Elderly polypharmacy patients' needs and concerns regarding medication assessed using the structured patient-pharmacist consultation model

Patient Educ Couns. 2017 Sep;100(9):1714-1719. doi: 10.1016/j.pec.2017.05.001. Epub 2017 May 1.

Abstract

Objective: To evaluate elderly polypharmacy patients' needs and concerns regarding medication through the Structured Patient-Pharmacist Consultation (SPPC).

Methods: Older patients on chronic treatment with ≥5 medications were asked to fill in the SPPC form at home. A consultation with the community pharmacist, structured according to patient's answers, followed within 2-4 weeks. Logistic regression associated patients' individual treatment with care issues and consultation outcomes.

Results: Out of 440 patients, 39.5% experienced problems, and 46.1% had concerns about medication use. 122 patients reported reasons for discontinuing treatment. The main outcome of the consultation was a better understanding of medication use (75.5%). Side effects and/or non-adherence were identified in 50% of patients, and 26.6% were referred to the doctor. Atrial fibrillation, COPD, anticoagulants, benzodiazepines, and beta agonists/corticosteroids were associated with problems during medication use. Patients with diabetes improved their understanding of medication use significantly.

Conclusion: Patients on benzodiazepines, anticoagulants, and beta agonists/corticosteroids, with atrial fibrillation and/or COPD, may have a higher potential for non-adherence. Counseling patients based on the SPPC model may be particularly useful for patients with diabetes.

Practice implications: The SPPC model is a useful tool for counseling based on patient needs.

Keywords: Adherence; Community pharmacy; Elderly patients; Medication use; Poly-pharmacy; Structured patient-pharmacist consultation model.

MeSH terms

  • Aged
  • Community Pharmacy Services*
  • Counseling
  • Female
  • Humans
  • Male
  • Pharmacists*
  • Polypharmacy*
  • Professional-Patient Relations
  • Referral and Consultation*
  • Serbia