gms | German Medical Science

20. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

06. - 08.10.2021, digital

“I must, and I can live with that”: a thematic analysis of patients’ perspectives on polypharmacy and a digital decision support system for GPs

Meeting Abstract

  • Robin Brünn - Institut für Allgemeinmedizin, Goethe-Universität, Frankfurt am Main, Deutschland
  • Beate Müller - Institut für Allgemeinmedizin, Goethe-Universität, Frankfurt am Main, Deutschland
  • Benno Flaig - Institut für Allgemeinmedizin, Goethe-Universität, Frankfurt am Main, Deutschland
  • Petra Kellermann-Mühlhoff - Produktstrategie/-entwicklung, Barmer GEK, Wuppertal, Deutschland
  • Ute Karbach - Fakultät Rehabilitationswissenschaften, TU Dortmund, Dortmund, Deutschland
  • Sara Söling - Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Universität zu Köln, Köln, Deutschland
  • Christiane Muth - Institut für Allgemeinmedizin, Goethe-Universität, Frankfurt am Main, Deutschland
  • Marjan van den Akker - Institut für Allgemeinmedizin, Goethe-Universität, Frankfurt am Main, Deutschland

20. Deutscher Kongress für Versorgungsforschung (DKVF). sine loco [digital], 06.-08.10.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. Doc21dkvf166

doi: 10.3205/21dkvf166, urn:nbn:de:0183-21dkvf1669

Published: September 27, 2021

© 2021 Brünn et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Background and status of (inter)national research: As the number of patients with polypharmacy is rising steeply and care for those patients is highly complex, digitally supported medication reviews are tested to support physicians in handling the problems arising with this phenomenon. While many studies try to assess clinically relevant outcomes, little is known about patients’ roles and preferences in medication reviews.

Question and objective: This study aims to investigate patients’ perspectives on polypharmacy and the use of a digital decision support system to support general practitioners (GPs) in performing medication reviews. Since reporting on harmful outcomes in intervention trials is rare, we explicitly asked for unintended negative consequences by the use of digital decision support.

Method or hypothesis: Qualitative interviews with patients and informal caregivers recruited by GPs participating in the Innovation Fund Project AdAM (grant no. 01NVF16006), a cluster-randomized controlled clinical trial, taking place in the German region of Westfalen-Lippe. After a transcription ad verbatim, the interviews were analyzed using thematic analysis.

Results: Seven themes arose from the 13 interviews that were conducted: the patients successfully integrated medication use in their everyday lives, made use of medication plans, had both good and bad personal experiences with their medication, regarded their healthcare providers as the main source of medication-related information, discussed medication changes with their GPs, had trusting relationships with them, and viewed the use of digital decision support tools for medication reviews positively. No unintended negative consequences were reported.

Discussion: Interviewees reported positive attitudes towards the digital intervention and seemed to cope well with their medication. The close patient-GP relationship and patients’ high trust in their GPs’ actions is consistent with previous studies. Patients are aware of their lack of expertise and believe their GPs to give the best treatment, while they appreciate support for their GPs in the highly complex field of pharmacotherapy. This is especially true since patients experienced drug-related problems and noted difficulties in getting clear advice when healthcare providers’ opinions were contradictory. Patients, however, didn’t notice significant changes in care after the intervention. True purposive sampling could not be achieved due to small sample size, so our findings should be elaborated in larger and more diverse samples.

Practical implications: Interprofessional care involving physicians, pharmacists and nurses is appreciated by patients, as they are in favor of physicians sharing information, and acknowledge pharmacists as a source of drug-related information. As digital tools are highly regarded by patients, their use to intensify interprofessional care should be encouraged.

Appeal for practice (science and/or care) in one sentence: Polypharmacy patients appreciate both computerized decision support and clear communication between healthcare providers from different settings.