8 research outputs found
General Practitioners' Barriers Toward Medication Reviews in Polymedicated Multimorbid Patients:How can a Focus on the Pharmacotherapy in an Outpatient Clinic Support GPs?
Purpose: The aim of this study was to explore whether general practitioners (GPs) experienced barriers toward medication reviews in polymedicated, multimorbid patients, and how a clinical pharmacologist with a focus on pharmacotherapy can support the GPs in an outpatient clinic. Design: The study was descriptive and exploratory and had a qualitative design with a phenomenological/hermeneutic orientation for the interviews. Participants: The study comprised 14 interviews with 14 different GPs from the Capital Region of Denmark. Results: Three themes emerged from the interviews: (1) The care of patients With polypharmacy is challenged by the lack of professional dialogue and collaboration between GPs and hospital-based clinical pharmacologists, (2) the relationship between the patients with polypharmacy and the GP is characterized by care and individual considerations, and (3) the culture encourages adding medication and inhibits dialogue about medication withdrawal even for patients with polypharmacy. Conclusion and implications for practice: This study found that the primary barriers toward multimorbid patients with polypharmacy were the need for communication and teamwork with specialists (cardiologists, neurologists, endocrinologists, etc). Often, GPs felt that the specialists at the hospitals were more concerned about following standards and guidelines regarding specific diseases instead of a more holistic patient approach. To improve management of polypharmacy patients, the GPs suggest that a joint force is necessary, a partner-like relationship with greater transparency regarding information transfer, feedback, and shared decision-making, but also more education in the pharmacological field is essential
Validation studies in epidemiologic research:estimation of the positive predictive value
Effect of imipramine on urethral opening pressure:A randomized, double-blind, placebo-controlled crossover study in healthy women
Background sensitivity to chemotherapy-induced nausea and vomiting and response to antiemetics in paediatric patients:a genetic association study
Causes of discrepancies between medications listed in the national electronic prescribing system and patients' actual use of medications
Effects of a comprehensive medication review intervention on health-related quality of life and other clinical outcomes in geriatric outpatients with polypharmacy:A pragmatic randomized clinical trial
AIM: To investigate the effects of a comprehensive medication review intervention on healthârelated quality of life (HRQoL) and clinical outcomes in geriatric outpatients exposed to polypharmacy. METHODS: Pragmatic, nonblinded, randomized clinical trial with followâup after 4 and 13âmonths. Participants were geriatric outpatients taking âĽ9 medicines. The intervention was an additional consultation with a physician focusing on reviewing medication, informing patients about their medicines and increasing crossâsectoral communication as supplement to and compared with usual care. The primary outcome was change in HRQoL after 4 months measured with the EuroQoL 5âdimension 5âlevel (EQâ5Dâ5L) questionnaire. Secondary outcomes were HRQoL after 13âmonths, mortality, admissions, falls and number of medicines after 4 and 13âmonths. RESULTS: Of 785 eligible patients, 408 were included (age: mean 80.6 [standard deviation 7.22] years; number of medicines: median 12 [interquartile range 10â14]; females 71%). After 4 months, the adjusted betweenâgroup difference in EQâ5Dâ5L index score was 0.066 in favour of the medication consultation (95% confidence interval 0.01 to 0.12, Pâ=â.02). After 4 months, two (1%) participants had died in the medicationâconsultation group and nine (4%) in the usualâcare group (logârank test, Pâ=â.045). The medication consultation reduced the number of medicines by 2.0 (15.8%) after 4 months and 1.3 (10.7%) after 13âmonths. There were no statistically significant differences in mortality or HRQoL after 13âmonths, and no differences in falls or admissions. CONCLUSIONS: An additional consultation with medication review and increased communication as supplement to usual geriatric outpatient care improved HRQoL and reduced mortality after 4 months