“I don’t know how many of these [medicines] are necessary..”—A focus group study among elderly users of multiple medicines

Moen, Janne; Böhm, A.; Tillenius, Therese; Antonov, Karolina; Nilsson, J. Lars G.; Ring, Lena

doi:10.1016/j.pec.2008.08.019

Cited by 105 publications

(120 citation statements)

References 39 publications

Supporting

Mentioning

104

Contrasting

Unclassified

Order By: Relevance

“…8 However, elderly users of multiple medicines report minimal self-medication because of fear of interactions with their prescription drugs. 32 Our study suggests that there is no association between use of herbal preparations and OTC drugs and multiple use of prescribed drugs.…”

Section: Discussionmentioning

confidence: 57%

Factors Associated with Multiple Medication Use in Different Age Groups

et al. 2009

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 57%

Factors Associated with Multiple Medication Use in Different Age Groups

et al. 2009

Self Cite

View full text Add to dashboard Cite

show abstract

“…For example, the subtheme of psychological benefits of withdrawal, which arose from studies looking at neurological medications, was not mentioned in any of the focus groups and neither was the subtheme of stigma associated with medication taking, perhaps because older adults consider medication use to be 'normal'. 27 There are several important limitations of this study and the results must be viewed in the context in which the data were collected. 28 First, both of the older adult groups were relatively healthy and high functioning; different views may be held by those with poorer health or those requiring permanent high-level care.…”

Section: Discuss This Articlementioning

confidence: 95%

“…Moen et al 27 conducted a focus group study with older adults in Sweden to assess their attitudes towards taking multiple medications and Linsky et al 30 conducted a qualitative study of US veterans in relation to their perception of proactive medication cessation. Both of these studies found that the relationship with their doctor had an influence on their attitudes to medications and willingness to withdraw one or more of them.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Beliefs and attitudes of older adults and carers about deprescribing of medications: a qualitative focus group study

Reeve¹,

2016

View full text Add to dashboard Cite

“…22 Substantial evidence shows that older people's attitudes can be internally contradictory: they may be positive about both taking their medicines [24][25][26] and taking fewer medicines. 27 Older people's willingness to either tolerate polypharmacy or discontinue a medicine seems to be influenced by the communication skills 24 27 and perceived experience of the clinician, 28 and the degree to which the older person trusts them.…”

Section: Older People's Attitudes Towards Medicinementioning

confidence: 99%

Too much medicine in older people? Deprescribing through shared decision making

Jansen

Naganathan

Carter

et al. 2016

BMJ

232

233

View full text Add to dashboard Cite

Jansen and colleagues explore the role of shared decision making in tackling inappropriate polypharmacy in older adults Too much medicine is an increasingly recognised problem, 1 2 and one manifestation is inappropriate polypharmacy in older people. Polypharmacy is usually defined as taking more than five regular prescribed medicines.3 It can be appropriate (when potential benefits outweigh potential harms) 4 but increases the risk of older people experiencing adverse drug reactions, impaired physical and cognitive function, and hospital admission. [5][6][7] There is limited evidence to inform polypharmacy in older people, especially those with multimorbidity, cognitive impairment, or frailty.8 Systematic reviews of medication withdrawal trials (deprescribing) show that reducing specific classes of medicines may decrease adverse events and improve quality of life. [9][10][11] Two recent reviews of the literature on deprescribing stressed the importance of patient involvement and shared decision making.12 13 Patients and clinicians typically overestimate the benefits of treatments and underestimate their harms.14 When they engage in shared decision making they become better informed about potential outcomes and as a result patients tend to choose more conservative options (eg, fewer medicines), facilitating deprescribing. 15 However, shared decision making in this context is not easy, and there is little guidance on how to do it. 16 We draw together evidence from the psychology, communication, and decision making literature (see appendix on thebmj.com). For each step of the shared decision making process we describe the unique tasks required for deprescribing decisions; identify challenges for older adults, their companions, and clinicians (figure); give practical advice on how challenges may be overcome; highlight where more work is needed; and identify priorities for future research (table). 17 18 Process for deprescribing with older adultsStep 1: creating awareness that options existThe clinician and patient acknowledge that a decision can be made about continuation or discontinuation of medicines, and that this requires input from both clinician and patient. When to initiate discussions about deprescribingPrescribing new medicines is often straightforward, driven by a new diagnosis, symptom, or test result. When to consider ceasing medicines is less clear.12 Possible triggers include the number of medicines taken (perhaps ≥10); a new symptom that may be an adverse effect of a medicine; identifying high risk, ineffective, or unnecessary medicines; apparent non-adherence; or changed treatment priorities. 19 Most of these situations can be identified only by a medicines review. Reviews can be triggered by important life transitions (such as hospital admission, a new diagnosis, or seeing a new doctor) and can be initiated by the clinician or patient, but they are often Older people's attitudes towards medicineClinicians may be reluctant to initiate discussions about deprescribing with older people, believing tha...

show abstract

“I don’t know how many of these [medicines] are necessary..”—A focus group study among elderly users of multiple medicines

Cited by 105 publications

References 39 publications

Factors Associated with Multiple Medication Use in Different Age Groups

Factors Associated with Multiple Medication Use in Different Age Groups

Beliefs and attitudes of older adults and carers about deprescribing of medications: a qualitative focus group study

Too much medicine in older people? Deprescribing through shared decision making

Contact Info

Product

Resources

About