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Attitude towards medication deprescribing among older patients attending the geriatric centre: a cross-sectional survey in Southwest Nigeria

Por: Akande-Sholabi · W. · Ajilore · C. O. · Adebusoye · L. A. · Fakeye · T. O.
Objectives

This study set out to assess older people’s perception of their medications, attitude towards medication use and their willingness to have medications deprescribed in a geriatric centre in Southwestern Nigeria.

Design and setting

A cross-sectional study was conducted at the Chief Tony Anenih Geriatric Centre, University of Ibadan, using an interviewer-administered questionnaire. The questionnaire used was a revised version of the Patient’s Attitude Towards Deprescribing Questionnaire. Descriptive statistics, and multivariate and bivariate analyses were performed using SPSS V.23. Statistical significance was set at p

Participants

415 older patients aged ≥60 years who attended the geriatric centre in University College Hospital Ibadan between April and July 2022.

Main outcome measure

The primary outcome was the willingness of the older person to deprescribe if recommended by the physician.

Results

The mean age of the participants was 69.6±6.4 years, and 252 (60.7%) were female. Overall, the willingness and positive attitude to medication deprescribing among respondents were 60.5% and 89.7%, respectively. Factors significantly associated with willingness to deprescribe were financial self-support (p=0.021), having no previous hospital admission (p=0.009), better-perceived quality of health relative to peers (p

Conclusion

Participants demonstrated greater willingness to deprescribe if the physicians recommended it. Predictive factors that may influence willingness to deprescribe were direct involvement with medications, appropriateness of medication and concerns about stopping medications.

Software‐based interventions for low back pain management: A systematic review and meta‐analysis

Abstract

Introduction

Using software for self-management interventions can improve health outcomes for individuals with low back pain, but there is a dearth of research to confirm its effectiveness. Additionally, no known research has evaluated the effective elements of software-based interventions for low back pain self-management components. This study aimed to synthesize the effectiveness of software-based interventions to promote self-management health outcomes among individuals with low back pain.

Design

A systematic review and meta-analysis was conducted.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, relevant studies up to July 2022 were searched via four electronic databases: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Web of Science.

Results

4908 adults with low back pain who participated in 23 studies were included. Software-based interventions were effective in reducing fear avoidance (mean difference [MD] = −0.95, 95% CI: −1.45 to −0.44), pain catastrophizing (MD = −1.31, 95% CI: −1.84 to −0.78), disability (MD = −8.21, 95% CI: −13.02 to −3.39), and pain intensity (MD = −0.86, 95% CI: −1.17 to −0.55). Specifically, interventions that included an exercise component were more effective in reducing pain and disability. Additionally, cognitive behavioral therapy (CBT) intervention significantly reduced fear avoidance and pain catastrophizing but had no noticeable impact on disability and pain compared to standard treatment. The certainty of the evidence in this review varied from very low to high across outcomes. The heterogeneity of the study results was significant, suggesting that future studies in this area could optimize the design, time points, measures, and outcomes to strengthen the evidence.

Conclusions

Low back pain self-management interventions delivered through software-based programs effectively reduce pain intensity, disability, fear avoidance, and pain catastrophizing.

Clinical Relevance

Low back pain is among the most common reasons for seeking healthcare visits. Combining exercise and counseling through soft-based programs may effectively address this issue and its associated suffering and disability.

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