Healthcare utilisation and knowledge concerning prescribed drugs among older people

Patients' knowledge of the indications for their medications - a scoping review

BACKGROUND

Inadequate medication knowledge may contribute to inappropriate medication use and treatment harms. We aimed to map and synthesise the existing evidence on patients' knowledge of the indications for their medications.

METHOD

We searched MEDLINE, Embase, CINAHL, PsychInfo and the Cochrane Library for studies that assessed patients' knowledge of the indications for their medications from inception to June 16, 2022. A pair of reviewers independently screened and extracted data on study characteristics, aims, and methods used to assess and report patients' knowledge of the indications for their medications.

RESULTS

We included 99 studies conducted in 33 countries, published between 1979 and 2021, with 42,377 participants in total (median 126 participants [Interquartile range: 63-338]). Studies were observational (n = 77), experimental (n = 18), or qualitative interviews (n = 4). The exact question used to assess knowledge of the indications was reported in 27 studies and was phrased in 25 different ways. Knowledge of the indications was reported as a proportion of either 1) all participants (n = 65) or 2) the total number of medications used by all patients (n = 13). Sixteen studies used both reporting methods, while five only reported a proportion without specifying the denominator. Fourteen studies in various populations reported the number of participants with correct knowledge of all their medications, ranging from 19% (long-term psychiatric in-patients) to 87% (general practice patients).

CONCLUSION

We did not identify any established scientific standard for assessing patients' knowledge of the indications for their medications. The wide range of study methodologies and reporting styles observed call for a methodological consensus in this research field. Estimates of correct knowledge varied widely between studies, but whether this was due to differences in study populations or study methodology could not be determined. Furthermore, we did not identify any study investigating whether participants' knowledge of the indications for their medications was associated with the quality, e.g. appropriateness, of their treatment.

Impact of therapeutic education on the evolution of social representations of medication in patients with Parkinson's disease: A quantitative and qualitative study (ETPARK REMED)

BACKGROUND

Among the workshops of our therapeutic patient education (TPE) program, the medication workshop (TPEM workshop) is very frequently proposed to patients in view of the difficulties they encounter related to the complexity of managing antiparkinsonian treatment. Patients' appropriation of their medications could depend on their social representations.

OBJECTIVES

To evaluate the effect of our TPEM workshop on the social representations PD patients have of their medications and to compare it with that of another therapeutic intervention such as a talking group defined as the control group.

METHODS

This single-center, prospective, randomized, parallel-group study investigated the social representations of medication through a questionnaire on knowledge about antiparkinsonian medications, a questionnaire on beliefs about medication (BMQ), and a word association task.

RESULTS

In the TPEM group (n=16), the workshop induced significant effects over time on the knowledge questionnaire (P=0.01), BMQ specific necessity and concerns scores (P=0.04 and 0.01, respectively), necessity-concerns differential (P=0.04), and BMQ general harm (P=0.04). No significant difference was found in the talking group (n=6). Comparison of the two groups showed a significant difference of the BMQ general harm with a decrease in belief in the harmfulness of the medications in the workshop group (P=0.03). The results of the verbal association task showed a modification in the content and structure of the social representations of medication in the TPEM group.

DISCUSSION

The TPEM workshop helped reduce initial negative aspects of medication representations. Improved knowledge of their medication allowed patients to feel more competent and legitimate in communicating with caregivers, modifying their beliefs about medications. Indeed, the medication was perceived as less restrictive, care becoming central as shown by the emergence of the medical team in the social representations of the medication.

CONCLUSION

All the results show a specific beneficial effect of the TPEM workshop through an evolution of the social representations of medications, which became more positive in our PD patients.

Do older adults know the purpose of their medications? A survey among community-dwelling people

PURPOSE

This study assessed the level of knowledge among community-dwelling older individuals about the purpose of medications and the characteristics that influenced that knowledge. We focused on drugs frequently used and/or often involved in iatrogenic events.

METHODS

This cross-sectional survey included 2690 community-dwelling older adults, aged 68 years and above, who reported using at least one drug of interest, in the canton of Vaud, Switzerland. Participants reported drugs that they currently used and described their purpose. A good knowledge level was defined as knowledge of the exact purpose or identification of the anatomical system or organ targeted by the drug. We performed a multivariate logistic regression analysis to identify factors associated with a good knowledge level for all drugs of interest. Sampling weights were employed to provide representative estimates.

RESULTS

On average, patients had good knowledge of 80.6% of the drugs reported. The highest knowledge levels were demonstrated for non-steroidal antiinflammatory drugs, antidiabetics, analgesics, and endocrinological drugs and the lowest for platelet aggregation inhibitors, minerals, anticoagulants, and other narrow therapeutic index drugs. Overall, 66% of participants had good knowledge of the purpose of all the drugs of interest. Polypharmacy and receiving help with drug management were negatively associated with good knowledge (adjusted OR_{4-5 drugs} 0.45; 95% CI 0.29-0.71, adjusted OR_{≥ 6 drugs} 0.20; 95% CI 0.13-0.31, and adjusted OR_help 0.42; 95% CI 0.18-0.99).

CONCLUSION

This study showed that education about drugs was lacking among patients that received multiple drugs, particularly patients that used anticoagulants and antiplatelet inhibitors.

[Level of knowledge of antibiotics prescribed in outpatients]

INTRODUCTION

The lack of patient knowledge about their medication is considered to be one of the main reasons for an inappropriate use.

OBJECTIVE

This study the level of knowledge in patients about their prescribed antibiotic, and describes some of the factors related to this.

DESIGN

A cross-sectional, descriptive and observational study with an analytical component. SITE: A community pharmacy in Murcia.

METHODS

The study form was offered to all customers who arrived to obtain antibiotics while the study was taking place. A validated form was used to determined the level of knowledge was a validated form.

RESULTS

A total of 126 patients, most of them women, with an average age of 44.6 years were included. Half of the study population had no knowledge which could ensure the correct use of the antibiotic they were taking. The «process of use» of the medication was the best known dimension by the study population, followed by the «therapeutic aim». The dimension related to the «safety» of the medication was the one with the lowest values. After a logistic regression, a link between the knowledge of the antibiotic and the «know the name of the antibiotic» (p=.05; r=2.15) and the «number of antibiotic the patient takes» (p=.02; r=0.30) variables.

CONCLUSIONS

The results show that there is a certain lack of information on the use of antibiotics by the study sample. Thes results could help to show the way to follow in future studies, targeted to meet the need of information.