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Torres-Novellas B, Rius P, Figueiredo-Escribá C, Mariño EL, Modamio P. Drug-Related Problems Detected in Complex Chronic Patients by Community Pharmacists of Catalonia: Perception of the Person-Centred Approach Necessity. Healthcare (Basel) 2024; 12:240. [PMID: 38255127 PMCID: PMC10815887 DOI: 10.3390/healthcare12020240] [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: 12/02/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024] Open
Abstract
Community pharmacies are healthcare settings in which pharmacists are in an ideal position to carry out pharmaceutical care. The aim of this study was to analyse the number, type and groups of drugs that caused drug-related problems (DRPs) detected in complex chronic patients who are outpatients, the interventions and actions of community pharmacists and their impact on patient medication adherence. The study was designed as a secondary analysis of a multicentre study in the field of primary healthcare and community pharmacies in Catalonia (Spain). The patients who took part were divided into two groups by the primary care physician depending on whether or not they were considered likely to receive their medication through a monitored dosage system (MDS) based on pre-established criteria. Patients underwent 12 months of follow-up by community pharmacists. The prevalence of DRPs among the studied complex chronic patients was high (n = 689). The most identified DRP was nonadherence (31.20%). In the MDS group, results showed a statistically significant increase of 21% in the number of adherent patients with respect to the baseline visit (p-value = 0.0008). Community pharmacists can have an important role in addressing DRPs and optimizing the safety and effectiveness of medications for these patients and in involving them in their own health conditions.
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Affiliation(s)
- Berta Torres-Novellas
- Catalan Council of Pharmacists’ Associations (CCFC), 08009 Barcelona, Spain
- Clinical Pharmacy and Pharmaceutical Care Unit, Department of Pharmacy and Pharmaceutical Technology, and Physical Chemistry, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain
| | - Pilar Rius
- Catalan Council of Pharmacists’ Associations (CCFC), 08009 Barcelona, Spain
| | - Carlos Figueiredo-Escribá
- Clinical Pharmacy and Pharmaceutical Care Unit, Department of Pharmacy and Pharmaceutical Technology, and Physical Chemistry, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain
| | - Eduardo L. Mariño
- Clinical Pharmacy and Pharmaceutical Care Unit, Department of Pharmacy and Pharmaceutical Technology, and Physical Chemistry, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain
| | - Pilar Modamio
- Clinical Pharmacy and Pharmaceutical Care Unit, Department of Pharmacy and Pharmaceutical Technology, and Physical Chemistry, Faculty of Pharmacy and Food Science, University of Barcelona, 08028 Barcelona, Spain
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Yang C, Zhu S, Hui Z, Mo Y. Psychosocial factors associated with medication burden among community-dwelling older people with multimorbidity. BMC Geriatr 2023; 23:741. [PMID: 37964196 PMCID: PMC10648314 DOI: 10.1186/s12877-023-04444-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Older people with multimorbidity are often prescribed multiple medication treatments, leading to difficulties in self-managing their medications and negative experiences in medication use. The perceived burden arising from the process of undertaking medication self-management practices has been described as medication burden. Preliminary evidence has suggested that patients' demographic and clinical characteristics may impact their medication burden. Little is known regarding how psychosocial factors affect medication burden in older people with multimorbidity. The aim of this study was to identify psychosocial factors associated with medication burden among community-dwelling older people with multimorbidity. METHODS This is a secondary analysis of a cross-sectional study. A total of 254 older people with three or more chronic conditions were included in the analysis. Participants were assessed for demographics, medication burden, psychosocial variables (depression, medication-related knowledge, beliefs, social support, self-efficacy, and satisfaction), disease burden, and polypharmacy. Medication burden was measured using items from the Treatment Burden Questionnaire. Univariate and multivariate linear regression models explored factors associated with medication burden. RESULTS The mean age of participants was 70.90 years. Participants had an average of 4.40 chronic conditions, and over one-third had polypharmacy. Multivariate analysis showed that the participants' satisfaction with medication treatments (β = -0.32, p < 0.001), disease burden (β = 0.25, p = 0.009), medication self-efficacy (β = -0.21, p < 0.001), polypharmacy (β = 0.15, p = 0.016), and depression (β = 0.14, p = 0.016) were independently associated with medication burden. Other factors, including demographic characteristics, medication knowledge, medication beliefs, medication social support, and the number or specific types of chronic conditions, were not independently associated with medication burden. CONCLUSIONS Poor medication treatment satisfaction, great disease burden, low medication self-efficacy, polypharmacy, and depression may increase individuals' medication burden. Understanding psychosocial aspects associated with medication burden provides an important perspective for identifying older people who are overburdened by their medication treatments and offering individualised treatments to relieve their burden.
