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Liu L, Brokenshire B, Davies D, Harrison J. Preliminary feasibility assessment of a targeted, pharmacist-led intervention for older adults with polypharmacy: a mixed-methods study. Int J Clin Pharm 2024; 46:1102-1113. [PMID: 38753077 PMCID: PMC11399159 DOI: 10.1007/s11096-024-01740-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/05/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Polypharmacy is associated with the prescription of inappropriate medications and avoidable medication-related harm. A novel pharmacist-led intervention aims to identify and resolve inappropriate medication prescriptions in older adults with polypharmacy. AIM To conduct a preliminary feasibility assessment of the intervention in primary care, testing whether specific components of the intervention procedures and processes can be executed as intended. METHOD The mixed-methods study was approved by the New Zealand Health and Disability Ethics Committees and public health agency. Patients from a New Zealand general practice clinic were recruited over 4 weeks to receive the intervention. The preliminary feasibility assessment included measures of intervention delivery, patient-reported outcome measures, and perspectives from ten patients and six clinicians. Data were analysed quantitatively and qualitatively to determine if a full-scale intervention trial is warranted. The study's progression criteria were based on established research and guided the decision-making process. RESULTS The intervention met the study's progression criteria, including patient recruitment, retention, and adherence to the intervention procedures. However, several modifications were identified, including: (1) enhancing patient recruitment, (2) conducting a preliminary meeting between the patient and pharmacist, (3) supporting pharmacists in maintaining a patient-centred approach, (4) reviewing the choice of patient-reported outcome measure, (5) extending the 8-week follow-up period, (6) allocating more time for pharmacists to conduct the intervention. CONCLUSION The study found the intervention feasible; however, additional development is required before progressing to a full-scale trial. This intervention has the potential to effectively reduce medication-related harm and improve outcomes for older adults with polypharmacy. TRIAL REGISTRATION NUMBER ACTRN12621000268842 Date registered: 11/03/2021.
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Affiliation(s)
- Lisheng Liu
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
- Primary, Public and Community Health, Te Whatu Ora MidCentral District, Palmerston North, New Zealand
| | - Bernadette Brokenshire
- Primary, Public and Community Health, Te Whatu Ora MidCentral District, Palmerston North, New Zealand
| | - Deborah Davies
- Primary, Public and Community Health, Te Whatu Ora MidCentral District, Palmerston North, New Zealand
| | - Jeff Harrison
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
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Wang Y, Jian S, Huang Z, Chen H, Hu Y, Fang S. Medication-related burden and its association with medication adherence among elderly tuberculosis patients in Guizhou, China: a cross-sectional study. Front Pharmacol 2024; 15:1416005. [PMID: 39268464 PMCID: PMC11391241 DOI: 10.3389/fphar.2024.1416005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 08/19/2024] [Indexed: 09/15/2024] Open
Abstract
Introduction Tuberculosis (TB) morbidity and mortality are significantly increasing in the elderly worldwide. Their optimal health outcomes are hampered by medication related burden (MRB) and poor treatment adherence. Understanding th e MRB status from patients' perspectives and its association with adherence among elderly TB patients will help achieve the End TB targets. Thus, we aimed to identify the incidence of MRB and nonadherence among elderly TB patients in Guizhou, and determine their association. Methods A cross-sectional study was conducted in three prefectures with high TB notifications in Guizhou in 2022. The data were collected via face-to-face structured interviews. MRB was measured using the Living with Medicines Questionnaire version 3 (LMQ-3), which consists of eight domains. Nonadherence was assessed by treatment interruption, which was defined as any interruption lasting at least 1 day at any time within the last 3 months. A binary unconditional logistic regression model was used to determine the association between variables. Results Of the 405 elderly TB patients enrolled, 49.4% and 42.7% of the respondents perceived suffering from moderate and high MRB, respectively. The incidence of nonadherence among patients was 33.6%. Patients with higher scores in domain 2 (practical difficulties) [OR adj = 1.19; 95% CI (1.11-1.28)] and domain 4 (side effects burden of prescribed medications) [OR adj = 1.16; 95% CI (1.06-1.27)] were more likely to experience nonadherence. But, patients with higher scores in domain 8 (control/autonomy of medicine use) [OR adj = 0.70; 95% CI (0.61, 0.81)] were more likely to occur adherence. Patients with a high education level [OR adj = 0.29; 95% CI (0.08, 0.92)] had a decreased risk of nonadherence, but those with a living expense from a retirement salary [OR adj = 2.55; 95% CI (1.16, 5.71)] had an increased risk of nonadherence. Discussion The incidence of MRB and medication nonadherence is high among elderly TB patients in Guizhou. The significant associations between the three domains of MRB and nonadherence highlight that measuring MRB in multiple dimensions using the LMQ-3 in elderly TB patients could assist clinicians in providing patient-centered care, and multifaceted interventions targeting the identified problems should be implemented to reduce MRB and nonadherence among elderly TB patients in Guizhou.
