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Eine einfache Priorisierungstabelle für das Management von Polypharmazie bei allgemeinmedizinischen Patienten – eine Pilotstudie

DOI: 10.3238/zfa.2019.0394-0398

german translation / full article

Nina Enthaler, Jochen Schuler, Tim Johansson, Maria Flamm

Keywords: family medicine multimorbidity patient involvement polypharmacy

BackgroundPolypharmacy has become a global health problem. Numerous interventions to reduce polypharmacy have been published in the past years, but applicable best practice models are missing. The prioritization table is a tool for classifying drugs according to treatment intention and clinical need. The patients are closely involved in the definition and achievement of the individual therapy goal. The aim of this study was to pilot-test the prioritization table for the use in primary care regarding the identification of potentially dispensable drugs, feasibility, and practicability.MethodsNon-controlled pilot study conducted in primary care offices in Salzburg, Austria, with patients taking at least eight different substances. Using the prioritization table, each drug was categorized by treatment intention and clinical importance. This facilitates the identification of potentially dispensable drugs. The process is carried out by the family physician (FP) together with the patient. The primary endpoint was the percentage of potentially dispensable substances. ResultsFive FPs and 39 patients were recruited for the pilot testing. 29 % (n = 140) of all substances were classified as “less important” and “not important”. 13 % (n = 61) of all substances were assessed as potentially dispensable by the FPs after discussion with the patient.ConclusionsThe prioritization table was feasible and enabled FPs together with their patients to identify potentially dispensable substances to a great extent. However, the evaluation of efficacy regarding clinical endpoints remains to be undertaken within a larger randomised, controlled study. KeywordsFamily medicine; patient involvement; polypharmacy; multimorbidity


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