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  • Jungo, Katharina TabeaUniv Bern, Switzerland,University of Bern (author)

General practitioners' deprescribing decisions in older adults with polypharmacy : a case vignette study in 31 countries

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • 2021-01-07
  • BioMed Central (BMC),2021
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:lnu-101131
  • https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-101131URI
  • https://doi.org/10.1186/s12877-020-01953-6DOI
  • https://lup.lub.lu.se/record/0badf09b-4070-4618-81db-4d6915bd1effURI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background General practitioners (GPs) should regularly review patients' medications and, if necessary, deprescribe, as inappropriate polypharmacy may harm patients' health. However, deprescribing can be challenging for physicians. This study investigates GPs' deprescribing decisions in 31 countries. Methods In this case vignette study, GPs were invited to participate in an online survey containing three clinical cases of oldest-old multimorbid patients with potentially inappropriate polypharmacy. Patients differed in terms of dependency in activities of daily living (ADL) and were presented with and without history of cardiovascular disease (CVD). For each case, we asked GPs if they would deprescribe in their usual practice. We calculated proportions of GPs who reported they would deprescribe and performed a multilevel logistic regression to examine the association between history of CVD and level of dependency on GPs' deprescribing decisions. Results Of 3,175 invited GPs, 54% responded (N = 1,706). The mean age was 50 years and 60% of respondents were female. Despite differences across GP characteristics, such as age (with older GPs being more likely to take deprescribing decisions), and across countries, overall more than 80% of GPs reported they would deprescribe the dosage of at least one medication in oldest-old patients (> 80 years) with polypharmacy irrespective of history of CVD. The odds of deprescribing was higher in patients with a higher level of dependency in ADL (OR =1.5, 95%CI 1.25 to 1.80) and absence of CVD (OR =3.04, 95%CI 2.58 to 3.57). Interpretation The majority of GPs in this study were willing to deprescribe one or more medications in oldest-old multimorbid patients with polypharmacy. Willingness was higher in patients with increased dependency in ADL and lower in patients with CVD.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Mantelli, SophieUniv Bern, Switzerland,University of Bern (author)
  • Rozsnyai, ZsofiaUniv Bern, Switzerland,University of Bern (author)
  • Missiou, AristeaUniv Ioannina, Greece,University of Ioannina (author)
  • Kitanovska, Biljana GerasimovskaUniv St Cyril & Metodius Skopje, North Macedonia,The Saints Cyril and Methodius University of Skopje (author)
  • Weltermann, BirgittaUniv Duisburg Essen, Germany;Univ Bonn, Germany,University Hospital Essen,University of Bonn (author)
  • Mallen, ChristianKeele Univ, UK,Keele University (author)
  • Collins, ClaireIrish Coll Gen Practitioners, Ireland,Irish College of General Practitioners (author)
  • Bonfim, DaianaHosp Israelita Albert Einstein, Brazil,Albert Einstein Israelite Hospital (author)
  • Kurpas, DonataWroclaw Med Univ, Poland,Wrocław Medical University (author)
  • Petrazzuoli, FerdinandoLund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups(Swepub:lu)med-fpz (author)
  • Dumitra, GindrovelRomanian Soc Family Med, Romania,Romanian National Society of Family Medicine (author)
  • Thulesius, HansLinnaeus University,Lunds universitet,Linnéuniversitetet,Institutionen för medicin och optometri (MEO),Lund University, Sweden,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups(Swepub:lu)smi-hth (author)
  • Lingner, HeidrunHannover Med Sch, Germany,Hannover Medical School (author)
  • Johansen, Kasper LorenzDanish Coll Gen Practitioners, Denmark,Danish College of General Practitioners (author)
  • Wallis, KatharineUniv Queensland, Australia,University of Queensland (author)
  • Hoffmann, KathrynMed Univ Vienna, Austria,Medical University of Vienna (author)
  • Peremans, LieveUniv Antwerp, Belgium,University of Antwerp (author)
  • Pilv, LiinaUniv Tartu, Estonia,University of Tartu (author)
  • Ster, Marija PetekUniv Ljubljana, Slovenia,University of Ljubljana (author)
  • Bleckwenn, MarkusUniv Leipzig, Germany,Leipzig University (author)
  • Sattler, MartinSoc Sci Luxembourgois Med Gen, Luxembourg,Société Scientifique Luxembourgeoise de Médecine Générale (SSLMG) (author)
  • van der Ploeg, MillyLeiden Univ, Netherlands,Leiden University Medical Centre (author)
  • Torzsa, PeterSemmelwe Univ, Hungary,Semmelweis University (author)
  • Kanska, Petra BomberovaCharles Univ Prague, Czech Republic,Charles University in Prague (author)
  • Vinker, ShlomoTel Aviv Univ, Israel,Tel-Aviv University (author)
  • Assenova, RadostMed Univ Plovdiv, Bulgaria,Medical University of Plovdiv (author)
  • Bravo, Raquel GomezUniv Luxembourg, Luxembourg,University of Luxembourg (author)
  • Viegas, Rita P. A.NOVA Med Sch, Portugal,NOVA University Lisbon (author)
  • Tsopra, RosyUniv Paris, France;Hop Europeen Georges Pompidou, France,Hôpital Européen Georges-Pompidou,Paris-Sorbonne University (author)
  • Pestic, Sanda KreitmayerUniv Tuzla, Bosnia and Herzegovina,University of Tuzla (author)
  • Gintere, SandraRiga Stradins Univ, Latvia,Riga Stradins University (author)
  • Koskela, Tuomas H.Tampere Univ, Finland,University of Tampere (author)
  • Lazic, VanjaDom Zdravlja Zagreb Ctr, Croatia,University Hospital of Infectious Diseases (author)
  • Tkachenko, VictoriaShupyk Natl Med Acad Postgrad Educ, Ukraine,Shupyk National Healthcare University of Ukraine (author)
  • Reeve, EmilyUniv South Australia, Australia;Dalhousie Univ, Canada;Nova Scotia Hlth Author, Canada,University of South Australia,Dalhousie University (author)
  • Luymes, ClareLeiden Univ, Netherlands;UWV Employee Insurance Agcy, Netherlands,Leiden University Medical Centre (author)
  • Poortvliet, Rosalinde K. E.Leiden Univ, Netherlands,Leiden University Medical Centre (author)
  • Rodondi, NicolasUniv Bern, Switzerland,Bern University Hospital,University of Bern (author)
  • Gussekloo, JacobijnLeiden Univ, Netherlands,Leiden University Medical Centre (author)
  • Streit, SvenUniv Bern, Switzerland,University of Bern (author)
  • Univ Bern, SwitzerlandUniversity of Bern (creator_code:org_t)

Related titles

  • In:BMC Geriatrics: BioMed Central (BMC)21:1, s. 1-121471-2318

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