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Affiliation(s)
- Yun Wang
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Sisi Jian
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Zhongfeng Huang
- Department of Tuberculosis, Guiyang Public Health Clinical Center, Guiyang, China
| | - Huijuan Chen
- Institute of Health Promotion and Education, Guizhou Center for Disease Prevention and Control, Guiyang, China
| | - Yuanxia Hu
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, China
| | - Shilin Fang
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, China
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Katusiime B, Cassidy R, Krska J, Corlett SA. Medicine burden experiences of people living with HIV and association with stigma. AIDS Care 2024; 36:227-237. [PMID: 37848005 DOI: 10.1080/09540121.2023.2264557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/22/2023] [Indexed: 10/19/2023]
Abstract
The medicine burden of people living with HIV (PLWH) is unknown. Between 2018 and 2020, participants completed a survey comprising outcome measures for medicine burden (LMQ-3) and stigma experiences (SSCI-8). Participants were HIV+ adults (≥18 years), using antiretrovirals (ARV) with or without non-ARV medicines, recruited via two outpatient clinics in southeast England and online via HIV charities across the UK. Spearman's correlations between medicine burden levels and stigma scores were calculated. Participants were mostly males (72%, 101/141) of mean (SD) age 48.6 (±12.31) years. Total number of medicines ranged from 1-20. High medicine burden was self-reported by 21.3% (30) and was associated with polypharmacy (≥ 5 medicines) (101.52 Vs 85.08, p = 0.006); multiple doses versus once daily regimes (109.31 Vs 85.65, p = 0.001); unemployment (98.23 Vs 84.46, p = 0.004); and ethnicity (97 Vs 86.85, p = 0.041 for non-White versus White participants). A correlation between medicine burden and stigma was observed (r = 0.576, p < 0.001). The LMQ-3 demonstrated adequate construct validity and reliability (domain loadings ranging 0.617-0.933 and Cronbach's α of 0.714-0.932). Assessment of medicine burden and psychosocial stigma in PLWH could enable identification of those needing additional support in future research and practice.
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Affiliation(s)
- B Katusiime
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, UK
| | - R Cassidy
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - J Krska
- Medway School of Pharmacy, The Universities of Kent and Greenwich, Chatham, UK
| | - S A Corlett
- Medway School of Pharmacy, The Universities of Kent and Greenwich, Chatham, UK
- Clinical Trials, Research and Innovation, Medway NHS Foundation Trust, Windmill Road, Gillingham, UK
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Mikkola H, Dimitrow M, Hämeen-Anttila K, Laukkanen E, Airaksinen M. Understanding medication-related burden from patient perspectives: a qualitative study testing the applicability of the conceptual model among chronically ill outpatients in Finland. BMJ Open 2023; 13:e077214. [PMID: 38040425 PMCID: PMC10693891 DOI: 10.1136/bmjopen-2023-077214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/13/2023] [Indexed: 12/03/2023] Open
Abstract
OBJECTIVES Disease self-management and medication therapy can cause burden to patients that can influence adherence. The conceptual model 'patients' lived experience with medicine' (PLEM) brings new insights into medication-related burden (MRB) from patient perspective. This study aimed to test the applicability of the PLEM model by interviewing chronically ill patients in Finland and to investigate the MRB experienced by the Finnish patients. DESIGN Focus group discussion study conducted online via Zoom. Directed qualitative content analysis guided by the PLEM model. SETTING Outpatient primary care in Finland. PARTICIPANTS Chronically ill outpatients (n=14) divided into five focus groups according to their chronic condition: asthma (n=3), heart disease (n=3), diabetes (n=6), intestinal disease (n=2). RESULTS Our findings were mainly in line with the PLEM model although some new contributing factors to MRB emerged. In general, the participants were satisfied with their medication, and that it enabled them to live normal lives. The most common causes of MRB were medication routines and the healthcare system. The participants introduced two new aspects contributing to MRB: medication-related environmental anxiety associated with the waste resulting from medicine use, and the effect of medication use on their working life. Our findings are consistent with previous findings that a higher level of MRB may lead to independently modifying the medication regimen or not taking the medicine. CONCLUSIONS Our findings provide further evidence that the PLEM model is an applicable tool also in the Finnish context for gaining better understanding of MRB in chronically ill patients self-managing their long-term medications. The model provides a promising tool to understand the connection between MRB and the rationale for not always taking medicines as prescribed. Further research is needed to explore the potential of the model in extending patient perspectives in chronic disease management.
