PUB - Publikationen an der Universität Bielefeld

Background Studies have shown considerable discrepancies between the medication lists reported by patients, physicians, and pharmacists. Objective To investigate discrepancies in prescribed medications as reported by patients, general practitioners (GPs), and community pharmacists (CPs) in older patients with polypharmacy. Methods Study design: Cross-sectional analysis. Setting: Twenty-four GP centres and 17 associated community pharmacies in the Netherlands. Data sources: Postal questionnaires, home visits, and the electronic patient record systems of the GPs and CPs. We defined a medication discrepancy as any inconsistency between the patient’s, GP’s, or CP’s medication list. For fixed medications, we included inconsistencies in the medication’s name, dose, or frequency; for variably used medications, we included only inconsistencies in the medication’s name. Logistic regression analyses and GEE were performed to identify discrepancy-related patient and medication characteristics. Results Data from 751 patients (mean age 72.9 years (SD 7.6), 47.3% female) using 5989 prescribed medications (average 8, range 3–19) were analysed. The overall patient-GP-CP discrepancy was 71.9% at the patient level and 21.8% at the medication level. Statistically significant associations with discrepancy included various medication characteristics, e.g. any additional medication (OR 1.45, 95% CI 1.33–1.59) and variable medication usage (varying ORs 1.61–5.78), and the patient characteristic ‘Living in a residential care home’ (OR 0.42, 95% CI 0.18–0.997). Conclusion We found a high patient-GP-CP discrepancy, with a 72% discrepancy in prescribed medication at the patient level and a 22% discrepancy at the medication level. ‘Living in a residential care home’ reduced the chance of medication discrepancy, whereas medication characteristics, such as variable medication usage, increased it.