Article
Medication review in primary care for patients with polypharmacy results in 30% changes in presciptions and a stable quality of life
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Published: | September 5, 2017 |
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Background: Multifaceted interventions are necessary to optimize the medication profile of patients with polypharmacy. In the PIL-study (Polypharmacy Intervention Limburg) general practitioner, pharmacist, medical specialist, practice nurse and patient closely collaborate in performing medication reviews. In this presentation we answer to the following questions.
Research Questions:
- 1.
- Do medication reviews result in changes in medication prescriptions and dosages?
- 2.
- Does patients’ better quality of life increase after medication review?
Methods: The PIL study is a cluster randomised clinical trial (RCT), using stepped wedge design, in 24 general practice centres and 17 associated pharmacies involving 751 patients. Data collected at baseline and after 1 year follow up are analysed. We collected data through questionnaires directly from the patients, and medication lists from the GP and pharmacists, and registration of medication review advise of the GP and pharmacist in collaboration with involved specialists.
Results: At baseline 751 patients used 5990 prescribed medications (mean 7.98 per patient). After 1 year follow up, 601 patients still used 4360 medications with a mean of 7.25. The intervention resulted in 1857 changes in medication prescriptions, 799 (13.3%) were stopped, 482 (8.0%) changed in dosages, 399 (6.1%) newly started medications and 237 (4.3%) restarted medication, During follow up time, we recorded a total of 3015 changes. Quality of life of the patients during the study remained stable.
Conclusion: Although GPs had the feeling they made few changes, 30% of all prescribed medications were changed during intervention.