Factors associated with appropriate knowledge of the indications for prescribed drugs among community-dwelling older patients with polypharmacy

Bosch-Lenders, Donna; Maessen, D W H A; Stoffers, Jelle; Knottnerus, J. A.; Winkens, Björn; Akker, Marjan van den

doi:10.1093/ageing/afw045

Cited by 41 publications

(38 citation statements)

References 14 publications

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“…However, given the progressive nature of the disease and the occurrence of motor fluctuations during the disease course, correct timing is essential for efficient control of motor symptoms. In line with a former study in older subjects, a relevant proportion of our patients did not exactly know the names, reasons, and dosages of all their prescribed medications (35). Moreover, in other conditions and cohorts, lack of knowledge was found to be a critical determinant of nonadherence independent of education (36,37).…”

Section: Self-reported Reasons For Nonadherencesupporting

confidence: 65%

What Predicts Different Kinds of Nonadherent Behavior in Elderly People With Parkinson's Disease?

et al. 2020

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Background: Detailed knowledge about nonadherence to medication could improve medical care in elderly patients. We aimed to explore patterns and reasons for nonadherence in people with Parkinson's disease (PD) aged 60 years and older. Methods: Detailed clinical data and adherence (German Stendal Adherence with Medication Score) were assessed in 230 patients with PD (without dementia). Descriptive statistics were used to study reasons for nonadherence in detail, and general linear models were used to study associations between clusters of nonadherence and clinical parameters. Results: Overall, 14.2% (n = 32) of the patients were fully adherent, 66.8% (n = 151) were moderately nonadherent, and 19.0% (n = 43) showed clinically meaningful nonadherence. In the multivariable analysis, nonadherence was associated with a lower education level, higher motor impairment in activities of daily living, higher number of medications per day, and motor complications of PD. Three clusters of nonadherence were observed: 59 (30.4%) patients reported intentional nonadherence by medication modification; in 72 (37.1%) patients, nonadherence was associated with forgetting to take medication; and 63 (32.5%) patients had poor knowledge about the prescribed medication. A lower education level was mainly associated with modification of medication and poorer knowledge about prescribed medication, but not with forgetting to take medication. Patients with motor complications, which frequently occur in those with advanced disease stages, tend to be intentionally nonadherent by modifying their prescribed medication. Increased motor problems and a higher total number of drugs per day were associated with less knowledge about the names, reasons, and dosages of their prescribed medication. Conclusions: Elderly patients with PD report many reasons for intentional and non-intentional nonadherence. Understanding the impact of clinical parameters on different patterns of nonadherence may facilitate tailoring of interventions and counseling to improve outcomes.

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Section: Self-reported Reasons For Nonadherencesupporting

confidence: 65%

What Predicts Different Kinds of Nonadherent Behavior in Elderly People With Parkinson's Disease?

et al. 2020

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“…Use of psychotropic polypharmacy was associated with the patients' lack of knowledge about the effects of their primary antipsychotic drugs, which appears consistent with previous findings. For example, Donna Bosch-Lenders et al (2016) investigated the factors associated with knowledge of indications for prescribed drugs among community-dwelling older patients receiving polypharmacy in the Netherlands and found a strong negative association between the number of prescribed drugs and patient medication knowledge [25]. There are a number of side effects with antipsychotic polypharmacy, including extrapyramidal motor side effects, cognitive impairment, high cost, and increased risk of death [12].…”

Section: Discussionmentioning

confidence: 99%

Patients’ Knowledge about Prescribed Antipsychotics and Medication Adherence in Schizophrenia: A Cross-Sectional Survey

et al. 2017

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Data on the knowledge about antipsychotic medications prescribed in patients with schizophrenia are very limited. Moreover, it remains unclear how patients' knowledge about prescribed antipsychotics affects medication adherence. ighty-one Japanese outpatients with schizophrenia according to the International Classification of Diseases, 10th edition, were included. Patients' knowledge of the primary antipsychotics prescribed to them in terms of therapeutic effects, type, and implicated neurotransmitters was assessed with a multiple-choice questionnaire developed for this study. Medication possession ratios (MPRs) were compared between patients who answered correctly and those who did not in each category. The percentages of subjects who answered correctly regarding antipsychotic effects, type, and implicated neurotransmitters were low at 30.9%, 30.9%, and 7.4%, respectively. No differences were found in MPRs between subjects who answered correctly and those who did not. Our preliminary results indicate that patients lack knowledge about their antipsychotic medications. More concerning, they suggest that knowledge about prescribed antipsychotics may not directly translate into actual medication adherence in patients with schizophrenia.

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“…How much these patient misbeliefs and knowledge deficits might impair the medication process and interfere with decision-making by healthcare professionals or with correct drug handling by patients is currently unknown, but should be considered as a potentially influential source of variability and error. Knowledge deficits of patients have also been reported with regard to other domains of drug treatment such as a drug's indication 10. Furthermore, even if a patient would in theory correctly identify a product as a medication, it is uncertain whether he/she would actually report it during drug history taking or rather forget11 12 or deliberately choose not to mention it 13…”

Section: Discussionmentioning

confidence: 99%

What do laypeople consider ‘medication’ and are they aware of modulators of a drug’s effects?

et al. 2016

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ObjectivesHealthcare providers expect patients to be responsible partners during drug treatment, who know potential risks impeding drug effects and are able to accurately report prescribed and non-prescribed medication. This presumes that they have the same understanding of the term ‘medication’ as healthcare providers. We assessed which products laypeople label as medication and which modulators of drug effects they know.MethodsPeople visiting the otorhinolaryngology outpatient clinic at a university hospital were invited to anonymously complete a questionnaire assessing which products out of 23 listed examples are medications and valuing 12 modulators potentially influencing drug effects.ResultsAmong 94 participants, 86 (91.5%) identified on average 14.4±3.3 (62.6%) of the products and 79 (84.0%) identified 6.7±2.0 (55.5%) of the modulators correctly. Women performed better than men (p<0.01). Regular medication intake, education level and age did not influence the results.ConclusionsLaypeople are at risk of misclassifying medications and modulators of drug effects.

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Factors associated with appropriate knowledge of the indications for prescribed drugs among community-dwelling older patients with polypharmacy

Cited by 41 publications

References 14 publications

What Predicts Different Kinds of Nonadherent Behavior in Elderly People With Parkinson's Disease?

What Predicts Different Kinds of Nonadherent Behavior in Elderly People With Parkinson's Disease?

Patients’ Knowledge about Prescribed Antipsychotics and Medication Adherence in Schizophrenia: A Cross-Sectional Survey

What do laypeople consider ‘medication’ and are they aware of modulators of a drug’s effects?

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