Attitudes toward deprescribing among adults with heart failure with preserved ejection fraction.
Academic Medical Centers
Aged
Aged, 80 and over
Attitude to Health
Deprescriptions
Female
Frail Elderly
/ psychology
Frailty
/ drug therapy
Heart Failure
/ drug therapy
Humans
Logistic Models
Male
Multimorbidity
New York City
Odds Ratio
Patient Acceptance of Health Care
/ psychology
Polypharmacy
Racial Groups
/ psychology
Retrospective Studies
Stroke Volume
deprescribing
frailty
heart failure
polypharmacy
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
12
03
2021
received:
22
01
2021
accepted:
14
03
2021
pubmed:
13
5
2021
medline:
12
10
2021
entrez:
12
5
2021
Statut:
ppublish
Résumé
Attitudes toward deprescribing could vary among subpopulations. We sought to understand patient attitudes toward deprescribing among patients with heart failure with preserved ejection fraction (HFpEF). Retrospective cohort study. Academic medical center in New York City. Consecutive patients with HFpEF seen in July 2018-December 2019 at a program dedicated to providing care to older adults with HFpEF. We assessed the prevalence of vulnerabilities outlined in the domain management approach for caring for patients with heart failure and examined data on patient attitudes toward having their medicines deprescribed via the revised Patient Attitudes Toward Deprescribing (rPATD). Among 134 patients with HFpEF, median age was 75 (interquartile range 69-82), 60.4% were women, and 35.8% were nonwhite. Almost all patients had polypharmacy (94.0%) and 56.0% had hyperpolypharmacy; multimorbidity (80.6%) and frailty (78.7%) were also common. Overall, 90.3% reported that they would be willing to have one or more of their medicines deprescribed if told it was possible by their doctors; and 26.9% reported that they would like to try stopping one of their medicines to see how they feel without it. Notably, 91.8% of patients reported that they would like to be involved in decisions about their medicines. In bivariate logistic regression, nonwhite participants were less likely to want to try stopping one of their medicines to see how they feel without it (odds ratio 0.25, 95% confidence interval [0.09-0.62], p = 0.005). Patients with HFpEF contend with many vulnerabilities that could prompt consideration for deprescribing. Most patients with HFpEF were amenable to deprescribing. Race may be an important factor that impacts patient attitudes toward deprescribing.
Sections du résumé
BACKGROUND/OBJECTIVES
Attitudes toward deprescribing could vary among subpopulations. We sought to understand patient attitudes toward deprescribing among patients with heart failure with preserved ejection fraction (HFpEF).
DESIGN
Retrospective cohort study.
SETTING
Academic medical center in New York City.
PARTICIPANTS
Consecutive patients with HFpEF seen in July 2018-December 2019 at a program dedicated to providing care to older adults with HFpEF.
MEASUREMENTS
We assessed the prevalence of vulnerabilities outlined in the domain management approach for caring for patients with heart failure and examined data on patient attitudes toward having their medicines deprescribed via the revised Patient Attitudes Toward Deprescribing (rPATD).
RESULTS
Among 134 patients with HFpEF, median age was 75 (interquartile range 69-82), 60.4% were women, and 35.8% were nonwhite. Almost all patients had polypharmacy (94.0%) and 56.0% had hyperpolypharmacy; multimorbidity (80.6%) and frailty (78.7%) were also common. Overall, 90.3% reported that they would be willing to have one or more of their medicines deprescribed if told it was possible by their doctors; and 26.9% reported that they would like to try stopping one of their medicines to see how they feel without it. Notably, 91.8% of patients reported that they would like to be involved in decisions about their medicines. In bivariate logistic regression, nonwhite participants were less likely to want to try stopping one of their medicines to see how they feel without it (odds ratio 0.25, 95% confidence interval [0.09-0.62], p = 0.005).
CONCLUSIONS
Patients with HFpEF contend with many vulnerabilities that could prompt consideration for deprescribing. Most patients with HFpEF were amenable to deprescribing. Race may be an important factor that impacts patient attitudes toward deprescribing.
Identifiants
pubmed: 33978239
doi: 10.1111/jgs.17204
pmc: PMC9198814
mid: NIHMS1810890
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1948-1955Subventions
Organisme : NIA NIH HHS
ID : P30 AG022845
Pays : United States
Organisme : NIA NIH HHS
ID : R24 AG064025
Pays : United States
Informations de copyright
© 2021 The American Geriatrics Society.
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