Psychological and Clinical Factors That Predict Intent to Deprescribe Medications Among Older Adults
研究概览
详细说明
Around one-half of older adults take one or more medications that are inappropriate or medically unnecessary. These medications can cause side effects that are unacceptable to patients. Several studies provide guidance to clinicians about the process of stopping specific types of medications (e.g., steps that clinicians can take to reduce and stop a medication for anxiety or difficulty sleeping). However, these approaches are not always successful. A critical gap with these approaches is they tend to focus on the medication, rather than the patient, and their individual needs.
Our research team seeks to learn more about factors that are important to patients when they consider reducing or stopping a medication. The investigators will do this by conducting two surveys each with 4,800 older adults across four countries (United States, United Kingdom, Netherlands, and Australia). Each participant will be asked to give their opinions on a hypothetical patient scenario that has been developed by our diverse team in partnership with our stakeholder organizations. In the first survey, the investigators will examine how the reason for using the medication (e.g. preventing a disease or treating symptoms of a disease) as well as the reason for a recommendation to stop the medication (e.g. lack of benefit vs. potential for harm) influence older adults' willingness to stop medications. In the second survey, the investigators will examine how different social and clinical factors and whether the participant is making a recommendation about oneself (as if they were the patient in the case) or on behalf of the patient in the case (e.g., if it was their friend) influence their willingness to stop medications. The investigators will work with Qualtrics, an international company that distributes surveys, to collect this data that does not include any identifying information.
The investigators anticipate that once the survey is designed and show that it is successful for studying patient perspectives about stopping medicines, it can then apply the same study approach to test the effect of other relevant factor that may influence the decision to stop or reduce a medication. The investigators anticipate that our research will significantly contribute to our understanding of how older adults make decisions about stopping medications. This information will be helpful to researchers and clinicians to ensure future services can be developed to best support patients to make decisions about stopping or reducing inappropriate or unnecessary medication.
研究类型
注册 (实际的)
联系人和位置
学习地点
-
-
Michigan
-
Ann Arbor、Michigan、美国、48109
- University of Michigan
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- 65 years and older
- Resides in a participating country
Exclusion Criteria:
- None
学习计划
研究是如何设计的?
设计细节
- 观测模型:仅案例
- 时间观点:横截面
队列和干预
团体/队列 |
干预/治疗 |
---|---|
Survey 1 Statin - May cause harm
Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication.
The primary care provider raises the idea of stopping the statin as it may be causing harm.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
Survey 1 Stain - May lack benefit
Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication.
The primary care provider raises the idea of stopping the statin as it may lack benefit.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
Survey 1 Statin - May cause harm and lack benefit
Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication.
The primary care provider raises the idea of stopping the statin as it may be causing harm and lack benefit.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
Survey 1 PPI - May cause harm
Participants in this arm will be exposed to a scenario in which a patient takes a proton pump inhibitor (heartburn) medication.
The primary care provider raises the idea of stopping the PPI as it may be causing harm.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
Survey 1 PPI - May lack benefit
Participants in this arm will be exposed to a scenario in which a patient takes a proton pump inhibitor (heartburn) medication.
The primary care provider raises the idea of stopping the PPI as it may lack benefit.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
Survey 1 PPI - May cause harm and lack benefit
Participants in this arm will be exposed to a scenario in which a patient takes a proton pump inhibitor (heartburn) medication.
The primary care provider raises the idea of stopping the PPI as it may be causing harm and lack benefit.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
Survey 2 Statin - May cause harm and lack benefit
Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication.
The primary care provider raises the idea of stopping the statin as it may be causing harm and lack benefit.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
Survey 2 Statin - Cardiologist
Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication.
The primary care provider raises the idea of stopping the statin previously started by a cardiologist.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
Survey 2 Statin - Daughter Preference
Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication.
The primary care provider raises the idea of stopping the statin but the patient's adult daughter prefers for her to continue the medication.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
Survey 2 Statin - Husband Stroke
Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication.
The primary care provider raises the idea of stopping the statin but the patient's husband previously had a stroke after he stopped his statin.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
Survey 2 Statin - Flier
Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication.
The primary care provider raises the idea of stopping the statin but the patient saw an educational flier about strokes in the waiting room.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
Survey 2 Statin - Difficulty Maintaining Lifestyle Changes
Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication.
The primary care provider raises the idea of stopping the statin but the patient recognizes that they have had difficulty exercising and eating healthier foods.
|
Participants will be randomized to one of the arms.
Each arm will contain a different hypothetical scenario.
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Response to question statement "I think that Mrs. EF should follow her PCPs recommendation and stop taking simvastatin."
大体时间:1 year
|
Level of agreement with the primary care provider's recommendation to stop the medication presented in the hypothetical scenario (1=strongly disagree, 6=strongly agree)
|
1 year
|
合作者和调查者
出版物和有用的链接
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- HUM00183129
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.