Polypharmacy and deprescribing attitudes among stroke survivors: Opportunities for enhanced patient centered care

中风幸存者多重用药及停药态度:提升以患者为中心的护理的契机

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Abstract

OBJECTIVE: This study aimed to 1) describe the burden of polypharmacy among stroke survivors compared to older adults without a history of stroke and 2) assess their attitudes towards deprescribing. METHODS: This is a cross-sectional study of US Medicare Beneficiaries aged ≥65 who participated in the National Health and Aging Trends Study. Polypharmacy was defined by the number of regular medications reported (no polypharmacy, ≤5; moderate, 6-10; severe, >10). Deprescribing attitudes were elicited from the Medication Attitudes Module. Ordinal and logistic regression assessed the associations between polypharmacy, history of stroke, and deprescribing attitudes, adjusting for falls and comorbidities. RESULTS: Of the 2073 respondents, 253 reported a prior stroke. Compared to older adults without a history of stroke, stroke survivors were more likely to report polypharmacy (moderate: 39.4 % vs 29.8 %; severe: 22.6 % vs 9.8 %; p < 0.01). Most stroke survivors (87.1 %) and older adults without stroke (89.0 %) would be willing to stop one or more medications. Polypharmacy had the strongest association with favorable attitudes toward deprescribing. CONCLUSION: Stroke survivors report greater polypharmacy than older adults without a history of stroke. Both groups overwhelmingly favor deprescribing. Stroke survivors represent a key population that would welcome and benefit from efforts to deprescribe.

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