Imagine this: Your doctor suggests you stop taking a medication. Would you be more likely to follow that advice than if it came from your pharmacist? A recent study reveals some surprising insights into how patients perceive the idea of deprescribing – or safely stopping medications – particularly when it comes to common drugs like insulin, statins, and blood pressure medications.
This study, published in Basic and Clinical Pharmacology and Toxicology, highlights a crucial aspect of patient care: patients’ attitudes toward deprescribing vary significantly depending on the specific medication. The authors emphasize the importance of understanding these attitudes to improve healthcare practices.
The study found that patients often trust their physicians more than their community pharmacists when it comes to deprescribing.
But here’s where it gets controversial… Patients generally have a more positive view of stopping statins and blood pressure medications compared to insulin and sulfonylureas. The research suggests that patients perceive insulin as more essential than other medications.
So, what’s driving these different perceptions? One factor is the perceived appropriateness of stopping a medication. The study showed that patients considered insulin use more appropriate than other drug classes.
Let’s break down the details:
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Medication Optimization: A Key Goal
Optimizing medication is about improving health outcomes and reducing costs. Medication Therapy Management (MTM) is a widely adopted strategy for this. MTM involves reviewing all prescribed medications, over-the-counter drugs, and herbal products a patient takes. Pharmacists look for potential issues like duplicate medications or unnecessary prescriptions. -
Beyond MTM: Comprehensive Medication Management
MTM has limitations, and some practices have expanded it into comprehensive medication management. This approach involves pharmacists working directly with patients and other healthcare team members. -
The Study’s Focus
The study aimed to understand how older patients view deprescribing cardiovascular and diabetes medications (statins, blood pressure meds, sulfonylureas, and insulin). All patients received medication reviews as part of the study. In the Netherlands, where the study took place, pharmacists and general practitioners commonly conduct these reviews for older patients and those taking multiple medications. The researchers measured medication-specific appropriateness and concern levels. -
Key Findings
Out of 310 patients, 280 were included in the final analysis. A significant 87% of patients were willing to stop one or more medications if their doctor approved. However, only 45% were comfortable with their community pharmacist suggesting it.The study also revealed that patients taking insulin were less open to stopping it compared to other medications. Only 20% of insulin users were positive about discontinuing it, compared to 37% for sulfonylureas, 44% for blood pressure medications, and 48% for statins.
The authors noted that healthcare providers often need to convince type 2 diabetes patients to start insulin, which may reinforce the belief that insulin cannot be stopped.
For appropriateness, the study found no significant difference between statins and blood pressure medications. However, the appropriateness score for insulin was higher compared to all other medication classes. Also, approximately 78% of patients taking insulin worried about missing out on future benefits, compared to 61% taking sulfonylureas, 53% taking blood pressure medications, and 49% taking statins.
The researchers suggest that these differences in perception might relate to how patients experience the medication’s effectiveness and the perceived severity of their condition.
In Conclusion: Patients’ perceptions of deprescribing vary greatly depending on the medication. Insulin, in particular, seems to be viewed differently than statins and blood pressure medications.
What do you think? Do you agree that patients might be more hesitant to stop insulin? Do you think the perceived severity of the condition plays a role in these attitudes? Share your thoughts in the comments below!
Disclaimer: This information is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider for any health concerns or before making any decisions about your treatment.