Study shows significant deficits in the medication plan

Practice often deviates from the medication plan
Blood thinners, analgesics, cholesterol-lowering drugs and many other medicines are particularly reliant on older people. The correct intake of funds is very important. To ensure this and to keep track, helping so-called medication plans, which are usually created by the family doctor. But only every 16th medical medication plan also corresponds to the intake practice, as a study by the Westfälische Wilhelms-Universität Münster shows. The researchers published their findings in the "Journal of Evaluation in Clinical Practice"..

There was an average of five deviations from the medication plan for each patient
The study is part of a training model project of the Westfälische Wilhelms-Universität Münster for drug therapy safety (AMTS). The topic of drug therapy safety is integrated into the training of pharmacists in the so-called apo-AMTS model. It is a cooperation with the Apothekerkammer Westfalen-Lippe.

Substantial deviations in the medication plan. Image: Kzenon-fotolia

As part of the study, program participants analyzed the drug intake of 500 patients over a 15-month period. 399 of the accompanying patients (80 percent) had an individual medication plan. It contained an average of nine prescription drugs in the range of one to 21 active substances and a non-prescription drug in a range of zero to six preparations. However, on average, more than five deviations per patient were detected during the check-up. A total of 2,021 differences between the medicines to be taken according to the medication plans and those actually taken were registered. "The discrepancies were in 78 percent of cases prescription and in 22 percent of the cases non-prescription drugs and supplements," said the university.

Almost every fifth deviation in the medication plan involved the withdrawal of a drug without informing the doctor
According to the study, 41 percent of the deviations involved the replacement of one drug with a largely similar drug from another manufacturer. "The exchange itself is not the problem because the effectiveness is the same. But the fact that there is a different name on the medication plan than on the medication given, it can lead to misunderstandings and false income in the patients, "said Georg Hempel, who led the study together with Isabel Waltering and Oliver Schwalbe. In 30 percent of cases, patients took a drug that was not part of the medication plan. In 18 percent of the deviations, one or more drugs were discontinued without the physician's knowledge. "In eleven percent of cases, there were some significant deviations in the dose. Most of the deviations were for hypertension (494 cases), followed by analgesics (178) and antidepressants (105), "the University's statement said.

Possible deficits in the cooperation of doctors and pharmacists
"Complete and up-to-date information about the prescribed medication is a prerequisite for safe and optimal therapy. Before handing over the medication plan, a medication analysis must be carried out, "emphasize the study authors. Public pharmacies should, in their view, play a key role in the preparation and regular updating of medication plans. "Especially for patients who take several medications - which are in most cases older people - a collaboration between doctors and pharmacists is particularly important. Obviously, there are still high deficits here, "explains Waltering. As an AMTS lecturer, she has been involved in the training of 428 pharmacists to become the AMTS Manager for the past three years. "These pharmacists, as pilots between the patient and the prescribing physicians, can make a decisive contribution to improving therapy safety." (Ag)