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Affiliation(s)
- Heidi Mikkola
- Finnish Medicines Agency Fimea, Helsinki, Uusimaa, Finland
- School of Pharmacy, University of Eastern Finland Faculty of Health Sciences, Kuopio, Pohjois-Savo, Finland
| | - Maarit Dimitrow
- Division of Pharmacology and Pharmacotherapy, University of Helsinki Faculty of Pharmacy, Helsinki, Uusimaa, Finland
| | - Katri Hämeen-Anttila
- School of Pharmacy, University of Eastern Finland Faculty of Health Sciences, Kuopio, Pohjois-Savo, Finland
| | - Emilia Laukkanen
- Savonia University of Applied Sciences, Kuopio, Pohjois-Savo, Finland
- Department of Nursing Science, University of Eastern Finland Faculty of Health Sciences, Kuopio, Pohjois-Savo, Finland
| | - Marja Airaksinen
- Division of Pharmacology and Pharmacotherapy, University of Helsinki Faculty of Pharmacy, Helsinki, Uusimaa, Finland
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Sacco K, West LMB, Grech LM, Krska J, Cordina M. Assessing medication-related burden of community-dwelling individuals with chronic conditions in a small island state. Chronic Illn 2023:17423953231205918. [PMID: 37801519 DOI: 10.1177/17423953231205918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
OBJECTIVES Medication taking in the management of chronic conditions causes a significant burden on individuals. The aim of this study was to explore the medication-related burden in ambulatory adult patients with chronic conditions in Malta. METHODS A cross-sectional survey utilising the living with medicines questionnaire V3 (LMQ V3) was conducted in Maltese residents over the age of 18 years, taking at least 1 medication for a chronic condition and recruited through community events. The overall LMQ score, the domain scores and the visual analog scale data were analysed to determine relationships with the demographic factors. RESULTS A total of 337 responses were analysed revealing a moderate (42.4%) to high medication (36.8%) related burden. The drivers of medication-related burden were primarily: 'side-effects of prescribed medication' (r = -0.843, p < 0.001), 'attitudes/concerns about medicine use' (r = -0.830, p < 0.001) and 'impact/interferences to day-to-day life' (r = -0.820, p < 0.001). Lack of autonomy to vary the dosage regimen resulted in a higher burden (r = -0.260, p < 0.001). Males experienced an overall higher burden (p = 0.046) especially related to practical difficulties (p = 0.04), cost-related burden (p = 0.04) and side-effects of prescribed medication (p = 0.01). CONCLUSION Medication-related burden is complex and multi-faceted as demonstrated by the findings of this study. Healthcare professionals should seek to identify and address factors causing this burden to improve patient outcomes.
