Beliefs about medication after hospital discharge in patients with polypharmacy: are patients convinced of the benefits of their medicines?

Abstract

Introduction: Negative beliefs about medication can pose a threat to treatment adherence, which in turn can jeopardize drug effectiveness and beneficial health outcomes. In order to support and empower patients in safe medication use at home, it is important to assess patients’ preferences and beliefs affecting patients’ motivation to start and continue with treatment. Little is known about medication beliefs in geriatric patients with polypharmacy recently discharged from hospital and the impact of discharge management on patients’ beliefs.
 Aims: This study aimed to describe beliefs about medication in geriatric patients with polypharmacy post-discharge and to evaluate the impact of discharge management on patients’ beliefs.
 Methods: A cross-sectional study was conducted between November 2019 and March 2020 in twelve general hospitals in Belgium. Four hundred geriatric patients with polypharmacy were surveyed at hospital discharge and two to five days post-discharge using the Beliefs about Medicines Questionnaire and a self-developed questionnaire concerning medication-related discharge management.
 Results: Most geriatric patients with polypharmacy held strong beliefs about the necessity of medication for maintaining their health now and in the future. However, a significant proportion was concerned about the possible negative effects of medication such as long-term effects and the development of medication dependence. Nevertheless, the benefits of medication outweighed the disadvantages as the mean necessity score (19.4/25) outweighed the mean concern score (11.9/25). Patients receiving help with medication management post-discharge had stronger necessity-, concern- and harm-related beliefs. No patient- or discharge management-related factors were significant predictors of medication beliefs in this sample.
 Conclusions and implications for practice: Although polymedicated patients hold predominantly positive beliefs about medication, it is important to discuss beliefs about medication with patients, as respected partners in care, prior to discharge in order to prevent non-adherence and enhance safe medication practices at home. Actively involving the patient in (decisions about) medication enables patients to express doubts and concerns about their medicines and ensures that pharmacotherapeutic care is more attuned to the patients’ values, preferences and needs. However, patients should be provided with sufficient and correct information to avoid misconceptions and misplaced concerns and to allow patients to make an accurate assessment of the pros and cons of medicines.