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- Title
How do physicians conduct medication reviews?
- Authors
Tarn, Derjung M.; Paterniti, Debora A.; Kravitz, Richard L.; Fein, Stephanie; Wenger, Neil S.
- Abstract
<bold>Background: </bold>Medication reviews are recommended annually for older patients. A medication review is a discussion of a patient's complete set of medications, but the actual content of a review is not well specified. The medical literature suggests that it is an exhaustive evaluation, but what physicians actually ask about their patients' medication regimens has been little studied.<bold>Objective: </bold>To describe what physicians do when they review medications in the office setting.<bold>Methods: </bold>Qualitative content analysis of audio-taped encounters between 100 patients aged 65 and older and 28 primary care physicians in two health care systems in Sacramento, California.<bold>Results: </bold>Physicians use a combination of non-mutually exclusive strategies when reviewing chronic medications that include: (1) efforts to obtain a complete list of patient medications (36% of visits), (2) discussion of a topic related to the management of each of a patient's chronic medications (47% of visits), and (3) sequential discussion of the majority of a patient's medications without intervening discussion (45% of visits). Of 10 medication management topics that were discussed in medication reviews, a mean of 1.5 topics (SD = 1.7, range 0-7) were mentioned for each medication, with efficacy and directions being most common. Physicians conducted a sequential discussion that included discussion of each of a patient's medications in only 32% of visits.<bold>Conclusions: </bold>Comprehensive discussions about chronic medications are uncommon in routine practice. Practical conceptualization of what constitutes a physician-conducted medication review is needed.
- Subjects
SACRAMENTO (Calif.); CALIFORNIA; CLINICAL drug trials; ELDER care; MEDICAL care; QUALITATIVE research; DRUGS &; economics; RESEARCH; PHYSICIAN-patient relations; RESEARCH methodology; ACQUISITION of data; EVALUATION research; MEDICAL cooperation; COMPARATIVE studies; DRUGS; RESEARCH funding; PATIENT education; PATIENT compliance; PHYSICIANS; MEDICAL appointments; DRUG side effects
- Publication
JGIM: Journal of General Internal Medicine, 2009, Vol 24, Issue 12, p1296
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-009-1132-4