Perspective of elderly patients on chronic use of potentially inappropriate medication - Results of the qualitative CIM-TRIAD study

PLoS One. 2018 Sep 19;13(9):e0202068. doi: 10.1371/journal.pone.0202068. eCollection 2018.

Abstract

Although potentially inappropriate medication (PIM) is associated with risk of harm due to adverse effects, it is frequently prescribed for elderly patients. The aim of this qualitative multi-center study was to gain insight into contextual factors that might lead to chronic PIM use. We conducted semi-structured interviews with elderly patients with or without chronic PIM use (patient interviews: n = 52). Patients were between 86 and 96 years old. The participants were recruited from the AgeCoDe study. Interviews were audiotaped and transcribed verbatim. The transcripts of the interviews were analysed using qualitative content analysis. Deductive and inductive categories were determined. We found contextual factors related to the patient and related to patient-general practitioner (GP) communication that might lead to chronic PIM use (i.e., positive features of PIM, maintaining characteristics of medication intake, barriers to deprescribe PIM, external actors supporting PIM intake, system-related factors). Besides certain health-related behaviours (e.g., own obligation to report to GP) and medication-related attitudes and knowledge (e.g., awareness of side effects and interaction of medicines), patient-GP-interactions that were characterised by mutual agreements on drugs (e.g., concerning dosage or discontinuation of a drug) might be advantageous to reduce the probability of chronic PIM use. The results might assist in the development of guidelines and educational programs aiming to reduce PIM use in the elderly.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Drug-Related Side Effects and Adverse Reactions / diagnosis
  • Drug-Related Side Effects and Adverse Reactions / prevention & control
  • Female
  • General Practitioners / statistics & numerical data
  • Humans
  • Inappropriate Prescribing / statistics & numerical data*
  • Interviews as Topic
  • Male
  • Patients / statistics & numerical data*
  • Potentially Inappropriate Medication List / statistics & numerical data*
  • Qualitative Research*
  • Risk Assessment / methods
  • Risk Assessment / statistics & numerical data
  • Risk Factors

Grant support

This work is part of the CIM-TRIAD study that was funded by the German Federal Ministry of Education and Research (https://www.bmbf.de/; grants: 01GY1311A, 01GY1311B, 01GY1311C) and is published in affiliation with the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe; funded by the German Federal Ministry of Education and Research; grants KND 01GI0102, 01GI0420, 01GI0422, 01GI0423, 01GI0429, 01GI0431, 01GI0433, 01GI0434; grants KNDD 01GI0710, 01GI0711, 01GI0712, 01GI0713, 01GI0714, 01GI0715, 01GI0716; and grants AgeQualiDe 01GY1322A, 01GY1322B, 01GY1322C, 01GY1322D, 01GY1322E, 01GY1322F, 01GY1322G). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.