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Affiliation(s)
- Katya Sacco
- Medicines Use Research Group, Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Lorna M Bonnici West
- Medicines Use Research Group, Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Applied Research & Innovation Centre, Malta College of Arts, Science and Technology, Paola, Malta
| | - Lauren M Grech
- Medicines Use Research Group, Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Janet Krska
- Medway School of Pharmacy, Universities of Greenwich and Kent, Chatham Maritime, UK
| | - Maria Cordina
- Medicines Use Research Group, Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Ensing HT, Schulte RA, Koster ES. Implementing a newly prescribed cardiovascular medicine in daily routine: The patient perspective at readmission to primary care. Res Social Adm Pharm 2023; 19:293-300. [PMID: 36266176 DOI: 10.1016/j.sapharm.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 09/20/2022] [Accepted: 10/10/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Readmission to primary care is challenging for patients due to involvement of multiple healthcare providers across different settings and implementing new medicines into their daily routine. Elucidating patients' needs is crucial to tailor counseling support. OBJECTIVE To explore the patient perspectives on implementing a newly prescribed cardiovascular medicine into their daily routine at readmission to primary care. METHODS A qualitative study was performed within the outpatient pharmacy. Adult patients who were prescribed a new cardiovascular medicine by their treating hospital physician at hospital discharge or during an outpatient clinic visit were eligible to participate. Purposive sampling was applied to equally distribute adherence-influencing factors. Patients were interviewed by telephone and inclusion continued until theoretical data saturation. An adapted Greenhalgh framework for implementation research was used for a thematic content analysis by conceptualizing the new medicine as an innovation that requires implementation by a patient (adopter). RESULTS Data saturation was reached at 44 patients of which 19 discontinued their new medicine at the time of the interview. Reasons for discontinuing included: side-effects, insufficient efficacy or negligence. Patients considered a lack of basic knowledge on their newly prescribed cardiovascular medicine as a major barrier for adopting it into their daily routine. They were in need of information on risks and benefits of their new medicine. A noticeable effect and tailored counseling facilitated patients in taking their medicine as prescribed. Patients mentioned personalized organizing tools and routinization of medication intake as important success factors for addressing their practical challenges with their new medicine. CONCLUSIONS By applying the adapted Greenhalgh framework, this study provided a unique and structured insight in patients' barriers and facilitators that could influence their ability to implement a new cardiovascular medicine at readmission to primary care. This knowledge enables pharmacists to tailor their patient support and provide individualized patient counseling.
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Affiliation(s)
- Hendrik T Ensing
- Outpatient Pharmacy 'de Brug 24/7', Zorggroep Almere, Almere, the Netherlands
| | - Roos A Schulte
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands
| | - Ellen S Koster
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.
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Bekalu AF, Yenit MK, Tekile M, Birarra MK. Medication-related burden and associated factors among diabetes mellitus patients at Felege Hiwot Comprehensive Specialized Hospital in northwest Ethiopia. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:977216. [PMID: 36992753 PMCID: PMC10012090 DOI: 10.3389/fcdhc.2022.977216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022]
Abstract
Background Evaluating the medicine burden from the patients' perspective is essential for getting good health outcomes of diabetes mellitus (DM) management. However, data are limited regarding this sensitive area. Thus, the study was aimed to determine the medication-related burden (MRB) and associated factors among DM patients at Felege Hiwot Comprehensive Specialized Hospital (FHCSH) in northwest Ethiopia. Methods A cross-sectional study was conducted on 423 systematically selected DM patients attending the DM clinic of FHCSH from June to August 2020. The medication-related burden was measured by using the Living with Medicines Questionnaire version 3 (LMQ-3). Multiple linear regression was used to identify factors associated with medication-related burden and reported with 95% confidence interval (CI). p-value <0.05 was considered as statistically significant to declare an association. Results The mean LMQ-3 score was 126.52 ( ± 17.39). The majority of the participants experienced moderate (58.9%, 95% CI: 53.9-63.7) to high (26.2%, 95% CI: 22.5-30.0) degrees of medication burden. Nearly half (44.9%, 95% CI: 39.9-49.7) of the participants were non-adherent to their prescribed medications. VAS score (B = 12.773, p = 0.001), ARMS score (B = 8.505, p = 0.001), and fasting blood glucose (FBS) on visit (B = 5.858, p = 0.003) were significantly associated with high medication-related burden. Conclusion A significant number of patients suffered from high medication-related burden and non-adherence to long-term medicine. Therefore, multidimensional intervention to decrease MRB and to upgrade adherence is required to increase patients' quality of life.
