Rational medication management mode and its implementation effect for the elderly with multimorbidity: A prospective cohort study in China

Abstract

BackgroundAs one of the countries with the most serious degree of aging, the incidence of potentially inappropriate drug use among the elderly is as high as 30. 4% in Chinese communities, and the lack of effective medication management and poor medication compliance at home are the main factors. Given these situations, we constructed a Rational Medication Management Mode based on family physician service, carried out an empirical research and evaluated the implementation effect.MethodsA prospective cohort study was conducted from September to December 2021 to analyze the implementation effect of the Rational Medication Management Mode by comparing the outcome indicators between the intervention group and control group. The primary outcome of this study was medication number and polypharmacy (taking 5 or more medications) at 90 days. The secondary outcomes included the situation for behavioral self-management and knowledge-belief-behavior of rational medication use.ResultsA total of 618 elderly patients (309 in the intervention group and 309 in the control group) with multimorbidity were included in this study, those were all available at follow-up at 90 days. At 90 days, the number of medications was achieved by 3.88 (1.48), and patients with polypharmacy were reduced by 59.55% in the intervention group, having a significant difference compared with the control group (P < 0.001). Patients with medication reminders, intermittent medication and adverse drug reactions were achieved in 294 (95.15%), 47 (15.21%), and 51 (16.51%) respectively in the intervention group (P < 0.001). The knowledge, belief, behavior security and behavior compliance of rational medication use of elderly patients were all greatly improved in the intervention group at 90 days (P < 0.0001).ConclusionThe Rational Medication Management Mode based family physician service, which provides the support of manuals and pillboxes, can decrease the elderly patients' number of drugs with multimorbidity, reduce the incidence of polypharmacy, enhance behavioral self-management, increase the knowledge and belief of rational medication use, and improve the security and compliance of medication usage behavior. In order to provide a practical basis for rational medication management of elderly patients with multimorbidity under the background of long-term prescriptions in China.

Analysis of the Current Status and Moderated Mediating Effect of Medication Beliefs, Medication Adherence, and Social Support Among Elderly Individuals with Polypharmacy in Rural Hangzhou, China

“…In this study, it was not found that "health education" (17) and "whether to sign a contract with a family doctor" (18) were factors affecting the medication compliance of elderly people with multiple drugs in rural Hangzhou, which was different from the results of some studies (19)(20)(21). These ndings contribute to a better understanding of the relationship between drug use knowledge, drug use beliefs, and social support, and provide evidence for subsequent interventions to improve the status of multiple drug use in rural elderly groups.…”

Knowledge, attitude, and practice of medication and its influencing factors among residents in western China: a large-scale cross-sectional study

“…However, they have low awareness and knowledge levels of rational drug use and poor understanding ability ( 25 ) and urgently require drug use knowledge. Therefore, it is suggested that relevant departments regularly organize pharmacists to conduct public lectures and seminars on rational drug use in rural areas and communities, distribute popular science books, provide medication consultation and guidance, follow up medication, and establish a chronic management center throughout the process, which can reduce the amount of multidrug use in elderly patients, reduce the incidence of multidrug use, enhance behavioral self-management, and increase knowledge and belief in rational drug use, eventually improving safety and medication adherence behavior ( 26 , 27 ). At the same time, these will constantly improve the overall quality of the science popularization team, establish a systematic and standardized science popularization system, provide a practical guarantee for promoting the widespread popularization of pharmacy science, promote the improvement of the scientific quality of safe drug use of residents, and actively help the implementation of the strategy of “Healthy China.”…”

Risk prediction model of polypharmacy for community-dwelling elderly patients: An assessment tool for early detection

“…For the independent variables, based on previous research results ( Jokanovic et al, 2015 ; Yang et al, 2015 ; Tang et al, 2021 ; Tang et al, 2022 ), we used age, living district (countryside or suburb or central-city), preference for medical institutions, number of visits (for community healthcare center, secondary hospital, and tertiary hospital, respectively), number of diagnoses, main types of disease as the eight risk factors.…”