Characteristics of older adults predict concern about stopping medications

Abstract

Objective: To predict the association between demographic, psychological, and medication-specific characteristics and the level of concern about stopping medications among older adults.

Design: Cross-sectional study in which participants read 6 vignettes in which a primary care provider broached the idea of stopping a medication. Medications differed in risk, regulatory status, and indication for discontinuation.

Setting and participants: National Web-based survey distributed to adults aged 65 years or older by Dynata in January 2019.

Outcome measures: Participants reported their concern about stopping each medication (7-point scale, not at all to extremely), their preferences for more versus less care (Medical Maximizer-Minimizer Scale, MMS), medication attitudes (Beliefs about Medicines Questionnaire, BMQ), demographic characteristics, and health literacy. We used a generalized estimating equations population-averaged model to examine characteristics associated with concern about stopping medications among all the vignettes and linear regressions to explore levels of concern for individual vignettes. Regressions included the MMS, BMQ, health literacy, and demographics.

Results: A total of 942 individuals started the survey, and 823 were included in our analysis. Approximately one-half of participants (range: glyburide, 49.5% to aspirin, 56.0%) reported substantial concern (≥ 4 on a 1-7 scale) about stopping each medication. Characteristics that significantly increased concern about stopping medications included female gender, identifying as black or African American, higher MMS score, and higher BMQ specific score. Higher MMS score predicted increased concern about stopping medications for each of the 6 medications.

Conclusion: Characteristics of older adults (e.g., medical maximizing-minimizing preferences), as opposed to medication-specific characteristics, predict concern about stopping medications.