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Patient selection and general practitioners' perception of collaboration in medication review.

Authors
  • Rose, Olaf1
  • Richling, Ina2
  • Voigt, Karen3
  • Gottschall, Mandy3
  • Köberlein-Neu, Juliane4
  • 1 College of Pharmacy, Department of Pharmacotherapy & Translational Research, College of Pharmacy, University of Florida, USA. Electronic address: [email protected]
  • 2 College of Pharmacy, Department of Pharmacotherapy & Translational Research, College of Pharmacy, University of Florida, USA.
  • 3 Department of General Practice/Medical Clinic III, Medical School, Technische Universität Dresden, Dresden, Germany . , (Germany)
  • 4 Center for Health Economics and Health Services Research, Schumpeter School of Business and Economics, University of Wuppertal, Germany. , (Germany)
Type
Published Article
Journal
Research in social & administrative pharmacy : RSAP
Publication Date
May 01, 2019
Volume
15
Issue
5
Pages
521–527
Identifiers
DOI: 10.1016/j.sapharm.2018.06.019
PMID: 30139537
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Implementation of collaborative Medication Review (MR) into routine care faces several barriers. The study aim was to gain information on patient selection for a MR by general practitioners (GPs). GP selection was compared to objective selection criteria on identifying patients, who would benefit from a MR the most. A secondary objective of this study was to get insight into GPs perception on interprofessional collaboration with pharmacists. GPs were interviewed for a qualitative study on expected outcomes of MR in former study patients. They were asked to select patients, for whom they expected a major benefit from the MR. Results were compared to objective selection criteria, obtained from the WestGem study. Further interviews were done on aspects of patient selection and perception of interprofessional collaboration, results were presented descriptively. The study covered 6 GPs with 78 former study patients. GPs would have chosen 45 out of the 78 patients (57.7%) for a MR. According to changes in the Medication Appropriateness Index, 24 of these patients had a greater benefit from the MR. Patient selection by the number of prescribed drugs had reached a higher specificity at a cut-off of 9 drugs, compared to selection by the GP (67% vs. 61.5%). GPs mentioned medication safety, certain diseases, polymedication, multimorbidity as selection criteria. Increasing quality of therapy and better insight into the patient's drug regimen was appreciated by the GPs as perceived personal advantage of the MR. GPs preferred to have a MR initiated by themselves, but appraised concise interprofessional collaboration with pharmacists. Patient selection for MR should take objective parameters into account and combine them with subjective impressions. GPs preferred the initiation of a MR by themselves but expressed a positive attitude towards collaboration with a pharmacist afterwards. Recommendations should be relevant and concise. Copyright © 2018 Elsevier Inc. All rights reserved.

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