Association between recorded medication reviews in primary care and adequate drug treatment management – a cross-sectional study

Objective To investigate the association between a recorded procedure code for a medication review and adequate drug treatment management, and to explore factors associated with this code. Design and setting Cross-sectional study; two primary health care centres, in Region Västra Götaland, Sweden. S...

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Autores principales:	Naldy Parodi López, Staffan A. Svensson, Susanna M. Wallerstedt
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	aged cross-sectional studies inappropriate prescribing medication review pharmacoepidemiology prescription drugs primary health care Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/596fc3ac37d94f3385e84686c9ad47db
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spelling	oai:doaj.org-article:596fc3ac37d94f3385e84686c9ad47db2021-12-01T14:40:58ZAssociation between recorded medication reviews in primary care and adequate drug treatment management – a cross-sectional study0281-34321502-772410.1080/02813432.2021.1973239https://doaj.org/article/596fc3ac37d94f3385e84686c9ad47db2021-11-01T00:00:00Zhttp://dx.doi.org/10.1080/02813432.2021.1973239https://doaj.org/toc/0281-3432https://doaj.org/toc/1502-7724Objective To investigate the association between a recorded procedure code for a medication review and adequate drug treatment management, and to explore factors associated with this code. Design and setting Cross-sectional study; two primary health care centres, in Region Västra Götaland, Sweden. Subjects A total of 302 consecutive patients (≥65 years old, 59% female; median number of drugs: six) requiring a non-urgent consultation with a physician in October–November 2017. Main outcome measure Adequate drug treatment management (treatment that did not require any further action), determined in consensus by two specialists in family medicine blinded to the medication review code. Results Adequate drug treatment management was, overall, less common in those with a recorded medication review over the last year: 63% versus 73% (p = 0.047). This negative association was evident among patients aged 65–74 years: 49% versus 74% (p = 0.003), but absent in those ≥75 years old: 67% versus 70% (p = 0.77). Recommendations from consensus included the search for additional information to be able to make a decision regarding initiation or withdrawal of a drug (n = 53), withdrawal of a drug (n = 41), or ordering a laboratory test (n = 25). Factors associated with a recorded procedure code included age above the remuneration limit of 75 years (odds ratio: 9.8; 95% confidence interval 5.0–19), type 2 diabetes (3.0 (1.5–6.2)), hypertension (2.4 (1.2–4.8)), and depression (2.5 (1.02–6.0)). Conclusions The presence of a recorded medication review was not positively associated with adequate drug treatment management but was associated with the age limit for remuneration, and some chronic diseases.Key points To improve drug treatment in older people in primary care, a remuneration system linked to recorded medication reviews has been introduced. In this study, fewer patients with than without a recorded medication review (63% versus 73%) had adequate drug treatment management. A recorded medication review was ten times more common in those ≥75 years, that is, the age limit for remuneration. Recorded codes for medication reviews were also common in those with type 2 diabetes, hypertension, and depression.Naldy Parodi LópezStaffan A. SvenssonSusanna M. WallerstedtTaylor & Francis Grouparticleagedcross-sectional studiesinappropriate prescribingmedication reviewpharmacoepidemiologyprescription drugsprimary health carePublic aspects of medicineRA1-1270ENScandinavian Journal of Primary Health Care, Vol 0, Iss 0, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	aged cross-sectional studies inappropriate prescribing medication review pharmacoepidemiology prescription drugs primary health care Public aspects of medicine RA1-1270
spellingShingle	aged cross-sectional studies inappropriate prescribing medication review pharmacoepidemiology prescription drugs primary health care Public aspects of medicine RA1-1270 Naldy Parodi López Staffan A. Svensson Susanna M. Wallerstedt Association between recorded medication reviews in primary care and adequate drug treatment management – a cross-sectional study
description	Objective To investigate the association between a recorded procedure code for a medication review and adequate drug treatment management, and to explore factors associated with this code. Design and setting Cross-sectional study; two primary health care centres, in Region Västra Götaland, Sweden. Subjects A total of 302 consecutive patients (≥65 years old, 59% female; median number of drugs: six) requiring a non-urgent consultation with a physician in October–November 2017. Main outcome measure Adequate drug treatment management (treatment that did not require any further action), determined in consensus by two specialists in family medicine blinded to the medication review code. Results Adequate drug treatment management was, overall, less common in those with a recorded medication review over the last year: 63% versus 73% (p = 0.047). This negative association was evident among patients aged 65–74 years: 49% versus 74% (p = 0.003), but absent in those ≥75 years old: 67% versus 70% (p = 0.77). Recommendations from consensus included the search for additional information to be able to make a decision regarding initiation or withdrawal of a drug (n = 53), withdrawal of a drug (n = 41), or ordering a laboratory test (n = 25). Factors associated with a recorded procedure code included age above the remuneration limit of 75 years (odds ratio: 9.8; 95% confidence interval 5.0–19), type 2 diabetes (3.0 (1.5–6.2)), hypertension (2.4 (1.2–4.8)), and depression (2.5 (1.02–6.0)). Conclusions The presence of a recorded medication review was not positively associated with adequate drug treatment management but was associated with the age limit for remuneration, and some chronic diseases.Key points To improve drug treatment in older people in primary care, a remuneration system linked to recorded medication reviews has been introduced. In this study, fewer patients with than without a recorded medication review (63% versus 73%) had adequate drug treatment management. A recorded medication review was ten times more common in those ≥75 years, that is, the age limit for remuneration. Recorded codes for medication reviews were also common in those with type 2 diabetes, hypertension, and depression.
format	article
author	Naldy Parodi López Staffan A. Svensson Susanna M. Wallerstedt
author_facet	Naldy Parodi López Staffan A. Svensson Susanna M. Wallerstedt
author_sort	Naldy Parodi López
title	Association between recorded medication reviews in primary care and adequate drug treatment management – a cross-sectional study
title_short	Association between recorded medication reviews in primary care and adequate drug treatment management – a cross-sectional study
title_full	Association between recorded medication reviews in primary care and adequate drug treatment management – a cross-sectional study
title_fullStr	Association between recorded medication reviews in primary care and adequate drug treatment management – a cross-sectional study
title_full_unstemmed	Association between recorded medication reviews in primary care and adequate drug treatment management – a cross-sectional study
title_sort	association between recorded medication reviews in primary care and adequate drug treatment management – a cross-sectional study
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/596fc3ac37d94f3385e84686c9ad47db
work_keys_str_mv	AT naldyparodilopez associationbetweenrecordedmedicationreviewsinprimarycareandadequatedrugtreatmentmanagementacrosssectionalstudy AT staffanasvensson associationbetweenrecordedmedicationreviewsinprimarycareandadequatedrugtreatmentmanagementacrosssectionalstudy AT susannamwallerstedt associationbetweenrecordedmedicationreviewsinprimarycareandadequatedrugtreatmentmanagementacrosssectionalstudy
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Association between recorded medication reviews in primary care and adequate drug treatment management – a cross-sectional study

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