Abstract
BackgroundPatient awareness surveys on polypharmacy have been reported previously, but no previous study has examined the effects of sending feedback to health professionals on reducing medication use. Our study aimed to conduct a patient survey to examine factors contributing to polypharmacy, feedback the results to health professionals, and analyze the resulting changes in the number of polypharmacy patients and prescribed medications.MethodsAfter conducting a questionnaire survey of patients in Study 1, we provided its results to the healthcare professionals, and then surveyed the number of polypharmacy patients and oral medications using a before-after comparative study design in Study 2. In Study 1, we examined polypharmacy and its contributing factors by performing logistic regression analysis. In Study 2, we performed a t-test and a chi-square test.ResultsIn the questionnaire survey, significant differences were found in the following 3 items: age (odds ratio (OR) = 3.14; 95% confidence interval (CI) = 2.01–4.91), number of medical institutions (OR = 2.34; 95%CI = 1.50–3.64), and patients’ difficulty with asking their doctors to deprescribe their medications (OR = 2.21; 95%CI = 1.25–3.90). After the feedback, the number of polypharmacy patients decreased from 175 to 159 individuals and the mean number of prescribed medications per patient decreased from 8.2 to 7.7 (p < 0.001, respectively).ConclusionsProviding feedback to health professionals on polypharmacy survey results may lead to a decrease in the number of polypharmacy patients. Factors contributing to polypharmacy included age (75 years or older), the number of medical institutions (2 or more institutions), and patients’ difficulty with asking their physicians to deprescribe their medications. Feedback to health professionals reduced the percentage of polypharmacy patients and the number of prescribed medications.Trial registrationUMIN. Registered 21 June 2020 - Retrospectively registered, https://www.umin.ac.jp/ctr/index-j.htm
Highlights
Patient awareness surveys on polypharmacy have been reported previously, but no previous study has examined the effects of sending feedback to health professionals on reducing medication use
For age and the number of medical institutions visited on a regular basis for medical care, the cutoff values were set based on the receiver operating characteristic (ROC) curve; the cutoff value for age was 75 years (area under the curve (AUC) = 0.690; 95% confidence interval (CI) = 0.64–0.74, p < 0.001), and the cutoff value for the number of medical institutions visited on a regular basis was 2 (AUC = 0.640; 95% CI = 0.58–0.70, p < 0.001)
Univariate analysis showed that the percentages of the following items were significantly higher in the polypharmacy group than in the non-polypharmacy group: age 75 years or older, 2 or more medical institutions visited on a regular basis, and “patients’ difficulty with telling physicians about their wish to reduce their medication use” (Table 2)
Summary
Patient awareness surveys on polypharmacy have been reported previously, but no previous study has examined the effects of sending feedback to health professionals on reducing medication use. Our study aimed to conduct a patient survey to examine factors contributing to polypharmacy, feedback the results to health professionals, and analyze the resulting changes in the number of polypharmacy patients and prescribed medications. The reduction of medication use in polypharmacy patients is known to improve the quality of medical care [5]. The guideline for safe drug therapy for older adults [8], which uses a modified version of the STOPP criteria, has developed into a standard, reflecting current drug treatment in Japan. Measures against polypharmacy have been taken, for example, use of the medication booklet to identify prescription drugs, assess adherence, and recommend non-pharmacological treatments
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