Improving medication adherence and effective prescribing through a patient-centered prescription model in patients with multimorbidity

Purpose This study aimed to assess the impact of the patient-centered prescription (PCP) model in medication adherence and effective prescribing in patients with multimorbidity. Methods Uncontrolled before–after study in an intermediate care facility in a mixed urban–rural district. Inpatients aged ...

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Bibliographic Details
Published in:European journal of clinical pharmacology 2022, Vol.78 (1), p.127-137
Main Authors: González-Bueno, J., Sevilla-Sánchez, D., Puigoriol-Juvanteny, E., Molist-Brunet, N., Codina-Jané, C., Espaulella-Panicot, J.
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
Biomedical and Life Sciences
Biomedicine
Comorbidity
Female
Frail Elderly
Humans
Institutionalization
Male
Medication adherence
Medication Adherence - statistics & numerical data
Medication Therapy Management - organization & administration
Motivational Interviewing
Multimorbidity
Patient compliance
Patient-Centered Care - organization & administration
Patients
Pharmacoepidemiology and Prescription
Pharmacology/Toxicology
Polypharmacy
Potentially Inappropriate Medication List
Sex Factors
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Summary:Purpose This study aimed to assess the impact of the patient-centered prescription (PCP) model in medication adherence and effective prescribing in patients with multimorbidity. Methods Uncontrolled before–after study in an intermediate care facility in a mixed urban–rural district. Inpatients aged ≥ 65 years with multimorbidity exposed to polypharmacy before hospital admission were consecutively enrolled. Every patient’s treatment plan was analyzed through the PCP model, which includes interventions aimed at improving medication adherence. The primary endpoint was the change in the proportion of adherent patients between pre-admission and after discharge for all regularly scheduled long-term medications, using the proportion of days covered (PDC). Secondary endpoints included the change on mean PDC for all long-term medications, number of long-term medications, proportion of patients with hyperpolypharmacy, medication regimen complexity index (MRCI) score, drug burden index (DBI) score, number of potential inappropriate prescribing (PIP), and proportion of patients with ≥ 2 PIPs. Results Ninety-three non-institutionalized patients were included (mean age 83.0 ± SD 6.1 years). The proportion of adherent patients increased from 22.1 to 51.9% ( P  
ISSN:0031-6970
1432-1041
DOI:10.1007/s00228-021-03207-9