Understanding older patients' willingness to have medications deprescribed in primary care: a protocol for a cross-sectional survey study in nine European countries

Renata Vidonscky Lüthold; Katharina Tabea Jungo; Kristie Rebecca Weir; Anne-Kathrin Geier; Beatrice Scholtes; Donata Kurpas; Dorothea M G Wild; Ferdinando Petrazzuoli; Hans Thulesius; Heidrun Lingner; Radost Assenova; Rosalinde K E Poortvliet; Vanja Lazic; Zsofia Rozsnyai; Sven Streit

doi:10.1186/s12877-022-03562-x

Understanding older patients' willingness to have medications deprescribed in primary care: a protocol for a cross-sectional survey study in nine European countries

BMC Geriatr. 2022 Nov 30;22(1):920. doi: 10.1186/s12877-022-03562-x.

Authors

Renata Vidonscky Lüthold^{1

2}, Katharina Tabea Jungo¹, Kristie Rebecca Weir^{1

3}, Anne-Kathrin Geier⁴, Beatrice Scholtes⁵, Donata Kurpas⁶, Dorothea M G Wild⁷, Ferdinando Petrazzuoli^{8

9}, Hans Thulesius^{10

11}, Heidrun Lingner¹², Radost Assenova¹³, Rosalinde K E Poortvliet^{14

15}, Vanja Lazic¹⁶, Zsofia Rozsnyai¹, Sven Streit¹⁷

Affiliations

¹ Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.
² Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
³ Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
⁴ Department of General Practice, Faculty of Medicine, Leipzig University, Leipzig, Germany.
⁵ Research Unit of Primary Care and Health, Department of General Medicine, Faculty of Medicine, University of Liège, Liège, Belgium.
⁶ Family Medicine Department, Wrocław Medical University, Wrocław, Poland.
⁷ Institute of Family Medicine and General Practice, University Hospital Bonn, Bonn University, Bonn, Germany.
⁸ Sezione SNaMID Caserta, Caserta, Italy.
⁹ Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden.
¹⁰ Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
¹¹ Department of Clinical Sciences, Lund University, Malmö, Sweden.
¹² Hannover Medical School, Center for Public Health and Healthcare, Hannover, Germany.
¹³ Department of Urology and General Practice, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.
¹⁴ University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands.
¹⁵ Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
¹⁶ Health center Zagreb - Centar, Zagreb, Croatia.
¹⁷ Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland. sven.streit@biham.unibe.ch.

Abstract

Introduction: To reduce inappropriate polypharmacy, deprescribing should be part of patients' regular care. Yet deprescribing is difficult to implement, as shown in several studies. Understanding patients' attitudes towards deprescribing at the individual and country level may reveal effective ways to involve older adults in decisions about medications and help to implement deprescribing in primary care settings. In this study we aim to investigate older adults' perceptions and views on deprescribing in different European countries. Specific objectives are to investigate the patients' willingness to have medications deprescribed by medication type and to have herbal or dietary supplements reduced or stopped, the role of the Patient Typology (on medication perspectives), and the impact of the patient-GP relationship in these decisions.

Methods and analysis: This cross-sectional survey study has two parts: Part A and Part B. Data collection for Part A will take place in nine countries, in which per country 10 GPs will recruit 10 older patients (≥65 years old) each (n = 900). Part B will be conducted in Switzerland only, in which an additional 35 GPs will recruit five patients each and respond to a questionnaire themselves, with questions about the patients' medications, their willingness to deprescribe those, and their patient-provider relationship. For both Part A and part B, a questionnaire will be used to assess the willingness of older patients with polypharmacy to have medications deprescribed and other relevant information. For Part B, this same questionnaire will have additional questions on the use of herbal and dietary supplements.

Discussion: The international study design will allow comparisons of patient perspectives on deprescribing from different countries. We will collect information about willingness to have medications deprescribed by medication type and regarding herbal and dietary supplements, which adds important information to the literature on patients' preferences. In addition, GPs in Switzerland will also be surveyed, allowing us to compare GPs' and patients' views and preferences on stopping or reducing specific medications. Our findings will help to understand patients' attitudes towards deprescribing, contributing to improvements in the design and implementation of deprescribing interventions that are better tailored to patients' preferences.

Keywords: Deprescribing; Older adults; Polypharmacy; Primary care; Survey study.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Aged
Cross-Sectional Studies
Europe / epidemiology
Humans
Primary Health Care*
Surveys and Questionnaires
Switzerland

Grants and funding

R24 AG064025/AG/NIA NIH HHS/United States