title: Attitudes towards polypharmacy and medication withdrawal among older inpatients in Italy.
abstract: BACKGROUND
  From 20 to 65 % of older adults receiving polypharmacy take at least one potentially inappropriate medication (PIM), leading to a high risk of adverse drug reactions. The term deprescribing was coined to describe a process of optimization of drug regimens through the withdrawal of PIMs. There is a paucity of evidence on the attitudes, beliefs and willingness of hospitalized patients towards deprescribing.
  
  
  OBJECTIVE
  To measure at hospital discharge inpatients' attitudes and beliefs towards polypharmacy and the potential withdrawal of one or more of their medications using the PATD (Patients' Attitudes Towards Deprescribing) questionnaire and determine if they are associated with participant characteristics.
  
  
  METHODS
  Geriatric and internal medicine wards in an Italian teaching hospital.
  
  
  METHODS
  Administration of the PATD questionnaire (developed and validated in an Australian outpatient setting, translated and adapted to the Italian setting for this study) to a consecutive sample of 100 older (aged ≥65 years) inpatients with polypharmacy who were interviewed by a nurse or pharmacist at the time of hospital discharge.
  
  
  METHODS
  Older patients' attitudes and beliefs towards reducing medications and participant characteristics.
  
  
  RESULTS
  Eighty-nine percent of patients surveyed would like to reduce the number of daily medications. The desire for deprescribing was not associated with age, sex or number of medications or medical conditions; older patients were less aware of the reasons for taking medications.
  
  
  CONCLUSIONS
  The majority of hospitalized older adults with polypharmacy think they are taking a lot of drugs and would like to reduce this number. Older adults should not be considered a major limitation on deprescribing interventions. Future research should examine this issue with qualitative studies in order to gain a more in-depth understanding and explore how these findings can be translated into a multidisciplinary deprescribing process.
authors.affiliation: Area Terapie Intensive - SITRA, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy. alessandro.galazzi@policlinico.mi.it.
authors.forename: Alessandro
authors.identifier: http://orcid.org/0000-0003-0085-7015
authors.initials: A
authors.lastname: Galazzi
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Via Pascal 36, 20133, Milan, Italy.|IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Lusignani
authors.affiliation: Clinical Pharmacology, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Chiarelli
authors.affiliation: A. Bianchi Bonomi Hemophilia and Thrombosis Center, Piazza Castello 2, 20121, Milan, Italy.|IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122, Milan, Italy.
authors.forename: Pier Mannuccio
authors.initials: PM
authors.lastname: Mannucci
authors.affiliation: Department of Neuroscience, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa 19, 20156, Milan, Italy.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Franchi
authors.affiliation: Department of Neuroscience, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa 19, 20156, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Tettamanti
authors.affiliation: Cognitive Decline Partnership Centre, Kolling Institute of Medical Research, Royal North Shore Hospital, Pacific Hwy, St Leonards, NSW, 2065, Australia.|University of Sydney, Sydney, NSW, Australia.
authors.forename: Emily
authors.initials: E
authors.lastname: Reeve
authors.affiliation: Department of Neuroscience, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa 19, 20156, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Nobili
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005260:Female; D006784:Hospitals, Teaching / Q000379:methods; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control / Q000523:psychology*; D007297:Inpatients / Q000523:psychology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D019338:Polypharmacy; D011795:Surveys and Questionnaires
keywords: Deprescribing; Italy; Older adults; Patient attitudes; Polypharmacy; Potentially inappropriate medications (PIMs); Withdrawal