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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.
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.
O envelhecimento da população está associado ao aumento da prevalência de doenças crônicas, resultando em um uso crescente de múltiplos medicamentos, conhecido como polifarmácia. Este estudo analisa as implicações da polifarmácia em idosos, com ênfase nos desafios enfrentados pelos profissionais de saúde e pacientes. A revisão sistemática da literatura revelou que a polifarmácia está associada a riscos significativos, como interações medicamentosas adversas, iatrogenia e declínio funcional. Além disso, a complexidade dos regimes de medicação pode levar à baixa adesão ao tratamento, aumentando o risco de hospitalizações e custos de saúde. Identificou-se que fatores socioeconômicos e relacionais, como nível educacional e estado civil, influenciam a prevalência da polifarmácia e a adesão ao tratamento. Estratégias para melhorar a adesão incluem a participação ativa do paciente nas decisões de prescrição, educação sobre o uso adequado dos medicamentos, e o suporte de familiares e cuidadores. É essencial que os profissionais de saúde adotem uma abordagem holística, considerando as necessidades individuais dos pacientes e reduzindo o número de medicamentos sempre que possível. Este estudo destaca a importância de um diálogo eficaz entre profissionais de saúde e pacientes para otimizar a gestão da polifarmácia, melhorando a qualidade de vida dos idosos e reduzindo os riscos associados.
Polypharmacy, a growing public health and economic concern, is particularly common among the elderly due to the high prevalence of multimorbidity, such as dementia and stroke, which necessitates complex treatment regimens. While commonly understood as taking five or more medications, definitions of polypharmacy are varied and may be misleading in clinical practice. This research examines factors such as a country's expenditure on health and education, age, and clinicians’ holistic approaches to compare the prevalence of polypharmacy across different groups. The review included documentary research through PubMed, Scopus, and Google Scholar databases and search engines, resulting in seven selected sources. The average year of publication was 2020 (median: 2020; standard deviation: 1.63; range: 2018 to 2023). The level of polypharmacy was found to be significantly dependent on per capita expenditure on education (R 2 = -0.79; F(6) = -3.11; p = 0.02) and health (R 2 = -0.76; F(6) = -2.88; p = 0.03). Countries with higher spending in these areas had a lower proportion of participants with polypharmacy. Additionally, patients’ quality of life (QoL) is closely tied to the amount of medication they consume, highlighting the need for physicians to avoid unnecessary prescriptions. Patients impacted by polypharmacy often lack knowledge about their diseases and medications, negatively affecting their QoL and compliance. To develop effective treatment plans and improve clinical practice, doctors should consider these risk factors, prioritize patient education, and utilize innovative technologies to support patients. While polypharmacy is sometimes unavoidable and necessary, this approach could in some cases help mitigate the challenges and risks posed by inappropriate polypharmacy and enhance patients' QoL. Furthermore, policymakers should consider increasing spending on education and healthcare, as this may resolve clinical and economic problems related to the issue.
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