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OBJECTIVE: To study the opinion of elderly patients with polypharmacy regarding their medication and to study the differences in valuation of this medication between patient, Community pharmacist and general practitioner (GP). DESIGN Interviews and questionnaires. METHODS: Patients with 7 or more chronically used drugs were interviewed with the Patients Attitudes Towards Deprescribing questionnaire. Furthermore patients were asked to name their medication by heart, to rate the assumed importance of each currently used drug on a numeric rating scale (0-10) and to name three drugs they wanted to continue as well as three drugs they would prefer to stop. These last two questions were also presented to their GPs and Community pharmacists. RESULTS: 40 patients (mean age 79 years, average 11 drugs) were interviewed. The median number of drugs spontaneously recalled by name by the patient was 2. Though 85% of the patients believes all used drugs are necessary, 98% of them stated they would like to stop drugs if the GP said it was possible. Patients scored the importance of their drugs slightly higher than pharmacists or GPs (mean score: 7,5 versus 6,7 versus 6,9). Rating of importance for all groups seemed not to be based on comparison of numbers needed to treat. CONCLUSION: Patients consider their current medication useful and necessary, but almost all of them are Willing to stop some drugs. Their spontaneous knowledge of the drugs used seems low. Before performing medication reviews, GPs and pharmacists should test the patients' knowledge and provide them with Information necessary for making the right decisions.

Objective: This study tests the hypothesis that integrated family support, in which patients and caregivers are both supported by one professional staff, is more effective in influencing behavior problems and mood of the dementia patient than nonintegrated support, such as psychogeriatric day care only. Design: A quasi-experimental pretest-posttest control group design with matched groups was applied. Setting: Psychogeriatric day-care centers of four community centers and three nursing homes. Participants: Fifty-six dementia patients living at home and their caregivers. Intervention: The patients in the experimental group (n = 33) participated together with their caregivers in an integrated family support program, whereas the patients in the control group (n = 23) received psychogeriatric day care only. Measurements: Behavior problems and mood were observed using standardized behavior observation scales. Results: After 7 months the experimental support program, compared to the regular psychogeriatric day care, showed a large positive effect on the total number of behavior problems (effect size .75), and also specifically on the degree of inactivity (effect size .66) and nonsocial behavior (effect size .61). No effect on mood was found. Conclusions: In influencing the total amount of behavior problems, as well as the degree of inactivity and nonsocial behavior, the integrated family support program proved to be more effective than psychogeriatric day care. Because behavior problems are an important determinant for admission of persons with dementia into a nursing home, integrated family support may contribute to the delay of institutionalization.