><strong>Results: </strong>Four latent classes were identified: patients and spouses with low resistance-high coping (30.3%), patients with low resistance-moderate coping and spouses with high resistance-low coping (16.3%), patients with high resistance-moderate coping and spouses with moderate resistance-high coping (33.7%), patients and spouses with high resistance-low coping (19.7%). Multiple linear regression analysis showed that the number of chronic diseases a patient has, the use of oral hypoglycemic agents, family per capita monthly income, and latent classes of psychological insulin resistance and dyadic coping significantly affected insulin medication adherence (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>It is crucial to consider the psychological insulin resistance and dyadic coping of both patients and their spouses, include both in health plans, and develop comprehensive intervention strategies that address the couple as a unit.</p><p><strong>Implications for the profession and/or patient care: </strong>This study informs healthcare professionals by raising awareness of the different \"psychological-coping\" characteristics between elderly diabetic patients and their spouses, with insulin medication adherence and reducing the likelihood of readmission.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"2647-2655"},"PeriodicalIF":2.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conceptualizing the Facilitators and Barriers of Successful Multidisciplinary Teamwork Within the Reablement Process: A Scoping Review.","authors":"Craig Gibson, Michel D Landry, Hanne Tuntland","doi":"10.2147/PPA.S504007","DOIUrl":"10.2147/PPA.S504007","url":null,"abstract":"<p><strong>Background: </strong>As the global population ages, there is increasing pressure on health systems to provide high-quality and cost-effective care for this growing segment of the population. Reablement, primarily a strategic home-based rehabilitation approach, has been demonstrated to be a cost-effective, multidisciplinary, holistic, and person-centred approach to maintaining functional independence as one ages. Given that care delivery in the home setting for older persons is complex, a key feature of effective implementation of reablement is the integration of a multidisciplinary team.</p><p><strong>Objective: </strong>The primary objective of this study was to identify the facilitators and barriers that lead to successful teamwork in a multidisciplinary reablement team setting.</p><p><strong>Methods: </strong>Scoping review approach was used in this study to determine trends, and mapping themes prevalent in the peer-reviewed literature. Eligible articles were sourced from four electronic databases, and data were extracted, coded, analyzed and chartered in February 2024.</p><p><strong>Results: </strong>Twenty studies were included in this study. Six main themes were identified: (1) multidisciplinary teamwork for quality service development, (2) dynamics of multidisciplinary collaboration, (3) professional autonomy and reflective practice, (4) towards a flat organizational structure and shared goals, (5) openness and flexibility of developing new cultures, and (6) open and frequent communication for success. Each of the themes can exert a facilitating or/and inhibiting effect depending on the context.</p><p><strong>Conclusion: </strong>The findings indicate that multidisciplinary teamwork in reablement settings is diverse, complex, and situational. In this paper, we propose a conceptual model that integrates each theme as a way to understand the complexity and interconnectedness of the themes along the quest for greater multidisciplinary teamwork in reablement. Given the positive outcomes of both service consumers and providers, amplification of multidisciplinary teamwork within reablement holds the promise of effective care for older persons in a time of growing service demands.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"2621-2635"},"PeriodicalIF":2.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Stellate Ganglion Block Combined with Pharmacological Treatment for Rosacea: A Report of Two Cases.","authors":"Changjian Gao, Fang Wang, Lulu Zhou, Weiwei Zhan, Rui Min","doi":"10.2147/PPA.S484601","DOIUrl":"10.2147/PPA.S484601","url":null,"abstract":"<p><p>Rosacea is a chronic inflammatory disease primarily affecting the central facial region, significantly involving the facial blood vessels and the sebaceous gland units associated with hair follicles. The stellate ganglion block (SGB) technique can restore balance to autonomic nervous function by interrupting the impulse conduction of preganglionic and postganglionic sympathetic nerve fibers, thereby alleviating excessive peripheral blood vessel contraction, enhancing tissue blood supply, balancing hormone secretion, and modulating immune responses. SGB has demonstrated remarkable efficacy in treating various skin conditions affecting the head, face, and neck. In our case study, two patients with a disease duration exceeding six months underwent treatment involving oral medications, topical applications, and local cold spray, which yielded unsatisfactory results. Subsequently, our department employed the SGB method guided by multiple ultrasound assessments, resulting in nearly complete resolution of the intractable rosacea lesions in both patients.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"2657-2666"},"PeriodicalIF":2.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Attitudes Toward Polypharmacy and Willingness to Deprescribe Among Patients with Multimorbidity in Rural Areas of Shandong Province in China: A Cross-Sectional Study.","authors":"Xi Liu, Yang Zhao, Tianya Da, Shilong Zhang, Haipeng Wang, Hui Li","doi":"10.2147/PPA.S498472","DOIUrl":"10.2147/PPA.S498472","url":null,"abstract":"<p><strong>Purpose: </strong>Multimorbidity and polypharmacy have emerged as significant global issues, heightening the risks of potentially inappropriate medications (PIMs). This necessitates medication optimization through deprescribing. Understanding patients' decision-making preferences regarding medication cessation is crucial for mitigating medication-related risks. This study aims to capture the attitude of patients with multimorbidity towards deprescribing in rural China and to ascertain whether individual characteristics were linked to these attitudes.</p><p><strong>Patient and methods: </strong>A cross-sectional study employing the validated Patients' Attitudes Towards Deprescribing (PATD) questionnaire was performed in rural regions of Eastern China. The PATD Questionnaire was utilized to investigate patients' attitudes towards the concurrent use of multiple medications, with response elicited on a 5-point Likert scale. Utilizing multistage random sampling, a total of 560 participants with multimorbidity were randomly selected from two counties in Shandong Province. Descriptive statistics were reported on participant characteristics. Binary logistic regression analysis was conducted to identify the factors that influenced participants' willingness to discontinue or reduce their medication.</p><p><strong>Results: </strong>The median age of patients was 69.5 years (SD=8.2 years), and 314 were female. Nearly one in four patients experienced polypharmacy, while 42.2% had two chronic diseases. More than half of the participants (55.2%) reported that they would be willing to stop one or more medications if their physicians agreed, and 52.9% of participants agreed to reduce the medications taken. Participants with two chronic conditions (OR=3.038, 95% CI=1.342-6.881), taking less than 10 tablets (OR=2.994, 95% CI=1.113-8.054), having their own source of healthcare expenditure (OR=0.639, 95% CI=0.432-0.945), and hospitalization in the prior year (OR=0.636, 95% CI=0.429-0.944) were significantly associated with patients' attitudes toward deprescribing.</p><p><strong>Conclusion: </strong>Over half of patients with multimorbidity expressed a willingness to have one or more of their medicines deprescribed. Physicians can be trained in the integrated care of chronic diseases and encouraged to engage in discussions about deprescribing with patients having multimorbidity and polypharmacy during their routine practice.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"2637-2646"},"PeriodicalIF":2.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}