A Study on the Perceptions of Korean Older Adult Patients and Caregivers about Polypharmacy and Deprescribing
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants Recruitment
2.2. Survey
2.3. Data Collection and Recording
2.4. Data Analysis
3. Results
3.1. Participant Characteristics
3.2. Recognition of the Current State of Polypharmacy
3.3. Patients’ Perception of Deprescribing
3.4. Caregivers’ Perception of Deprescribing
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Patients (n = 250) | Caregivers (n = 250) |
---|---|---|
Age (years) | ||
65–69 | 248 (99.2) | |
70–79 | 2 (0.8) | |
20–29 | 8 (3.2) | |
30–39 | 74 (29.6) | |
40–49 | 90 (36) | |
50–59 | 29 (11.6) | |
60–69 | 49 (19.6) | |
Sex (male) | 144 (57.6) | 123 (49.2) |
Highest education completed | ||
High school graduation or below | 53 (21.2) | 46 (18.4) |
Bachelor’s | 176 (70.4) | 179 (71.6) |
Postgraduate | 21 (8.4) | 25 (10) |
Income per month (won) | ||
≤3 million | 69 (27.6) | 63 (25.2) |
3–5 million | 84 (33.6) | 89 (35.6) |
≥5 million | 97 (38.8) | 98 (39.2) |
Place of residence | ||
Home alone | 34 (13.6) | 39 (15.6) |
Home with spouse | 156 (62.4) | 123 (49.2) |
Home with children | 51 (20.4) | 56 (22.4) |
Home with other family members | 9 (3.6) | 22 (8.8) |
Facilities | 0 (0) | 10 (2.5) |
Type of insurance | ||
National Health Insurance Service | 220 (88) | |
Medical aid | 30 (12) | |
Private health insurance | 98 (39.2) |
Patients (n = 250) | Caregivers (n = 250) | |
---|---|---|
Number of regular medications† | ||
6 | 135 (54) | 217 (86.8) |
7 | 48 (19.2) | 21 (8.4) |
8 | 27 (10.8) | 4 (1.6) |
9 | 12 (4.8) | 2 (0.8) |
10 or more | 28 (11.2) | 6 (2.4) |
Taking western medications | 250 (100) | 245 (98) |
Taking herbal medications | 71 (28.4) | 88 (35.2) |
Consuming health functional foods | 212 (84.8) | 216 (86.4) |
Consuming health foods | 203 (81.2) | 206 (82.4) |
Causes of using medications | ||
Hypertension | 175 (70) | 172 (68.8) |
Diabetes mellitus | 95 (38) | 108 (43.2) |
Hyperlipidemia | 131 (52.4) | 89 (35.6) |
Digestive disorders | 107 (42.8) | 76 (30.4) |
Pain symptoms | 100 (40) | 63 (25.2) |
Osteoporosis | 69 (27.6) | 56 (22.4) |
Sleep disorders | 50 (20) | 53 (21.2) |
Heart diseases | 62 (24.8) | 39 (15.6) |
Stroke | 47 (18.8) | 29 (11.6) |
Degenerative brain diseases | 49 (19.6) | 29 (11.6) |
Respiratory diseases | 48 (19.2) | 29 (11.6) |
Mental symptoms | 34 (13.6) | 20 (8) |
Other diseases | 6 (2.4) | 11 (4.4) |
Item | Strongly Disagree | Disagree | Neither Agree Nor Disagree | Agree | Strongly Agree |
---|---|---|---|---|---|
Burden factor | |||||
1. I spend a lot of money on medicines. | 3 (1.2) | 25 (10) | 86 (34.4) | 109 (43.6) | 27 (10.8) |
2. Taking my medicines every day is very inconvenient. | - | 20 (8) | 68 (27.2) | 121 (48.4) | 41(16.4) |
3. I feel that I am taking a large number of medicines. | - | 5 (2) | 58 (23.2) | 135 (54) | 52 (20.8) |
4. I feel that my medicines are a burden to me. | 1 (0.4) | 26 (10.4) | 89 (35.6) | 106 (42.4) | 28 (11.2) |
5. Sometimes I think I take too many medicines. | 1 (0.4) | 26 (10.4) | 77 (30.8) | 123 (49.2) | 23 (9.2) |
Appropriateness factor | |||||
1.I feel that I may be taking one or more medicines that I no longer need. | 6 (2.4) | 79 (31.6) | 83 (33.2) | 76 (30.4) | 6 (2.4) |
2. I would like to try stopping one of my medicines to see how I feel without it. | 3 (1.2) | 48 (19.2) | 77 (30.8) | 99 (39.6) | 23 (9.2) |
