The INFORM Study: Identifying older peoples’ needs to empower discussions with healthcare professionals about their use of anticholinergic medicines
The INFORM study aims to understand how ‘patient empowerment’ can be applied to the deprescribing of anticholinergic medicines, a group of harmful medicines to older people, and develop a lay-led co-developed intervention which can increase older persons empowerment to engage with health professionals in discussions about their medicines.
Why are we studying this?
Anticholinergics, a group of medicines, are used for several common conditions including irritable bladder, allergies, and sickness. Around half of all older adults use one or more of these medicines. However, the more anticholinergic medicines taken by a person, the greater their risk of heart attack, dementia, falls and death. Harm resulting from older persons use of anticholinergic medications is common, placing significant burden upon health and social care providers and reducing quality of life for many older persons. How best to reduce use of these medications remains unknown. Several attempts to reduce prescribing of anticholinergics have been reported, typically involving educating prescribers, providing alerts to prescribers, or adding an expert prescribing service. These approaches target the prescriber. A different approach proposed to reduce medication harms involves targeting the patient as an agent of change. Empowerment allows patients to have greater control by having a say in the decisions and actions taken in relation to their health. Promoting patient empowerment features heavily within current health policy context including National Institute of Health and Care Excellence, NHS England, and Scottish Government. The Scottish Governments Realistic Medicine campaign aims to increase patient empowerment to improve medicine use. This is echoed by the British Geriatrics Society (BGS) who request future research focus on how components such as patient empowerment can be interlinked with deprescribing interventions. While evidence and policy suggest a role for empowering patients in relation to anticholinergic medicines, we do not know how best to achieve this.
What will we be doing?
We will be:
- Interviewing older people and their caregivers to explore how they understand the term empowerment in relation to their medicine use, identify what is needed (such as knowledge, confidence and skills) for them to be empowered, and how this can be facilitated, in relation to their medicine use.
- Build a co-developed (with patients, caregivers and health professionals) intervention, which can increase older people’s sense of empowerment to put discussions about their anticholinergic medicines on their agenda with their healthcare provider.
Who can participate?
We would like to interview people aged 65 years and older who use one or more anticholinergic medicines, and/or a caregiver of someone aged 65 years and older who uses one or more of these medicines, to find out what you think about being empowered to ask more questions about your medicines. At a later date you will be invited to attend a workshop to discuss this further (but you do not have to participate in the follow up workshop if you do not wish to).
A list of eligible medicines can be viewed here: INFORM- Eligible medicines
Further information about the study for those aged 65 years using one or more eligible medicines can be found here: INFORM Older person interview
Further information about the study for caregivers of someone aged over 65 years using one or more eligible medicines can be found here: INFORM Caregiver Interview
Who has funded this project?
This study is funded by the Sir Halley Stewart Trust (1106501521).
How can I get more information?
For further information please contact Dr. Carrie Stewart (carrie.stewart@abdn.ac.uk or by telephone 01224 438152).