Article
Relevance of complexity factors that cannot be derived from medication schedules
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Published: | November 21, 2022 |
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Background: In the HIOPP-6 pilot study, drug treatment of adult patients in primary care was analyzed regarding different factors contributing to the complexity of their pharmacotherapy. Some complexity factors, such as tablet splitting, use of inhalers etc., can be derived electronically from the “Bundeseinheitlicher Medikationsplan” (a standardized medication schedule), while other factors, such as swallowing difficulties, can only be reported by patients themselves [1]. As part of the HIOPP-6 study protocol, such individual patient-specific factors were addressed by general practitioners using predefined questions [2], [3].
Materials and Methods: Forty-eight patients answered eight questions each to identify 14 complexity factors that cannot be derived from the medication schedule. The questions were phrased as closed questions and were basically intended to indicate a problem by confirmation, e.g. ‘Do you have problems swallowing your drugs?’ for the complexity factor ‘swallowing difficulties’ or ‘Do you have problems distinguishing your drugs because they look similar or their names sound alike?’ for the complexity factor ‘similar drug appearance’.
Results: In total, the questions revealed complexity factors for nearly three out of four patients (72.9 %). Fifty percent of patients reported not using their medication schedule, although 29.2 % had difficulties remembering drug names or dosage schemes. One in eight patients reported difficulties handling drug packaging and/or physical impairments that affect drug administration. About one in ten patients (10.4 %) reported difficulties with similar drug appearances or with changes in prescriptions or generic substitutions. Only two patients (4.2 %) reported swallowing difficulties, none reported problems due to diverse storage conditions of their drugs.
Conclusion: There are highly relevant factors for the complexity of drug treatment that can only be detected by interviewing patients [3]. Therefore, an analysis of the complexity of drug treatment should not be based on medication schedule alone but should also include the patient’s perspective on factors that cannot be derived from the medication schedule.
References
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