Polypharmacy and medication deprescribing: A survey among multimorbid older adults in Denmark

• Published in: Pharmacology research & perspectives 2018-12, Vol.6 (6), p.e00431-n/a
• Main Authors: Schiøtz, Michaela L., Frølich, Anne, Jensen, Anette K., Reuther, Lene, Perrild, Hans, Petersen, Tonny S., Kornholt, Jonatan, Christensen, Mikkel B.
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Attitudes; Cardiovascular disease; Chronic illnesses; Chronic obstructive pulmonary disease; Clinics; Cohort Studies; Comorbidity; Data collection; Denmark; deprescribing; Deprescriptions; Diabetes; Drug Prescriptions - statistics & numerical data; Endocrinology; Female; Health education; Health literacy; Health Services Needs and Demand - statistics & numerical data; Hospitals; Humans; Hypertension; Male; Medication Adherence - statistics & numerical data; Medicine; Multimorbidity; Original; Osteoporosis; Outpatient care facilities; Pain; patient perspective; Patients; Pharmacists; Pharmacology; Polypharmacy; Population; Prescription drugs; Questionnaires; Studies; Surveys and Questionnaires
• ISSN: 2052-1707; 2052-1707
• DOI: 10.1002/prp2.431

Polypharmacy is common among multimorbid adults and associated with increased morbidity and mortality. Excessive polypharmacy (ie, ≥10 medicine) is strongly associated with inappropriate medication use, but little is known about attitudes toward deprescribing in patients with excessive polypharmacy. We surveyed 100 Danish individuals aged 65 years and above with ≥10 prescribed medications, using the validated Patients’ Attitudes Towards Deprescribing (PATD) instrument. Most participants (81, 81%) thought they took a large number of medications, and 79 (79%) believed that their medications were necessary. Even so, 85 (85%) reported that they would be willing to stop taking one or more of their regular medications if their doctor told them they could, and 11 (11%) felt that they took at least one regular medication that they no longer needed. When presented with visual presentation of various amounts of tablets and capsules, 62 (62%) of participants reported that they would be comfortable taking fewer medications than they did. Forty‐two (42%) participants had experience with stopping a regular medication. Almost all participants (92%) wanted to receive follow‐up by various means if a medication was discontinued. Forty‐one (41%) participants were interested in a consultation at an outpatient clinic specializing in polypharmacy. Overall, the answers to the PATD questionnaire suggest that our cohort of Danish, multimorbid outpatients with extensive polypharmacy have a high confidence in their healthcare providers for medication‐related decisions, even though some feel that they are taking more medications than they would like to and feel that some medications may be unnecessary. Our results underline the need for healthcare providers to offer medication reviews in patients with multimorbidity.