Association between recorded medication reviews in primary care and adequate drug treatment management – a cross-sectional study
Autor: | Susanna M. Wallerstedt, Naldy Parodi López, Staffan Svensson |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Male
Drug medicine.medical_specialty pharmacoepidemiology Cross-sectional study media_common.quotation_subject prescription drugs cross-sectional studies Type 2 diabetes Internal medicine Humans Medicine medication review Depression (differential diagnoses) media_common business.industry Procedure code Public Health Environmental and Occupational Health inappropriate prescribing Original Articles Odds ratio Pharmacoepidemiology medicine.disease Confidence interval primary health care aged Diabetes Mellitus Type 2 Pharmaceutical Preparations Female Public aspects of medicine RA1-1270 business Research Article |
Zdroj: | Scandinavian Journal of Primary Health Care, Vol 39, Iss 4, Pp 419-428 (2021) Scandinavian Journal of Primary Health Care article-version (VoR) Version of Record |
ISSN: | 1502-7724 0281-3432 |
Popis: | To investigate the association between a recorded procedure code for a medication review and adequate drug treatment management, and to explore factors associated with this code. Cross-sectional study; two primary health care centres, in Region Västra Götaland, Sweden. A total of 302 consecutive patients (≥65 years old, 59% female; median number of drugs: six) requiring a non-urgent consultation with a physician in October–November 2017. Adequate drug treatment management (treatment that did not require any further action), determined in consensus by two specialists in family medicine blinded to the medication review code. Adequate drug treatment management was, overall, less common in those with a recorded medication review over the last year: 63% versus 73% (p = 0.047). This negative association was evident among patients aged 65–74 years: 49% versus 74% (p = 0.003), but absent in those ≥75 years old: 67% versus 70% (p = 0.77). Recommendations from consensus included the search for additional information to be able to make a decision regarding initiation or withdrawal of a drug (n = 53), withdrawal of a drug (n = 41), or ordering a laboratory test (n = 25). Factors associated with a recorded procedure code included age above the remuneration limit of 75 years (odds ratio: 9.8; 95% confidence interval 5.0–19), type 2 diabetes (3.0 (1.5–6.2)), hypertension (2.4 (1.2–4.8)), and depression (2.5 (1.02–6.0)). The presence of a recorded medication review was not positively associated with adequate drug treatment management but was associated with the age limit for remuneration, and some chronic diseases.Key pointsTo improve drug treatment in older people in primary care, a remuneration system linked to recorded medication reviews has been introduced.In this study, fewer patients with than without a recorded medication review (63% versus 73%) had adequate drug treatment management.A recorded medication review was ten times more common in those ≥75 years, that is, the age limit for remuneration.Recorded codes for medication reviews were also common in those with type 2 diabetes, hypertension, and depression. To improve drug treatment in older people in primary care, a remuneration system linked to recorded medication reviews has been introduced. In this study, fewer patients with than without a recorded medication review (63% versus 73%) had adequate drug treatment management. A recorded medication review was ten times more common in those ≥75 years, that is, the age limit for remuneration. Recorded codes for medication reviews were also common in those with type 2 diabetes, hypertension, and depression. |
Databáze: | OpenAIRE |
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