Polypharmacy in Older Patients with Multimorbidity: The Agreement Between Patient and General Practitioner-Reported Drugs Observed in a Pilot cRCT.

medication management multimorbidity older patients pilot study polypharmacy primary care

Journal

International journal of environmental research and public health
ISSN: 1660-4601
Titre abrégé: Int J Environ Res Public Health
Pays: Switzerland
ID NLM: 101238455

Informations de publication

Date de publication:
21 Oct 2024
Historique:
received: 29 06 2024
revised: 08 10 2024
accepted: 16 10 2024
medline: 26 10 2024
pubmed: 26 10 2024
entrez: 26 10 2024
Statut: epublish

Résumé

Polypharmacy (≥5 drugs) increases the risk of discrepancies between patient- and general practitioner (GP)-reported drugs, leading to adverse outcomes. This explorative analysis assesses the agreement between patient- and GP-reported drugs under the influence of a paper-based patient portfolio in a pilot cluster randomized controlled trial (cRCT). Complete data were available for 68 patients aged 65 or older (26 were female), with multimorbidity, polypharmacy, and at least one hospitalization in the past year. Agreement was assessed for drug name and strength level. Differences between the intervention and control group (IG/CG) and comparisons between two time points (six-month interval) stratified according to gender were analyzed using Wilcoxon and Mann-Whitney U tests (α = 5%). To evaluate the reasons for discrepancies, the agreement of active pharmaceutical ingredients (APIs) and anatomical therapeutic chemical (ATC) groups was analyzed. At baseline, the agreement was 72.1% for the IG and 73.9% for the CG. Inclusion of the reported drug strength reduced the agreement in both groups (IG 66.7%, CG 60.0%). Agreement for the IG decreased statistically significantly after six months (-5.4%). ATC groups B, C, and H had the highest agreement, while N, R, and Z had the lowest. Large discrepancies in the drugs reported, due to the APIs and the corresponding ATC group, were observed.

Identifiants

pubmed: 39457362
pii: ijerph21101389
doi: 10.3390/ijerph21101389
pii:
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Federal Ministry of Education and Research in Germany [BMBF]
ID : 01GK1906A/01GK1906B

Auteurs

Lena Schäfer (L)

Institute of General Practice, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.

Michael Paulitsch (M)

Institute of General Practice, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.

Maria Hanf (M)

Institute of General Practice, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.

Truc Sophia Dinh (TS)

Institute of General Practice, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.

Astrid-Alexandra Klein (AA)

Department of General Practice, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307 Dresden, Germany.

Sophia Klasing (S)

Cooperation Unit Clinical Pharmacy, Internal Medicine IX-Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.

Hanna Seidling (H)

Cooperation Unit Clinical Pharmacy, Internal Medicine IX-Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.

Karen Voigt (K)

Department of General Practice, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307 Dresden, Germany.

Marjan van den Akker (M)

Institute of General Practice, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.

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Classifications MeSH