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Affiliation(s)
- Chen Yang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| | - Song Zhu
- Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhaozhao Hui
- School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China
- Shaanxi Health Culture Research Center, Xianyang, China
| | - Yihan Mo
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
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Al-Azayzih A, Kanaan RJ, Altawalbeh SM. Assessment of Drug-Related Problems and Health-Related Quality of Life Domains in Elderly Patients with Type 2 Diabetes Mellitus. Ther Clin Risk Manag 2023; 19:913-928. [PMID: 38023626 PMCID: PMC10655742 DOI: 10.2147/tcrm.s434235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/04/2023] [Indexed: 12/01/2023] Open
Abstract
Aims of the Study This study aimed to investigate the prevalence and predictors of Drug-related problems (DRPs), as well as to evaluate the impact of DRPs on the health-related quality of life in geriatric patients with type 2 diabetes mellitus. Methodology A cross-sectional study was conducted over a three-month period. Patients aged 60 years and older visited diabetes clinics from October 1, 2022, to December 31, 2022, were included in the study. Data were collected through structured questionnaires, whereas lab results, medication records, comorbidities, and the consequences of DRPs were collected from electronic medical records. DRPs were identified and classified using the PCNE V501 classification system. Health-related quality of life (HRQoL) was evaluated using the validated EuroQol criteria. Results A total of 491 patients participated in the study, and the mean age of the patients was 67.51 years (SD = 5.84 years). Female patients represented 52.34% of total subjects. A total of 461 (around 94%) experienced at least one drug-related problem (DRP), ranging from one to nine DRPs per patient, with a total number of DRPs equal to 1625 identified. The most common DRP was the drug choice problem, affecting 52.98% of patients. Factors such as high drug frequency, living conditions, the number of diabetes medications, comorbidities, and smoking were significantly associated with higher numbers of DRPs. Higher numbers of DRPs were found to significantly worsen health-related quality of life (HRQoL) among patients. Conclusion Geriatric individuals with type 2 diabetes mellitus encounter a significant prevalence of DRPs, with drug choice problems being the most common followed by dosing problems. Risk factors contributing to these DRPs include high drug frequency, living conditions, high number of diabetes medications, multimorbidity, and smoking. Also, the study concluded that the increased number of DRPs was associated with negative impact on HRQoL domains in geriatric patients with type 2 diabetes.
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Affiliation(s)
- Ahmad Al-Azayzih
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Roaa J Kanaan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Shoroq M Altawalbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Tang J, Wang K, Yang K, Jiang D, Fang X, Su S, Lin Y, Chen S, Gu H, Li P, Yan S. A combination of Beers and STOPP criteria better detects potentially inappropriate medications use among older hospitalized patients with chronic diseases and polypharmacy: a multicenter cross-sectional study. BMC Geriatr 2023; 23:44. [PMID: 36694126 PMCID: PMC9875512 DOI: 10.1186/s12877-023-03743-2] [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: 06/20/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Research on potentially inappropriate medications (PIM) and medication-related problems (MRP) among the Chinese population with chronic diseases and polypharmacy is insufficient. OBJECTIVES This study aimed to investigate the prevalence of PIM and MRP among older Chinese hospitalized patients with chronic diseases and polypharmacy and analyze the associated factors. METHODS A retrospective cross-sectional study was conducted in five tertiary hospitals in Beijing. Patients aged ≥ 65 years with at least one chronic disease and taking at least five or more medications were included. Data were extracted from the hospitals' electronic medical record systems. PIM was evaluated according to the 2015 Beers criteria and the 2014 Screening Tool of Older Persons' Prescriptions (STOPP) criteria. MRPs were assessed and classified according to the Helper-Strand classification system. The prevalence of PIM and MRP and related factors were analyzed. RESULTS A total of 852 cases were included. The prevalence of PIM was 85.3% and 59.7% based on the Beers criteria and the STOPP criteria. A total of 456 MRPs occurred in 247 patients. The most prevalent MRP categories were dosages that were too low and unnecessary medication therapies. Hyperpolypharmacy (taking ≥ 10 drugs) (odds ratio OR 3.736, 95% confidence interval CI 1.541-9.058, P = 0.004) and suffering from coronary heart disease (OR 2.620, 95%CI 1.090-6.297, P = 0.031) were the influencing factors of inappropriate prescribing (the presence of either PIM or MRP in a patient). CONCLUSION PIM and MRP were prevalent in older patients with chronic disease and polypharmacy in Chinese hospitals. More interventions are urgently needed to reduce PIM use and improve the quality of drug therapies.
