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. 2024 Jan 17;12(2):231.
doi: 10.3390/healthcare12020231.

Identification of Barriers for Active Disease Management and of Medication-Related Problems through Therapeutic Patient Education in Older Home-Care Patients

Sabrina Grigolo  1 , Barbara Bruschi  1 , Diego Di Masi  1 , Carla Bena  2 , Lucrezia Greta Armando  3 , Clara Cena  3
Affiliations

Identification of Barriers for Active Disease Management and of Medication-Related Problems through Therapeutic Patient Education in Older Home-Care Patients

Sabrina Grigolo et al. Healthcare (Basel). .

Abstract

Combining therapeutic patient education (TPE) with a medication review service could foster the adoption of appropriate lifestyles by patients and support care-providers in identifying strategies to improve the quality of prescribed care. This study aimed to identify barriers experienced by patients in managing their diseases and medication-related problems. This was a monocentric, case series, observational study involving home-care patients from the Local Health Authority ASL TO4. Patients were enrolled for a TPE intervention where drug therapies and patient habits were collected through narrative interviews. Medication review was performed to identify potentially inappropriate prescriptions (PIPs). Twenty patients (13 females) with a mean age of 74.7 years were enrolled. Patients had an average of 4.3 diseases and 80.0% of them were treated with ≥5 daily medications. The main PIPs involved ibuprofen, furosemide and pantoprazole. The qualitative analysis of the interviews identified seven macro-themes relating to different aspects of medication management: therapy; diseases; patient; patient journey; professionals; family and caregivers; drug information. The results of this study revealed some critical aspects related to the treatment path and healthcare professionals. These results will be used to plan educational interventions for polypharmacy patients to improve medication adherence and the understanding and management of diseases.

Keywords: home care service; medication review; narrative interview; polypharmacy; potentially inappropriate prescriptions.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Strategies adopted by patients and/or caregivers to remember the correct therapy to take: (a) diary with the daily therapy written day by day; (b) medication boxes with the daily dosage written by the patient; (c) cardboard box containing the daily medication with the dosage written on it.
Figure 2
Figure 2
Medication-related problems identified in the prescriptions of the study population. Numbers represent the number of medication-related problems for each category.
Figure 3
Figure 3
PIPs according to the Beers criteria considered for the analysis.
Figure 4
Figure 4
PIPs according to the STOPP criteria considered for the analysis.
See this image and copyright information in PMC

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