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Tijdschrift voor Psychiatrie 61 (2019) 8, 527 - 535


‘You tell me, you are the doctor’; patients on long-term psychiatric residences about their medication

N.E.D.M. Frankowski, K.P. Grootens, C.A. van der Stelt, A. Noort, R.J. van Marum

background In an era of patient centered care, the question rises whether practitioners of these patients are sufficiently aware of their treatment preferences.
aim To study the opinion and knowledge of older, long-term psychiatric patients about their medication and health priorities.
method Patients were interviewed with the Patient’s Attitudes Towards Deprescribing questionnaire. Furthermore patients were asked to name their medication by heart, their health priorities and preferences in medication changes. These preferences were compared with those of their practitioners.
results 47 patients (median age 67 years, median 11 drugs) were interviewed. The mean percentage of spontaneously recalled drugs was 37%. Though 64% believed all used drugs were necessary, 77% would like to deprescribe if the doctor said it was possible. Preferences in deprescribing of patients and doctors didn’t correspond in about 80%.
conclusion Most of old psychiatric patients are willing to deprescribe, but await initiative of their doctor. They can recall little of their currently used drugs. Preferences in deprescribing of the patient and doctor do often not match. We recommend to include a patient interview about the need for education and treatment preferences in the annual medication reviews in order to deprescribe and deliver more patient centered care.

keywords deprescribing, geriatric psychiatry, medication review, polypharmacy, shared decision making