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Affiliation(s)
- Abaynesh Fentahun Bekalu
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Kindie Yenit
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Masho Tigabe Tekile
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mequanent Kassa Birarra
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Zheng C, Meng J, Xiao X, Xie Y, Zhao D, Wang H. Polypharmacy, Medication-Related Burden and Antiretroviral Therapy Adherence in People Living with HIV Aged 50 and Above: A Cross-Sectional Study in Hunan, China. Patient Prefer Adherence 2022; 16:41-49. [PMID: 35027822 PMCID: PMC8752076 DOI: 10.2147/ppa.s340621] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/17/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE People living with HIV (PLWHIV) are susceptible to non-communicable diseases (NCDs) because of aging and infections. This means that the number of non-HIV medications increases, along with issues of polypharmacy and medication-related burden. The purpose of this study was to identify the current situation of polypharmacy and medication-related burden among PLWHIV aged 50 and above, as well as the relation between medication-related burden and antiretroviral therapy (ART) adherence. PATIENTS AND METHODS A cross-sectional study was conducted with 185 participants recruited from two HIV clinics in Yuelu District Center for Disease Control (CDC) and Changsha First Hospital in Hunan, China. Participants filled questionnaires about comorbidities, polypharmacy, medication-related burden, ART adherence and sociodemographic characteristics. RESULTS Among the participants, 40% were receiving polypharmacy, and PLWHIV, who were female (β = 5.946; 95% CI = 1.354, 10.541), had a lower monthly income (β = -4.777; 95% CI = -6.923, -2.632), and took more drugs (β = 2.200; 95% CI = 1.167, 3.233) were more likely to report a higher level of medication-related burden. The score of ART adherence was negatively associated with medication-related burden (rs = -0.250 p = 0.001). CONCLUSION The findings suggest that more attention should be paid to the issues of polypharmacy and targeted interventions should be developed to reduce medication-related burden among older PLWHIV.
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Affiliation(s)
- Chunyuan Zheng
- Xiangya Nursing School, Central South University, Changsha, Hunan, People’s Republic of China
| | - Jingjing Meng
- Xiangya Nursing School, Central South University, Changsha, Hunan, People’s Republic of China
| | - Xueling Xiao
- Xiangya Nursing School, Central South University, Changsha, Hunan, People’s Republic of China
| | - Ying Xie
- Xiangya Nursing School, Central South University, Changsha, Hunan, People’s Republic of China
| | - Di Zhao
- Xiangya Nursing School, Central South University, Changsha, Hunan, People’s Republic of China
| | - Honghong Wang
- Xiangya Nursing School, Central South University, Changsha, Hunan, People’s Republic of China
- Correspondence: Honghong Wang Xiangya Nursing School, Central South University, 172 Tongzipo Road, Changsha, Hunan, People’s Republic of ChinaTel +86-731-82650270Fax +86-731-88710136 Email
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Wang Y, Li X, Jia D, Lin B, Fu B, Qi B, Zhang Z. Exploring polypharmacy burden among elderly patients with chronic diseases in Chinese community: a cross-sectional study. BMC Geriatr 2021; 21:308. [PMID: 33985446 PMCID: PMC8117611 DOI: 10.1186/s12877-021-02247-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/23/2021] [Indexed: 11/18/2022] Open
Abstract
Background In the long-term use of multiple medications for elderly patients diagnosed with chronic diseases, medication problems are prominent, which seriously reduces their quality of life. The burden of medications of patients critically affects their medication beliefs, behaviors and disease outcomes. It may be a solution to stress the burden of medications of patients. Its medication issues develops a novel perspective. The present study aimed to exploit the Chinese version of Living with Medicines Questionnaire-3(C-LMQ-3) to quantify the medicines burden of elderly patients diagnosed with chronic diseases in China, and evaluate the relevant demographic characteristics of sub-populations with high medicines burden. Methods The survey was distributed to elderly patients aged ≥ 60 years with chronic disease by using ≥ 5 medicines, C-LMQ-3 scores and domain scores were compared by the characteristics of elderly patients by employing descriptive statistics and performing statistical tests. Results On the whole, 430 responses were analyzed, and the participants were aged between 60 and 91 years, with the average age of 73.57 years (SD: 7.87). Most of the responses were female (61.7 %) with middle school education (38.5 %). Moreover, 54.1 % of the participants lived with spouse only, 16.2 % had both spouse and children, and 10.0 % lived alone. As indicated from regression analysis, higher C-LMQ-3 scores were associated with those who were with low education level, 60–69 years-old, using ≥ 11 medicines, using medicines ≥ 3 times a day, income per month (RMB) ≤ 3000, and who having higher monthly self-paid medication (RMB) ≥ 300 (p < 0.01). Burden was mainly driven by cost-related burden, concerns about medicines, and the lack of autonomy over medicine regimens. Conclusions This study presents the preliminary evidence to elderly patients diagnosed with chronic diseases in mainland China that pay attention to multiple medications burden may help reduce the Drug Related Problems, whereas some elderly patients have a higher burden of medication. Chinese health care providers are required to primarily evaluate and highlight such patients, and formulate relevant intervention strategies to ensure medication adherence and daily medication management of elderly patients with polypharmacy.
