"I must, and I can live with that": a thematic analysis of patients' perspectives on polypharmacy and a digital decision support system for GPs

Robin Brünn, Beate S Müller, Benno Flaig, Petra Kellermann-Mühlhoff, Ute Karbach, Sara Söling, Christiane Muth, Marjan van den Akker, AdAM Study consortium, Lara Düvel, Till Beckmann, Reinhard Hammerschmidt, Julia Jachmich, Eva Leicher, Benjamin Brandt, Johanna Richard, Frank Meyer, Mathias Flume, Thomas Müller, Ferdinand M Gerlach, Ana Isabel González-González, Truc Sophia Dinh, Kiran Chapidi, Peter Ihle, Ingo Meyer, Nina Timmesfeld, Hans Joachim Trampisch, Renate Klaaßen-Mielke, Jale Basten, Wolfgang Greiner, Bastian Surmann, Holger Pfaff, Juliane Köberlein-Neu, Alexandra Piotrowski, Karolina Beifuß, Sarah Meyer, Daniel Grandt, Simone Grandt, Robin Brünn, Beate S Müller, Benno Flaig, Petra Kellermann-Mühlhoff, Ute Karbach, Sara Söling, Christiane Muth, Marjan van den Akker, AdAM Study consortium, Lara Düvel, Till Beckmann, Reinhard Hammerschmidt, Julia Jachmich, Eva Leicher, Benjamin Brandt, Johanna Richard, Frank Meyer, Mathias Flume, Thomas Müller, Ferdinand M Gerlach, Ana Isabel González-González, Truc Sophia Dinh, Kiran Chapidi, Peter Ihle, Ingo Meyer, Nina Timmesfeld, Hans Joachim Trampisch, Renate Klaaßen-Mielke, Jale Basten, Wolfgang Greiner, Bastian Surmann, Holger Pfaff, Juliane Köberlein-Neu, Alexandra Piotrowski, Karolina Beifuß, Sarah Meyer, Daniel Grandt, Simone Grandt

Abstract

Background: To investigate patients' perspectives on polypharmacy and the use of a digital decision support system to assist general practitioners (GPs) in performing medication reviews.

Methods: Qualitative interviews with patients or informal caregivers recruited from participants in a cluster-randomized controlled clinical trial (cRCT). The interviews were transcribed verbatim and analyzed using thematic analysis.

Results: We conducted 13 interviews and identified the following seven themes: the patients successfully integrated medication use in their everyday lives, used medication plans, had both good and bad personal experiences with their drugs, regarded their healthcare providers as the main source of medication-related information, discussed medication changes with their GPs, had trusting relationships with them, and viewed the use of digital decision support tools for medication reviews positively. No unwanted adverse effects were reported.

Conclusions: Despite drug-related problems, patients appeared to cope well with their medications. They also trusted their GPs, despite acknowledging polypharmacy to be a complex field for them. The use of a digital support system was appreciated and linked to the hope that reasons for selecting specific medication regimens would become more comprehensible. Further research with a more diverse sampling might add more patient perspectives.

Trial registration: ClinicalTrials.gov, NCT03430336 . Registered on February 6, 2018.

Keywords: Decision support; Interviews; Patient perspective; Polypharmacy; Primary care; Qualitative study.

Conflict of interest statement

None.

© 2021. The Author(s).

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Source: PubMed

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