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Affiliation(s)
- Jing Tang
- grid.413259.80000 0004 0632 3337Department of Pharmacy, Xuanwu Hospital, the First Clinical Medical College of Capital Medical University, No. 45, Changchun Street, Xicheng District 100053 Beijing, China ,National Clinical Research Center for Geriatric Disorders, Beijing, 100053 China
| | - Ke Wang
- grid.413259.80000 0004 0632 3337Department of Pharmacy, Xuanwu Hospital, the First Clinical Medical College of Capital Medical University, No. 45, Changchun Street, Xicheng District 100053 Beijing, China ,National Clinical Research Center for Geriatric Disorders, Beijing, 100053 China
| | - Kun Yang
- grid.413259.80000 0004 0632 3337Department of Evidence-Based Medicine, Xuanwu Hospital, the First Clinical Medical College of Capital Medical University, Beijing, 100053 China
| | - Dechun Jiang
- grid.413259.80000 0004 0632 3337Department of Pharmacy, Xuanwu Hospital, the First Clinical Medical College of Capital Medical University, No. 45, Changchun Street, Xicheng District 100053 Beijing, China ,National Clinical Research Center for Geriatric Disorders, Beijing, 100053 China
| | - Xianghua Fang
- grid.413259.80000 0004 0632 3337Department of Evidence-Based Medicine, Xuanwu Hospital, the First Clinical Medical College of Capital Medical University, Beijing, 100053 China
| | - Su Su
- grid.413259.80000 0004 0632 3337Department of Pharmacy, Xuanwu Hospital, the First Clinical Medical College of Capital Medical University, No. 45, Changchun Street, Xicheng District 100053 Beijing, China ,National Clinical Research Center for Geriatric Disorders, Beijing, 100053 China
| | - Yang Lin
- grid.411606.40000 0004 1761 5917Department of Pharmacy, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, 100029 China
| | - Shicai Chen
- grid.478016.c0000 0004 7664 6350Department of Pharmacy, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, 101149 China
| | - Hongyan Gu
- grid.414367.3Department of Pharmacy, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, 100038 China
| | - Pengmei Li
- grid.415954.80000 0004 1771 3349Department of Pharmacy, China-Japan Friendship Hospital, Beijing, 100029 China
| | - Suying Yan
- grid.413259.80000 0004 0632 3337Department of Pharmacy, Xuanwu Hospital, the First Clinical Medical College of Capital Medical University, No. 45, Changchun Street, Xicheng District 100053 Beijing, China ,National Clinical Research Center for Geriatric Disorders, Beijing, 100053 China
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Villén N, Roso-Llorach A, Gallego-Moll C, Danes-Castells M, Fernández-Bertolin S, Troncoso-Mariño A, Monteagudo M, Amado E, Violán C. Polypharmacy Patterns in Multimorbid Older People with Cardiovascular Disease: Longitudinal Study. Geriatrics (Basel) 2022; 7:geriatrics7060141. [PMID: 36547277 PMCID: PMC9777651 DOI: 10.3390/geriatrics7060141] [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: 11/10/2022] [Revised: 12/01/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
(1) Introduction: Cardiovascular disease is associated with high mortality, especially in older people. This study aimed to characterize the evolution of combined multimorbidity and polypharmacy patterns in older people with different cardiovascular disease profiles. (2) Material and methods: This longitudinal study drew data from the Information System for Research in Primary Care in people aged 65 to 99 years with profiles of cardiovascular multimorbidity. Combined patterns of multimorbidity and polypharmacy were analysed using fuzzy c-means clustering techniques and hidden Markov models. The prevalence, observed/expected ratio, and exclusivity of chronic diseases and/or groups of these with the corresponding medication were described. (3) Results: The study included 114,516 people, mostly men (59.6%) with a mean age of 78.8 years and a high prevalence of polypharmacy (83.5%). The following patterns were identified: Mental, behavioural, digestive and cerebrovascular; Neuropathy, autoimmune and musculoskeletal; Musculoskeletal, mental, behavioural, genitourinary, digestive and dermatological; Non-specific; Multisystemic; Respiratory, cardiovascular, behavioural and genitourinary; Diabetes and ischemic cardiopathy; and Cardiac. The prevalence of overrepresented health problems and drugs remained stable over the years, although by study end, cohort survivors had more polypharmacy and multimorbidity. Most people followed the same pattern over time; the most frequent transitions were from Non-specific to Mental, behavioural, digestive and cerebrovascular and from Musculoskeletal, mental, behavioural, genitourinary, digestive and dermatological to Non-specific. (4) Conclusions: Eight combined multimorbidity and polypharmacy patterns, differentiated by sex, remained stable over follow-up. Understanding the behaviour of different diseases and drugs can help design individualised interventions in populations with clinical complexity.
