Abstract

A Survey on Medication Reviews in Older Patients: Substantial Variation in Daily Practice

Kim PGM Hurkens, Carlota Mestres-Gonzalvo, Hugo AJM de Wit, P. Hugo M van der Kuy, Rob Janknegt, Frans Verhey, Jos MGA Schols, Leo ML Stolk, Coen DA Stehouwer and Wubbo Mulder

Objective: To assess the methods and frequency by which medication reviews are performed by general practitioners and nursing home physicians by means of a survey.

Methods: 134 nursing home physicians and general practitioners working in the southern part of the Netherlands, the province of Limburg were asked to fill in a digital questionnaire. Non response was followed by second emailing and a questionnaire on paper by regular post. The questionnaire was developed by an expert panel, consisting of two hospital pharmacists, an internist, a nursing home physician and a neuropsychiatrist.

Results: There was substantial inconsistency in the frequency of performing medication reviews, ranging from monthly (in 40%) by the nursing home physicians to four times a year (in 50%) by the general practitioners. Time spent on one review also varied significantly between groups, namely 10 minutes for a nursing home physician and 20 minutes for general practitioners. Meetings between the physician and pharmacist took place regularly (91%), but these were not organised for medication reviewing of individual patients. When medication was changed by another doctor, 47% of nursing home physicians and 44% of the general practitioners were informed often, whereas 40% and 50% respectively were only informed sometimes, and 13% of nursing home physicians and 6% of general practitioners never received any notice. 59% of the nursing home physicians and 89% of general practitioners considered workload to be a limiting factor in performing reviews.

Conclusions: This survey shows great inconsistency in the way medication reviews are done. To achieve a high standard, we may have to reconsider the way medication reviews are done.