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Association between older adults’ socioeconomic status and their healthcare experiences, preferences, and attitudes towards deprescribing : a cross-sectional study in 14 countries

Lüthold, Renata Vidonscky ; Kleijer-Werkman, Esther ; Jungo, Katharina Tabea ; Rozsnyai, Zsofia ; Adler, Limor ; Assenova, Radost ; Rogero-Blanco, Eloísa ; Bleckwenn, Markus ; Frese, Thomas and Henrard, Gilles , et al. (2025) In Archives of Public Health 83(1).
Abstract

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... (More)

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.

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Contribution to journal
publication status
published
subject
keywords
Deprescribing, Older adults, Patient care, Polypharmacy, Socioeconomic status
in
Archives of Public Health
volume
83
issue
1
article number
237
publisher
BioMed Central (BMC)
external identifiers
  • scopus:105018496920
  • pmid:41053907
ISSN
0778-7367
DOI
10.1186/s13690-025-01700-6
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2025.
id
f552772a-c8ea-4ede-a259-677bd741020c
date added to LUP
2025-12-11 09:26:31
date last changed
2025-12-12 03:00:24
@article{f552772a-c8ea-4ede-a259-677bd741020c,
  abstract     = {{<p>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 (OR<sub>lowSES</sub> 1.76, 95%CI 1.20-2.57). Those with medium SES were less likely to trust their GP (OR<sub>mediumSES</sub> 0.70, 95%CI 0.52-0.94). Both low and medium SES groups were less likely to be satisfied with their current medications (OR<sub>lowSES</sub> 0.45, 95%CI 0.29-0.71; OR<sub>mediumSES</sub> 0.63, 95%CI 0.44-0.92), less likely to report good health (OR<sub>lowSES</sub> 0.22, 95%CI 0.14-0.34; OR<sub>mediumSES</sub> 0.49, 95%CI 0.37-0.65), and had lower health literacy (OR<sub>lowSES</sub> 0.10, 95%CI 0.07-0.16; OR<sub>mediumSES</sub> 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.</p>}},
  author       = {{Lüthold, Renata Vidonscky and Kleijer-Werkman, Esther and Jungo, Katharina Tabea and Rozsnyai, Zsofia and Adler, Limor and Assenova, Radost and Rogero-Blanco, Eloísa and Bleckwenn, Markus and Frese, Thomas and Henrard, Gilles and Jennings, Aisling A. and Kurpas, Donata and Lazic, Vanja and Lingner, Heidrun and Mannheimer, Stina and Neelen, Anne Centeno and Pereira, Anabela and Petrazzuoli, Ferdinando and Poortvliet, Rosalinde K.E. and Szélvári, Ágnes and Wild, Dorothea M.G. and Streit, Sven and Vallejo-Yagüe, Enriqueta}},
  issn         = {{0778-7367}},
  keywords     = {{Deprescribing; Older adults; Patient care; Polypharmacy; Socioeconomic status}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Archives of Public Health}},
  title        = {{Association between older adults’ socioeconomic status and their healthcare experiences, preferences, and attitudes towards deprescribing : a cross-sectional study in 14 countries}},
  url          = {{http://dx.doi.org/10.1186/s13690-025-01700-6}},
  doi          = {{10.1186/s13690-025-01700-6}},
  volume       = {{83}},
  year         = {{2025}},
}