Department of General Practice / Medical Clinic III, Dresden Medical School, University of Technology, Fetscherstr, 74, Dresden 01307, Germany.
BMC Fam Pract. 2013 Aug 15;14:119. doi: 10.1186/1471-2296-14-119.
Multimorbidity is defined as suffering from coexistent chronic conditions. Multimorbid patients demand highly complex patient-centered care which often includes polypharmacy, taking an average of six different drugs per day. Adverse drug reactions, adverse drug events and medication errors are all potential consequences of polypharmacy. Our study aims to detect the status quo of the health care situation in Saxony's general practices for multimorbid patients receiving multiple medications. We will identify the most common clinical profiles as well as documented adverse drug events and reactions that occur during the treatment of patients receiving multiple medications. We will focus on exploring the motives of general practitioners for the prescription of selected drugs in individual cases where there is evidence of potential drug-drug-interactions and potentially inappropriate medications in elderly patients. Furthermore, the study will explore general practitioners' opinions on delegation of skills to other health professions to support medical care and monitoring of patients receiving multiple medications.
METHODS/DESIGN: This is a retrospective cross sectional study using mixed methods. Socio-demographic data as well as diagnoses, medication regimens and clinically important events will be analyzed retrospectively using general practitioners documentation in patients' records. Based on these data, short vignettes will be generated and discussed by general practitioners in qualitative telephone interviews.
To be able to improve outpatient health care management for patients receiving multiple medications, the current status quo of care, risk factors for deficient treatment and characteristics of concerned patients must be investigated. Furthermore, it is necessary to understand the physicians' decision making process regarding treatment.
多病共存是指同时患有多种慢性疾病。多病共存患者需要高度复杂的以患者为中心的护理，其中通常包括多种药物治疗，每天平均服用六种不同的药物。药物不良反应、药物不良事件和用药错误都是药物治疗的潜在后果。我们的研究旨在检测萨克森州接受多种药物治疗的多病共存患者的一般实践中的医疗保健状况现状。我们将确定最常见的临床特征以及在治疗接受多种药物治疗的患者期间发生的有记录的药物不良反应和反应。我们将专注于探索全科医生在个别情况下开具某些药物的动机，这些情况下有证据表明存在药物相互作用和老年人潜在不适当用药的情况。此外，该研究还将探讨全科医生对将技能委托给其他卫生专业人员以支持接受多种药物治疗的患者的医疗和监测的看法。
方法/设计：这是一项使用混合方法的回顾性横断面研究。使用全科医生在患者记录中的文件，回顾性地分析社会人口统计学数据以及诊断、药物治疗方案和临床重要事件。根据这些数据，将生成简短的情景并由全科医生在定性电话访谈中进行讨论。
为了能够改善接受多种药物治疗的患者的门诊医疗保健管理，必须调查当前的护理现状、治疗不足的风险因素以及相关患者的特征。此外，还需要了解医生在治疗方面的决策过程。
