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Record W3191585909 · doi:10.1093/gerona/glab222

Consumer Attitudes Towards Deprescribing: A Systematic Review and Meta-Analysis

2021· review· en· W3191585909 on OpenAlexaff
Kristie Rebecca Weir, Nagham Ailabouni, Carl R. Schneider, Sarah N. Hilmer, Emily Reeve

Bibliographic record

VenueThe Journals of Gerontology Series A · 2021
Typereview
Languageen
FieldMedicine
TopicPharmaceutical Practices and Patient Outcomes
Canadian institutionsNova Scotia Health AuthorityDalhousie University
FundersNational Health and Medical Research CouncilAustralian Research Council
KeywordsDeprescribingMeta-analysisEnvironmental healthPsychologyMedicinePolypharmacyIntensive care medicineInternal medicine

Abstract

fetched live from OpenAlex

BACKGROUND: Harmful and/or unnecessary medication use in older adults is common. This indicates deprescribing (supervised withdrawal of inappropriate medicines) is not happening as often as it should. This study aimed to synthesize the results of the Patients' Attitudes Towards Deprescribing (PATD) questionnaire (and revised versions). METHODS: Databases were searched from January 2013 to March 2020. Google Scholar was used for citation searching of the development and validation manuscripts to identify original research using the validated PATD, revised PATD (older adult and caregiver versions), and the version for people with cognitive impairment (rPATDcog). Two authors extracted data independently. A meta-analysis of proportions (random-effects model) was conducted with subgroup meta-analyses for setting and population. The primary outcome was the question: "If my doctor said it was possible, I would be willing to stop one or more of my medicines." Secondary outcomes were associations between participant characteristics and primary outcome and other (r)PATD results. RESULTS: We included 46 articles describing 40 studies (n = 10,816 participants). The meta-analysis found the proportion of participants who agreed or strongly agreed with this statement was 84% (95% CI 81%-88%) and 80% (95% CI 74%-86%) in patients and caregivers, respectively, with significant heterogeneity (I2 = 95% and 77%). CONCLUSION: Consumers reported willingness to have a medication deprescribed although results should be interpreted with caution due to heterogeneity. The findings from this study moves toward understanding attitudes toward deprescribing, which could increase the discussion and uptake of deprescribing recommendations in clinical practice.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.020
metaresearch head score (Gemma)0.048
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Meta-analysis · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.020
Threshold uncertainty score0.105

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0200.048
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0150.028
Bibliometrics0.0070.007
Science and technology studies0.0010.001
Scholarly communication0.0030.002
Open science0.0020.001
Research integrity0.0020.002
Insufficient payload (model declined to judge)0.0040.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.582
GPT teacher head0.532
Teacher spread0.049 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designMeta-analysis
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations114
Published2021
Admission routes1
Has abstractyes

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