3. I would like my doctor to reduce the dose of one or more of my medicines. | 3 (1.2) | 28 (11.2) | 58 (23.2) | 120 (48) | 41 (16.4) |
4. I think one or more of my medicines may not be working. | 3 (1.2) | 65 (26) | 97 (38.8) | 71 (28.4) | 14 (5.6) |
5. I believe one or more of my medicines may currently be giving me side effects. | 15 (6) | 87 (34.8) | 90 (36) | 55 (22) | 3 (1.2) |
Concerns about stopping factor | |||||
1. I would be reluctant to stop a medicine that I had been taking for a long time. | 6 (2.4) | 11 (4.4) | 57 (22.8) | 143 (57.2) | 33 (13.2) |
2. If one of my medications was stopped, I would be worried about missing out on future benefits. | 3 (1.2) | 17(6.8) | 62 (24.8) | 139 (55.6) | 29 (11.6) |
3. I get stressed whenever changes are made to my medicines. | 4 (1.6) | 34 (13.6) | 97 (38.8) | 94 (37.6) | 21 (8.4) |
4. If my doctor recommended stopping a medicine, I would feel that he/she was giving up on me. | 10 (4) | 79 (31.6) | 92 (36.8) | 57 (22.8) | 12 (4.8) |
5. I have had a bad experience when stopping a medicine before. | 15 (6) | 79 (31.6) | 81 (32.4) | 63 (25.2) | 12 (4.8) |
Involvement factor | |||||
1. I have a good understanding of the reasons I was prescribed each of my medicines. | 1 (0.4) | 10 (4) | 88 (35.2) | 136 (54.4) | 22 (8.8) |
2. I know exactly what medicines I am currently taking, and/or I keep an up-to-date list of my medications. | - | 19 (7.6) | 106 (42.4) | 106 (42.4) | 19 (7.6) |
3. I like to know as much as possible about my medicines. | 1 (0.4) | 6 (2.4) | 49 (19.6) | 154 (61.6) | 40 (16) |
4. I like to be involved in making decisions about my medicines with my doctors. | 1 (0.4) | 10 (4) | 99 (39.6) | 111 (44.4) | 29 (11.6) |
5. I always ask my doctor, pharmacist, or other healthcare professional if there is something I don’t understand about my medicines. | 1 (0.4) | 18 (7.2) | 64 (25.6) | 139 (55.6) | 28 (11.2) |
Global factor | |||||
1. If my doctor said it was possible, I would be willing to stop one or more of my regular medicines. | 1 (0.4) | 2 (0.8) | 48 (19.2) | 160 (64) | 39 (15.6) |
2. Overall, I am satisfied with my current medicines. | - | 13 (5.2) | 123 (49.6) | 104 (41.6) | 9 (3.6) |
Item | Strongly Disagree | Disagree | Neither Agree Nor Disagree | Agree | Strongly Agree |
---|---|---|---|---|---|
Burden factor | |||||
1. My care recipient’s medicines are quite expensive. | 4 (1.6) | 32 (12.8) | 81 (32.4) | 115 (46) | 18 (7.2) |
2. I think that my care recipient feels uncomfortable taking medicines every day. | 3 (1.2) | 21 (8.4) | 60 (24) | 134 (53.6) | 32 (12.8) |
3. I feel that the person I care for is taking a large number of medicines. | - | 15 (6) | 76 (30.4) | 129 (51.6) | 30 (12) |
4. I feel that my care recipient’s medicines are a burden to them. | 3 (1.2) | 37 (14.8) | 71 (28.4) | 123 (49.2) | 16 (6.4) |
5. Sometimes I think the person I care for takes too many medicines. | 5 (2) | 38 (15.2) | 88 (35.2) | 94 (37.6) | 25 (10) |
Appropriateness factor | |||||
1. I feel that the person that I care for may be taking one or more medicines that they no longer need. | 7 (2.8) | 80 (32) | 83 (33.2) | 73 (29.2) | 7 (2.8) |
2. I would like the doctor to try stopping one of my care recipient’s medicines to see how they feel without it. | 7 (2.8) | 62 (24.8) | 66 (26.4) | 100 (40) | 15 (6) |
3. I would like the doctor to reduce the dose of one or more of my care recipient’s medicines. | 8 (3.2) | 33 (13.2) | 70 (28) | 117 (46.8) | 22 (8.8) |
