Patrycja Szadkowska, Maciej Karolak
Analysis of the pharmacotherapy of seniors based on self-reported lists of medications used, in the context of providing medicines use review service in Poland
2023-09-12
Background. The aging of the population is one of the factors influencing the spread of the idea of pharmaceutical care. Due to changes in the organism, seniors are the group of patients who take the most drugs and are most vulnerable to drug problems. Currently, pharmaceutical care in Poland is at an early stage of development. At the same time, patients may be insufficiently aware of the possibility of obtaining pharmaceutical advice or using selected services. A pilot program of medicines use reviews - one of the first advanced pharmaceutical care services to be provided in Polish pharmacies - has recently ended. However, there has still not been enough research, taking into account the conditions of the Polish health care system, to help determine the specific requirements and how this service should be conducted.
Aim of the study. The aim of the study was to analyze self-completed lists of medicines, used by patients over 60 years of age, in order to determine their number and type, and to detect selected problems associated with them. At the same time, with the help of a questionnaire, the patients’ opinion on self-completion of the list of medicines used was examined, and the ability to perform this task without the assistance of a pharmacist was verified, including with regard to the errors made. In addition, the knowledge and opinion of patients regarding the drug review service was assessed.
Materials and methods. The study used an anonymous paper questionnaire containing: basic information about the patient, a list of preparations used by the patient in the form of a table, with instructions for completion, and a questionnaire, consisting of five questions, regarding the patients’ opinions on the questionnaire itself and the idea of reviewing the preparations used. Distribution and collection of the questionnaires were carried out in several public pharmacies in the Kuyavian-Pomeranian Voivodeship. The collected database was analyzed for basic statistical parameters using Statistica 13.1.
Results. Among the 121 seniors participating in the survey, the average number of medications used was more than 5. Patients mainly indicated prescription medications prescribed by a doctor. Cardiovascular drugs (ATC C) were the most commonly used group of medicines. 12 seniors (10% of the study group) would have been eligible for the recently conducted drug review pilot programme, as they declared permanent use of no less than 10 drugs, including at least 2 from ATC category C. Nearly half of the respondents reported having a drug problem, the most common being forgetting to take medication and the high cost of therapy. Less than 20% of seniors were aware of the possibility of having their medications written down and checked by a pharmacist, and only 12% were offered a drug review service. More than half of the respondents had no difficulty listing their medications on their own, however, 47% of the questionnaires were not filled out correctly or omitted some issues. In addition, the majority of seniors did not express interest in pharmacists support in creating a medication list. In contrast, one in two people noted the need for a medication review service.
Conclusion. The statistical respondent was characterized by multidrug use. Only one in ten seniors met the qualification criteria for the medicines use review pilot program (they were taking no less than 10 drugs on a permanent basis, including at least two from ATC Category C). Nearly half of the respondents correctly completed the list of medications they were taking based on the questionnaire they received. This, and similarly created documents, can be a tool for pharmacists to help optimize their work time when performing drug reviews. The number of problems reported by patients, related to pharmacotherapy, indicates the need to conduct drug reviews, in order to improve the effectiveness of treatment. At the same time, it is important to introduce additional patient education regarding this service, in order to increase their knowledge and awareness, as well as to spread the service itself.
Keywords: pharmaceutical care, elderly, medication use review, polypharmacy, drug related problem.
© Farm Pol, 2023, 79(4): 187–196