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Patients with Polypharmacy: Ambulatory Challenges and Solutions

DOI: 10.3238/zfa.2018.0396-0400

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Beate S. Müller, Mirella C. Uhl, Truc S. Nguyen, Goentje-Gesine Schoch, Ferdinand M. Gerlach, Christiane Muth

Keywords: multimorbidity patient safety polypharmacy primary care rebate contract

Background: Polypharmacy is associated with specific risks which could be avoided by the use of medication reviews. The aim of this study was to identify difficulties involved in the provision of care to multimorbid patients with polypharmacy, as well as barriers and facilitators to the implementation of medication reviews in primary care.Methods: We conducted three focus groups with 25 family physicians based on a semistructured interview. Qualitative content analysis was used to evaluate the data.Results: Participants faced two major challenges when dealing with polypharmacy. 1. frequent changes in medication packaging and pharmaceutical forms due to rebate contracts, risking compromising patient safety. 2. communication difficulties with other stakeholders, so that patients‘ medications were not completely known. We discussed how the involvement of various groups of people and software-based support would affect the implementation of a medication review program. The involvement of pharmacists and user-oriented IT solutions were generally considered helpful, while opinions differed on the advantages of including HCAs and patients in the process.Conclusions: Ten years after the introduction of rebate contracts, family physicians still have substantial reservations with regard to their risks to patient safety. Further studies will be necessary to quantify this assessment and to find ways of solving the problem. The findings of this study can be considered when planning medication reviews.


(State: 12.10.2018)

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