Association between older adults' socioeconomic status and their healthcare experiences, preferences, and attitudes towards deprescribing: a cross-sectional study in 14 countries. - 2025
Association between older adults' socioeconomic status and their healthcare experiences, preferences, and attitudes towards deprescribing: a cross-sectional study in 14 countries.
Deprescribing; Older adults; Patient care; Polypharmacy; Socioeconomic status; Public Health, Environmental and Occupational Health
Abstract :
[en] [en] BACKGROUND: Socioeconomic status (SES) can influence health outcomes. Both SES and older age are associated with polypharmacy, health literacy, and quality of care. Understanding how SES influences healthcare experiences of older adults with polypharmacy can serve to inform future interventions aiming at optimising patient care. Therefore, we investigated the association between older patients' SES and their i) attitudes towards deprescribing, ii) satisfaction with medications, iii) self-rated health, iv) health literacy, and v) trust in their general practitioner (GP).
METHODS: In this cross-sectional study, older patients with polypharmacy from 14 countries completed a survey on their attitudes towards deprescribing, healthcare experiences, and sociodemographic characteristics. We compared patients' responses across high (reference), middle, and low SES groups (defined by education and financial status), and performed multilevel logistic regressions adjusted for clustering at the country level to assess the association between patients' SES and the outcomes.
RESULTS: Among 1,320 older adults, compared to those with high SES, patients with low SES were more likely to want a medication deprescribed (ORlowSES 1.76, 95%CI 1.20-2.57). Those with medium SES were less likely to trust their GP (ORmediumSES 0.70, 95%CI 0.52-0.94). Both low and medium SES groups were less likely to be satisfied with their current medications (ORlowSES 0.45, 95%CI 0.29-0.71; ORmediumSES 0.63, 95%CI 0.44-0.92), less likely to report good health (ORlowSES 0.22, 95%CI 0.14-0.34; ORmediumSES 0.49, 95%CI 0.37-0.65), and had lower health literacy (ORlowSES 0.10, 95%CI 0.07-0.16; ORmediumSES 0.31, 95%CI 0.24- 0.41).
CONCLUSION: Older adults with lower SES expressed greater interest in deprescribing, lower satisfaction with medications, lower self-rated health, and lower health literacy. Our findings suggest key aspects to consider when optimising care of older adults with low SES.
Disciplines :
General & internal medicine
Author, co-author :
Lüthold, Renata Vidonscky; Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland ; Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland
Kleijer-Werkman, Esther; Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
Jungo, Katharina Tabea; Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland ; Division of Pharmacoepidemiology and Pharmacoeconomics and Center for Healthcare Delivery Sciences, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02120, USA
Rozsnyai, Zsofia; Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
Adler, Limor; Department of Family Medicine, Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
Assenova, Radost; Department of Urology and General Practice, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
Rogero-Blanco, Eloísa; General Ricardos Health Centre, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain ; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Bleckwenn, Markus; Institute of General Practice, Faculty of Medicine, Leipzig University, Leipzig, Germany
Frese, Thomas; Institute of General Practice and Family Medicine, Martin Luther-University Halle-Wittenberg, Halle (Saale), ST, Germany
Henrard, Gilles ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques
Jennings, Aisling A; Department of General Practice, University College Cork, Cork, Ireland
Kurpas, Donata; Division of Research Methodology, Department of Nursing, Faculty of Nursing and Midwifery, Wrocław Medical University, Wrocław, Poland
Lazic, Vanja; Health center Zagreb - Centar, Zagreb, Zagreb, Croatia
Lingner, Heidrun; Hannover Medical School, Center for Public Health and Healthcare, Department for Medical Psychology, Hannover, Germany
Mannheimer, Stina; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, VästraGötaland Region, Gothenburg, Sweden
Neelen, Anne Centeno; Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
Pereira, Anabela; Center for Health Technology and Services Research (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro. Campus Universitário de Santiago, 3810-193, Aveiro, Portugal ; Institute of Biomedical Sciences Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
Petrazzuoli, Ferdinando; Sezione SNaMID Caserta, Caserta, Italy ; Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
Poortvliet, Rosalinde K E; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands ; LUMC Center for Medicine for Older People, Leiden University Medical Center, Leiden, The Netherlands
Szélvári, Ágnes; Department of Family Medicine, Semmelweis University, Budapest, Hungary
Wild, Dorothea M G; Institute of Family Medicine and General Practice, University Hospital Bonn, Bonn University, Bonn, Germany
Streit, Sven; Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
Vallejo-Yagüe, Enriqueta; Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland. enriqueta.vallejo@unibe.ch
Association between older adults' socioeconomic status and their healthcare experiences, preferences, and attitudes towards deprescribing: a cross-sectional study in 14 countries.
This work was supported by Kollegium f\u00FCr Hausarztmedizin (KHM) through a research grant given to ZR and SS. KTJ was supported by a Postdoc.Mobility Fellowship from the Swiss National Science Foundation (P500PM_206728).
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