TY - JOUR
T1 - Patient behavior in medication management – Findings from a patient usability study that may impact clinical outcomes
T2 - Findings from a patient usability study that may impact clinical outcomes
AU - Schenk, Ariane
AU - Eckardt-Felmberg, Rahel
AU - Steinhagen-Thiessen, Elisabeth
AU - Stegemann, Sven
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Aims: Adequate medication management is a key condition to ensuring effective pharmacotherapy. However, it is well acknowledged that older people may encounter difficulties self-administering medicines in a correct manner. Methods: A mixed method pilot study was performed to investigate medication self-management in older and multimorbid patients with polypharmacy. The pilot study involved medication management tasks followed by semi-structured interviews in 20 patients. The tasks and interviews were based on the patients' individual medication plans, which had been prepared earlier by the pharmacy for each patient on basis of all their prescriptions. Results: The patients' self-reported medication management skills differed from their actual observed medication management performance. In addition, the routines and coping strategies used by the patients to deal with the complexity of their overall medication regimen were not in accordance with the medication plan and the instructions for use on the product labels. Issues were observed on all stages of the medication process that can be considered relevant to patient adherence, especially medication plan recall, product identification, product selection, product handling and product recognition in a multicompartment compliance aid. Conclusions: The pilot study suggested that medication management issues by older and multimorbid patients remain widely undetermined and unrecognized in primary care. Further investigation and interdisciplinary collaboration will be required to resolve the user problems and ensure adequate patient adherence.
AB - Aims: Adequate medication management is a key condition to ensuring effective pharmacotherapy. However, it is well acknowledged that older people may encounter difficulties self-administering medicines in a correct manner. Methods: A mixed method pilot study was performed to investigate medication self-management in older and multimorbid patients with polypharmacy. The pilot study involved medication management tasks followed by semi-structured interviews in 20 patients. The tasks and interviews were based on the patients' individual medication plans, which had been prepared earlier by the pharmacy for each patient on basis of all their prescriptions. Results: The patients' self-reported medication management skills differed from their actual observed medication management performance. In addition, the routines and coping strategies used by the patients to deal with the complexity of their overall medication regimen were not in accordance with the medication plan and the instructions for use on the product labels. Issues were observed on all stages of the medication process that can be considered relevant to patient adherence, especially medication plan recall, product identification, product selection, product handling and product recognition in a multicompartment compliance aid. Conclusions: The pilot study suggested that medication management issues by older and multimorbid patients remain widely undetermined and unrecognized in primary care. Further investigation and interdisciplinary collaboration will be required to resolve the user problems and ensure adequate patient adherence.
KW - age 65 and over
KW - medication errors
KW - medication issues
KW - medication management
KW - older adults
KW - therapeutic complexity
UR - http://www.scopus.com/inward/record.url?scp=85066332499&partnerID=8YFLogxK
U2 - 10.1111/bcp.13946
DO - 10.1111/bcp.13946
M3 - Article
C2 - 30937937
AN - SCOPUS:85066332499
SN - 0306-5251
VL - 86
SP - 1958
EP - 1968
JO - British Journal of Clinical Pharmacology
JF - British Journal of Clinical Pharmacology
IS - 10
ER -