Institute of Pharmaceutical Sciences of Western Switzerland University of Geneva, University of Lausanne, Geneva, Switzerland.
School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.
BMJ Open. 2022 Nov 3;12(11):e060083. doi: 10.1136/bmjopen-2021-060083.
The number of patients with chronic diseases and subsequent visits to various healthcare professionals has been rising over the past decades, exposing patients to potential risks of receiving conflicting medication information. This study aims to investigate the prevalence of conflicting information on medications perceived by chronic patients in Switzerland and to understand its impact on patients' medication self-management and navigation in the healthcare system.
This cross-sectional study included adult patients taking at least one prescribed medication for at least 6 months, who had visited at least two physicians in the past 3 months.
Data on patients' perceptions of conflicting information were collected in person through a 17-item questionnaire available on paper and electronically with four domains: (1) whether the patient had perceived any conflicting information, (2) categories of conflicting information, (3) impact and (4) sources involved in the conflicting information.
Of the 405 included patients, 47% perceived conflicting information related to one or more medication topics including indication, schedule, dosage, risk, severity or duration of side effects. Patients who perceived conflicting information were prescribed more drugs than those perceiving no conflicting information (p<0.01). Consequently, 65% of the participants modified their navigation of the healthcare system and 34% reported medication non-adherence. General practitioners (82%), specialist physicians (74%) and pharmacists (49%) were the healthcare professionals most often involved in conflicting information. Experience with the medication, its package insert and significant others were more frequently involved in conflicting information than internet or social media.
Nearly half the patients in our study perceived conflicting information in the outpatient healthcare system, which can decrease medication effectiveness and pose safety issues. This issue is widely overlooked and unaddressed. Consistency of information among healthcare providers in partnership with patients should be reinforced through guidelines and new models of interprofessional care.
在过去几十年中，慢性病患者的数量及其对各种医疗保健专业人员的就诊次数不断增加，使患者面临接收相互矛盾的药物信息的潜在风险。本研究旨在调查瑞士慢性患者感知到的药物信息冲突的普遍程度，并了解其对患者药物自我管理和在医疗保健系统中就诊的影响。
这项横断面研究纳入了至少服用一种处方药物 6 个月以上且在过去 3 个月内至少就诊过 2 次医生的成年患者。
通过一份包含 17 个项目的纸质和电子问卷，收集患者对药物信息冲突的看法，问卷有 4 个领域：（1）患者是否感知到任何相互矛盾的信息；（2）相互矛盾信息的类别；（3）影响；（4）涉及相互矛盾信息的来源。
在纳入的 405 名患者中，47%的患者认为与一种或多种药物相关的信息存在冲突，包括适应证、服用时间、剂量、风险、副作用的严重程度或持续时间。与未感知到相互矛盾信息的患者相比，感知到相互矛盾信息的患者服用的药物更多（p＜0.01）。因此，65%的参与者调整了他们对医疗保健系统的就诊策略，34%的患者报告药物不依从。全科医生（82%）、专科医生（74%）和药剂师（49%）是最常涉及药物信息冲突的医疗保健专业人员。与互联网或社交媒体相比，药物使用经验、药物说明书和其他重要人员更常涉及药物信息冲突。
我们研究中的近一半患者在门诊医疗保健系统中感知到了药物信息冲突，这可能会降低药物的疗效并带来安全问题。这个问题被广泛忽视且未得到解决。应该通过指南和新的跨专业护理模式，加强医疗保健提供者之间的信息一致性并与患者合作。
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