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Letter to the Editor| Volume 19, ISSUE 12, P1135-1136, December 2018

Development and Validation of the Perceptions, Attitudes, and Challenges of Physicians Towards Deprescribing (PACPD-12) Questionnaire

Published:August 30, 2018DOI:https://doi.org/10.1016/j.jamda.2018.07.010
Development and Validation of the Perceptions, Attitudes, and Challenges of Physicians Towards Deprescribing (PACPD-12) Questionnaire
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      An ideal holistic health care model, where an apt, cost-effective and well-timed medicine is available and the patient is fittingly counseled on his or her medications, is still a fantasy to most of the common people in a developing country. Factors like inappropriate medication use, polypharmacy, intentional and nonintentional nonadherence to medications, high drug costs, present barriers to ideal patient care.
      • Reeve E.
      • Shakib S.
      • Hendrix I.
      • et al.
      Development and validation of the Patients' Attitudes Towards Deprescribing (PATD) questionnaire.
      Int J Clin Pharm. 2013; 35: 51-56
      , 
      • Fick D.M.
      • Mion L.C.
      • Beers M.H.
      • Waller L.J.
      Health outcomes associated with potentially inappropriate medication use in older adults.
      Res Nurs Health. 2008; 31: 42-51
      , 
      • Kutner J.S.
      • Blatchford P.J.
      • Taylor D.H.
      • et al.
      Safety and benefit of discontinuing statin therapy in the setting of advanced, life-limiting illness: A randomized clinical trial.
      JAMA Intern Med. 2015; 175: 691-700
      , 
      • Eveleigh R.
      • Grutters J.
      • Muskens E.
      • et al.
      Cost-utility analysis of a treatment advice to discontinue inappropriate long-term antidepressant use in primary care.
      Fam Pract. 2014; 31: 578-584
      The complex process of deprescribing is gaining merit as one of the tools that can reduce the incidence of the previously mentioned issues. In spite of the documented efficacy of deprescribing in improving patients' outcomes,
      • Iyer S.
      • Naganathan V.
      • McLachlan A.J.
      • Le Conteur D.G.
      Medication withdrawal trials in people aged 65 years and older.
      Drugs Aging. 2008; 25: 1021-1031
      , 
      • Gnjidic D.
      • Le Couteur D.G.
      • Kouladjian L.
      • Hilmer S.N.
      Deprescribing trials: Methods to reduce polypharmacy and the impact on prescribing and clinical outcomes.
      Clin Geriatr Med. 2012; 28: 237-253
      , 
      • Page A.T.
      • Clifford R.M.
      • Potter K.
      • et al.
      The feasibility and effect of deprescribing in older adults on mortality and health: A systematic review and meta-analysis.
      Br J Clin Pharm. 2016; 82: 583-623
      , 
      • Johansson T.
      • Abuzahra M.E.
      • Keller S.
      • et al.
      Impact of strategies to reduce polypharmacy on clinically relevant endpoints: A systematic review and meta-analysis.
      Br J Clin Pharm. 2016; 82: 532-548
      , 
      • Cooper J.A.
      • Cadogan C.A.
      • Patterson S.M.
      • et al.
      Interventions to improve the appropriate use of polypharmacy in older people: A Cochrane systematic review.
      BMJ Open. 2015; 5: e009235
      its utility still remains lagging. The suboptimal use of deprescribing can stem from both patient- and prescriber-related factors. Our study aimed at developing and validating a novel questionnaire, thus offering the opportunity to correct the shortcomings in the current system. Because there are no standard questionnaires currently available to explore the prestated area, the Perceptions, Attitudes, and Challenges of Physicians towards Deprescribing (PACPD-12) questionnaire has large potential as an exploratory tool.
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      References

        • Reeve E.
        • Shakib S.
        • Hendrix I.
        • et al.
        Development and validation of the Patients' Attitudes Towards Deprescribing (PATD) questionnaire.
        Int J Clin Pharm. 2013; 35: 51-56
        View in Article
        • Fick D.M.
        • Mion L.C.
        • Beers M.H.
        • Waller L.J.
        Health outcomes associated with potentially inappropriate medication use in older adults.
        Res Nurs Health. 2008; 31: 42-51
        View in Article
        • Kutner J.S.
        • Blatchford P.J.
        • Taylor D.H.
        • et al.
        Safety and benefit of discontinuing statin therapy in the setting of advanced, life-limiting illness: A randomized clinical trial.
        JAMA Intern Med. 2015; 175: 691-700
        View in Article
        • Eveleigh R.
        • Grutters J.
        • Muskens E.
        • et al.
        Cost-utility analysis of a treatment advice to discontinue inappropriate long-term antidepressant use in primary care.
        Fam Pract. 2014; 31: 578-584
        View in Article
        • Iyer S.
        • Naganathan V.
        • McLachlan A.J.
        • Le Conteur D.G.
        Medication withdrawal trials in people aged 65 years and older.
        Drugs Aging. 2008; 25: 1021-1031
        View in Article
        • Gnjidic D.
        • Le Couteur D.G.
        • Kouladjian L.
        • Hilmer S.N.
        Deprescribing trials: Methods to reduce polypharmacy and the impact on prescribing and clinical outcomes.
        Clin Geriatr Med. 2012; 28: 237-253
        View in Article
        • Page A.T.
        • Clifford R.M.
        • Potter K.
        • et al.
        The feasibility and effect of deprescribing in older adults on mortality and health: A systematic review and meta-analysis.
        Br J Clin Pharm. 2016; 82: 583-623
        View in Article
        • Johansson T.
        • Abuzahra M.E.
        • Keller S.
        • et al.
        Impact of strategies to reduce polypharmacy on clinically relevant endpoints: A systematic review and meta-analysis.
        Br J Clin Pharm. 2016; 82: 532-548
        View in Article
        • Cooper J.A.
        • Cadogan C.A.
        • Patterson S.M.
        • et al.
        Interventions to improve the appropriate use of polypharmacy in older people: A Cochrane systematic review.
        BMJ Open. 2015; 5: e009235
        View in Article
        • Bagcchi S.
        India has low doctor to patient ratio, study finds.
        BMJ. 2015; 351: h5195
        View in Article

      Article info

      Publication history

      Published online: August 30, 2018

      Footnotes

      The authors declare no conflicts of interest.

      Identification

      DOI: https://doi.org/10.1016/j.jamda.2018.07.010

      Copyright

      © 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

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