Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
Department of Nursing Science, University Hospital Tuebingen, Institute of Health Sciences, Hoppe-Seyler-Str. 9, 72076, Tuebingen, Germany.
BMC Geriatr. 2020 Mar 30;20(1):116. doi: 10.1186/s12877-020-01513-y.
Despite increasing digitalisation the paper-based medication list remains one of the most important instruments for the documentation and exchange of medication-related information. However, even elderly patients with polypharmacy who are at high risk for medication errors and adverse drug events, frequently do not receive or use a complete and comprehensible medication list. Increasing the use of medication lists would be a great contribution to medication safety and facilitate the work of health care providers.
This study is related to the project MeinPlan (MyPlan) which comprised an information campaign on safe drug administration in the Rhine-Neckar region in South Germany. The campaign was evaluated in a before-and-after study based on a survey among two independent, representative samples of citizens over 65 years. In total, 5034 questionnaires were analysed. While the effects of the primary outcome (the percentage of citizens using a medication list) have been reported elsewhere, this analysis focusses on the effects of the campaign on citizens' medication beliefs and assesses whether medication beliefs are associated with the use of medication lists, the use of over-the-counter drugs and the use of the tools offered by the campaign. Medication beliefs were assessed with the German version of the General Beliefs About Medicines Questionnaire (BMQ) which results in subscales for "General Overuse", "General Usefulness" and "General Harm". The use of medication lists and over-the-counter drugs was assessed with self-developed questionnaire items.
No statistically significant change in citizens' medication beliefs before and after the campaign could be detected. Likewise, no association between medication beliefs and the use of medication lists, the use of over-the-counter drugs or the use of the tools offered by the campaign could be shown.
A campaign focussing on the risks of drug administration did not change the medication beliefs of the targeted population. Moreover, citizens' general medication beliefs do not seem to be crucial for their decision to use a medication list or over-the-counter drugs. Strategies to improve the use of medication lists by patients should focus on other influential factors, such as individual benefits and barriers and socio-psychological factors.
尽管数字化程度不断提高,但纸质用药清单仍是记录和交流药物相关信息的最重要工具之一。然而,即使是同时服用多种药物且存在较高用药错误和药物不良事件风险的老年患者,也常常无法获得或使用完整且易懂的用药清单。增加用药清单的使用将是对用药安全的巨大贡献,并有助于医疗保健提供者的工作。
本研究与德国南巴登-符腾堡州莱茵-内卡地区的安全药物管理信息宣传活动(MeinPlan,简称“我的计划”)有关。该活动通过对两个独立的、具有代表性的 65 岁以上居民样本进行调查,在一项前后对照研究中进行了评估。共分析了 5034 份问卷。虽然主要结果(使用用药清单的居民比例)的效果已在其他地方报告过,但本分析重点关注该活动对居民用药信念的影响,并评估用药信念是否与用药清单的使用、非处方药的使用以及活动提供的工具的使用相关。用药信念使用德国版一般药物信念问卷(BMQ)进行评估,该问卷产生“普遍过度使用”“普遍有用性”和“普遍危害”三个分量表。用药清单和非处方药的使用通过自行开发的问卷项目进行评估。
在活动前后,居民的用药信念未发生统计学意义上的变化。同样,也未能显示用药信念与用药清单的使用、非处方药的使用或活动提供的工具的使用之间存在关联。
专注于药物管理风险的宣传活动并未改变目标人群的用药信念。此外,居民的一般用药信念似乎不是他们决定使用用药清单或非处方药的关键因素。提高患者用药清单使用率的策略应侧重于其他有影响力的因素,如个人利益和障碍以及社会心理因素。