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Affiliation(s)
- Yongli Wang
- School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Henan, Zhengzhou, China.,Peking University People's Hospital, Xicheng Dist, Beijing, China
| | - Xiaodan Li
- Peking University People's Hospital, Xicheng Dist, Beijing, China
| | - Dongmei Jia
- Peking University People's Hospital, Xicheng Dist, Beijing, China
| | - Beilei Lin
- School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Henan, Zhengzhou, China
| | - Bo Fu
- School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Henan, Zhengzhou, China
| | - Bei Qi
- School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Henan, Zhengzhou, China
| | - Zhenxiang Zhang
- School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Henan, Zhengzhou, China.
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Wang Y, Krska J, Lin B, Mei Y, Katusiime B, Guo Y, Zhang Z. Cross-Cultural Adaptation and Reliability Testing of Chinese Version of the Living with Medicines Questionnaire in Elderly Patients with Chronic Diseases. Patient Prefer Adherence 2020; 14:2477-2487. [PMID: 33363363 PMCID: PMC7751840 DOI: 10.2147/ppa.s275006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/30/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The Living with Medicines Questionnaire (LMQ-3) is a reliable, valid instrument used to assess the medication-related burden of patients with chronic disease using long-term medication, but it has not been used in China. PURPOSE To translate and cross-culturally adapt the LMQ-3 into Chinese and assess its reliability and validity among elderly patients with chronic disease. METHODS After translation and back-translation, views from an expert group and cognitive interviews with elderly persons using multiple medicines were used to ensure the cultural relevance of the LMQ-3. Then, 412 participants aged 60-92 years were recruited from three communities in Zhengzhou to complete the instrument. Item analysis, internal consistency, content validity, exploratory factor analysis (EFA) and reliability testing were performed. RESULTS Item analysis identified nine items for possible removal, which were discussed with the originating team. Internal consistency testing confirmed the suitability of removing two of these items, which concurred with the views of the expert group and cognitive interviews. All other items were retained, but four were modified for clarification without changing their meaning, resulting in a 39-item instrument. EFA of this 39-item measure yielded an eight-factor model, similar to the English version. Cronbach's alpha of the Chinese version of LMQ-3 (C-LMQ-3) for elderly patients with chronic diseases was 0.855, and alpha values for the eight domains ranged from 0.822 to 0.932. Test-retest reliability was satisfactory, with ICC values for the eight domain scores ranging from 0.751 to 0.881. CONCLUSION With only minor modifications compared to the English version, the 39-item C-LMQ-3 is a valid tool, with adequate reliability, which can be used to assess the medication-related burden of long-term use of multiple medicines in elderly patients in China.
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Affiliation(s)
- Yongli Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
- Peking University People’s Hospital, Beijing, People’s Republic of China
| | - Janet Krska
- Medway School of Pharmacy, The Universities of Kent and Greenwich at Medway, Chatham, Kent, UK
| | - Beilei Lin
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Yongxia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Barbra Katusiime
- Medway School of Pharmacy, The Universities of Kent and Greenwich at Medway, Chatham, Kent, UK
| | - Yawen Guo
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Zhenxiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
- Correspondence: Zhenxiang Zhang School of Nursing and Health, No. 100 Science Avenue, Zhengzhou, Henan, People’s Republic of ChinaTel +86 13303816666Fax +86 371-86565001 Email
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