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Affiliation(s)
- Noemí Villén
- Medicines Area and Pharmacy Service, Barcelona Territorial Management, Institut Català de la Salut, 08015 Barcelona, Spain
- Department of Pediatrics, Obstetrics, Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, 08193 Cerdanyola del Vallès, Spain
| | - Albert Roso-Llorach
- Department of Pediatrics, Obstetrics, Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, 08193 Cerdanyola del Vallès, Spain
- IDIAP Research Institute, 08007 Barcelona, Spain
| | | | - Marc Danes-Castells
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, 08916 Badalona, Spain
- Sant Quirze del Vallès Primary Health Care Center Av. d′Ègara, s/n, Sant Quirze del Vallès, 08192 Barcelona, Spain
| | | | - Amelia Troncoso-Mariño
- Medicines Area and Pharmacy Service, Barcelona Territorial Management, Institut Català de la Salut, 08015 Barcelona, Spain
| | | | - Ester Amado
- Medicines Area and Pharmacy Service, Barcelona Territorial Management, Institut Català de la Salut, 08015 Barcelona, Spain
| | - Concepción Violán
- Department of Pediatrics, Obstetrics, Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, 08193 Cerdanyola del Vallès, Spain
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, 08916 Badalona, Spain
- North Metropolitan Research Support Unit, IDIAP Research Institute, Mataró, 08303 Barcelona, Spain
- North Metropolitan Primary Health Care Administration, Institut Català de Salut, Ctra. de Barcelona, 473, Sabadell, 08204 Barcelona, Spain
- Correspondence:
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Effects of a nurse-led medication self-management intervention on medication adherence and health outcomes in older people with multimorbidity: A randomised controlled trial. Int J Nurs Stud 2022; 134:104314. [DOI: 10.1016/j.ijnurstu.2022.104314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/27/2022]
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Yang C, Lee DTF, Wang X, Chair SY. Developing a Medication Self-management Program to Enhance Medication Adherence among Older Adults with Multimorbidity Using Intervention Mapping. THE GERONTOLOGIST 2022; 63:637-647. [PMID: 35583327 DOI: 10.1093/geront/gnac069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Suboptimal medication adherence is prevalent in older adults with multimorbidity. However, intervention programs for enhancing adherence in this population are limited. This study describes the development process of a medication self-management program for older adults with multimorbidity. RESEARCH DESIGN AND METHODS We adopted the first four steps of the Intervention Mapping to develop the program: (1) needs assessment, including a literature review, a systematic review, and a cross-sectional study, (2) development of program outcomes and objectives, (3) selection of theory-based intervention methods and practical applications, and (4) development of the program. RESULTS We conducted a needs assessment to identify factors affecting medication adherence among older adults with multimorbidity and created a logic model of the adherence problem in Step 1. In Step 2, we developed the specific program outcomes and objectives and then selected adherence information, personal motivation, social motivation, behavioral skills, and treatment experiences as modifiable and important targets that needed to change in this program. In Step 3, we chose several theory-based methods and strategies for practical applications. We finally created a nurse-led medication self-management program in Step 4. Feedback from relevant stakeholders refined the intervention protocol and materials. DISCUSSION AND IMPLICATIONS The newly developed medication self-management program incorporated theory and evidence from literature and empirical studies with the engagement of multiple stakeholders, making it a contextually and culturally appropriate intervention. This study provides insights into strategies for geriatrics healthcare professionals to support medication self-management among older adults with multimorbidity.
