Patient perceptions and experiences of medication review: qualitative study in general practice

Deborah McCahon*, Polly R Duncan, Rupert A Payne, Jeremy Horwood

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

2 Citations (Scopus)
39 Downloads (Pure)

Abstract

Background: Clinical medication reviews are a recognised strategy to address polypharmacy, a key part of general practice and positively associated with patient safety and clinical effectiveness. To date there has been little investigation of the patient perspective of medication reviews.
Objective: To explore patient experiences of medication review including the processes and activities that led up to and shaped the review.

Methods: Qualitative interview study within 10 general practices in Bristol. Participants were adults with polypharmacy (≥4 medications) and ≥2 long-term conditions who had a record of medication review with either a GP or pharmacist. Interviews were transcribed verbatim and analysed thematically using a data driven approach. Co-design work was undertaken with four patient and public involvement advisers to design and develop resources to support patient preparation for medication review.

Results: Twenty-one patients were interviewed (10 female, mean age 73 years, range 59-88 years). Medication review was viewed as an opportunity to assess the effectiveness and need for medications. Participants expected the review to focus upon medication related concerns, side-effects and symptoms. Those who were newer to review, were uncertain of the intended purpose, and described their review as a box-ticking exercise. Some participants were unfamiliar with the role of the pharmacist and expressed a lack of confidence in their clinical skills and knowledge. Face-to-face consultation and relationship continuity were considered important for efficient and effective medication review. Results informed co-production of a patient information leaflet to facilitate greater patient engagement and involvement in medication review.

Conclusions: A lack of understanding of the rationale for medication review can limit the value patients attach to these healthcare encounters. Improved prior communication and information around the intended purpose and potential benefits of medication review may enhance patient engagement and improve patient experience and outcomes.
Original languageEnglish
Article number293
Number of pages10
JournalBMC Primary Care
Volume23
Issue number1
DOIs
Publication statusPublished - 23 Nov 2022

Bibliographical note

Funding Information:
This research was funded by the Scientific Foundation Board of the Royal College of General Practitioners (Grant No SFB 2017-16). The funders of the study had no role in the study design, data collection, data analyses, data interpretation or writing of the manuscript.

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • clinical medication review, patient experience, medicines optimisation, primary care, clinical pharmacist

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