4. I think one or more of my care recipient’s medicines may not be working. | 10 (4) | 63 (25.2) | 91 (36.4) | 68 (27.2) | 18 (7.2) |
5. I believe one or more of my care recipient’s medications may be currently giving them side effects. | 20 (8) | 103 (41.2) | 62 (24.8) | 55 (22) | 10 (4) |
Concerns about stopping factor | |||||
1. I would be reluctant to stop one of my care recipient’s medicines that they had been taking for a long time. | 3 (1.2) | 23 (9.2) | 72 (28.8) | 130 (52) | 22 (8.8) |
2. If one of my care recipient’s medicines was stopped, I would be worried about missing out on future benefits. | 3 (1.2) | 21 (8.4) | 60 (24) | 142 (56.8) | 24 (9.6) |
3. I get stressed whenever changes are made to my care recipient’s medicines. | 7 (2.8) | 49 (19.6) | 83 (33.2) | 98 (39.2) | 13 (5.2) |
4. I feel that if I agreed to stop one of my care recipient’s medicines then this is like giving up on them. | 23 (9.2) | 78 (31.2) | 77 (30.8) | 58 (23.2) | 14 (5.6) |
5. The person that I care for has had a bad experience when stopping a medicine before. | 16 (6.4) | 80 (32) | 80 (32) | 62 (24.8) | 12 (4.8) |
Involvement factor | |||||
1. I have a good understanding of the reasons why my care recipient was prescribed each of their medicines. | 2 (0.8) | 12 (4.8) | 83 (33.2) | 134 (53.6) | 19 (7.6) |
2. I know exactly what medicines the person that I care for is currently taking, and/or I keep an up-to-date list of their medicines. | 1 (0.4) | 22 (8.8) | 94 (37.6) | 115 (46) | 18 (7.2) |
3. I like to know as much as possible about my care recipient’s medicines. | 1 (0.4) | 4 (1.6) | 54 (21.6) | 161 (64.4) | 30 (12) |
4. I like to be involved in making decisions about my care recipient’s medicines. | 2 (0.8) | 17 (6.8) | 96 (38.4) | 115 (46) | 20 (8) |
5. I always ask the doctor, pharmacist, or other healthcare professional if there is something I don’t understand about my care recipient’s medicines. | 1 (0.4) | 20 (8) | 81 (32.4) | 125 (50) | 23 (9.2) |
Global factor | |||||
1. If their doctor said it was possible, I would be willing to stop one or more of my care recipient’s medicines. | - | 6 (2.4) | 64 (25.6) | 155 (62) | 25 (10) |
2. Overall, I am satisfied with my care recipient’s current medicines. | 1 (0.4) | 18 (7.2) | 113 (45.2) | 108 (43.2) | 10 (4) |
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Lee, H.-G.; Kwon, S.; Jang, B.-H.; Jeon, J.P.; Lee, Y.-S.; Jung, W.-S.; Moon, S.-K.; Cho, K.-H. A Study on the Perceptions of Korean Older Adult Patients and Caregivers about Polypharmacy and Deprescribing. Int. J. Environ. Res. Public Health 2022, 19, 11446. https://doi.org/10.3390/ijerph191811446
Lee H-G, Kwon S, Jang B-H, Jeon JP, Lee Y-S, Jung W-S, Moon S-K, Cho K-H. A Study on the Perceptions of Korean Older Adult Patients and Caregivers about Polypharmacy and Deprescribing. International Journal of Environmental Research and Public Health. 2022; 19(18):11446. https://doi.org/10.3390/ijerph191811446
Chicago/Turabian StyleLee, Han-Gyul, Seungwon Kwon, Bo-Hyoung Jang, Jin Pyeong Jeon, Ye-Seul Lee, Woo-Sang Jung, Sang-Kwan Moon, and Ki-Ho Cho. 2022. "A Study on the Perceptions of Korean Older Adult Patients and Caregivers about Polypharmacy and Deprescribing" International Journal of Environmental Research and Public Health 19, no. 18: 11446. https://doi.org/10.3390/ijerph191811446