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Affiliation(s)
- Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Diana Tze Fan Lee
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiuhua Wang
- Xiangya Nursing School of Central South University, Changsha, China
| | - Sek Ying Chair
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Recalde M, Rodríguez C, Burn E, Far M, García D, Carrere-Molina J, Benítez M, Moleras A, Pistillo A, Bolíbar B, Aragón M, Duarte-Salles T. Data Resource Profile: The Information System for Research in Primary Care (SIDIAP). Int J Epidemiol 2022; 51:e324-e336. [PMID: 35415748 PMCID: PMC9749711 DOI: 10.1093/ije/dyac068] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/29/2022] [Indexed: 01/21/2023] Open
Affiliation(s)
| | | | - Edward Burn
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain,Centre for Statistics in Medicine, NDORMS, University of Oxford, Oxford, UK
| | - Marc Far
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Darío García
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Jordi Carrere-Molina
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Mencia Benítez
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Anna Moleras
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Andrea Pistillo
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Bonaventura Bolíbar
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - María Aragón
- Corresponding author. Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Gran Via Corts Catalanes, 587 àtic, 08007 Barcelona, Spain. E-mail:
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Special Issue-"Multimorbidity Development and Evolution: Clinical Implications". J Clin Med 2021; 10:jcm10163450. [PMID: 34441746 PMCID: PMC8396956 DOI: 10.3390/jcm10163450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022] Open
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Ohta R, Ueno A, Kitayuguchi J, Moriwaki Y, Otani J, Sano C. Comprehensive Care through Family Medicine: Improving the Sustainability of Aging Societies. Geriatrics (Basel) 2021; 6:geriatrics6020059. [PMID: 34199871 PMCID: PMC8293036 DOI: 10.3390/geriatrics6020059] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/21/2021] [Accepted: 06/03/2021] [Indexed: 02/07/2023] Open
Abstract
Comprehensive care through family medicine can enhance the approach to multimorbidity, interprofessional collaboration, and community care, and make medical care more sustainable for older people. This study investigated the effect of implementing family medicine and the comprehensiveness of medical care in one of the most rural communities. This implementation research used medical care data from April 2015 to March 2020. Patients' diagnoses were categorized according to the 10th revision of the International Statistical Classification of Disease and Related Health Problems (ICD-10). In 2016, family medicine was implemented in only one general hospital in Unnan. The comprehensiveness rate improved in all ICD-10 disease categories during the study period, especially in the following categories-infections; neoplasms; endocrine, nutritional, and metabolic diseases; mental disorders; nervous system; circulatory system; respiratory system; digestive system; skin and subcutaneous tissue; musculoskeletal system and connective tissue; and the genitourinary system. Implementing family medicine in rural Japanese communities can improve the comprehensiveness of medical care and resolve the issue of fragmentation of care by improving interprofessional collaboration and community care. It can be a solution for the aging of both patient and healthcare professionals. Future research can investigate the relationship between family medicine and patient health outcomes for improved healthcare sustainability.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, Unnan 699-1221, Shimane, Japan; (Y.M.); (J.O.)
- Correspondence: ; Tel.: +81-90-5060-5330
| | - Akinori Ueno
- Unnan Public Health Center, Unnan 699-1311, Shimane, Japan;
| | - Jun Kitayuguchi
- Physical Education and Medicine Research Center Unnan, Unnan 699-1105, Shimane, Japan;
| | - Yoshihiro Moriwaki
- Community Care, Unnan City Hospital, Unnan 699-1221, Shimane, Japan; (Y.M.); (J.O.)
| | - Jun Otani
- Community Care, Unnan City Hospital, Unnan 699-1221, Shimane, Japan; (Y.M.); (J.O.)
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, Izumo 693-8501, Shimane, Japan;
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