Medication beliefs and use of medication lists - is there a connection? Results from a before-and-after study in Germany.

BACKGROUND: Despite increasing digitalisation the paper-based medication list remains one of the most important instruments for the documentation and exchange of medication-related information. However, even elderly patients with polypharmacy who are at high risk for medication errors and adverse drug events, frequently do not receive or use a complete and comprehensible medication list. Increasing the use of medication lists would be a great contribution to medication safety and facilitate the work of health care providers. METHODS: This study is related to the project MeinPlan (MyPlan) which comprised an information campaign on safe drug administration in the Rhine-Neckar region in South Germany. The campaign was evaluated in a before-and-after study based on a survey among two independent, representative samples of citizens over 65 years. In total, 5034 questionnaires were analysed. While the effects of the primary outcome (the percentage of citizens using a medication list) have been reported elsewhere, this analysis focusses on the effects of the campaign on citizens' medication beliefs and assesses whether medication beliefs are associated with the use of medication lists, the use of over-the-counter drugs and the use of the tools offered by the campaign. Medication beliefs were assessed with the German version of the General Beliefs About Medicines Questionnaire (BMQ) which results in subscales for "General Overuse", "General Usefulness" and "General Harm". The use of medication lists and over-the-counter drugs was assessed with self-developed questionnaire items. RESULTS: No statistically significant change in citizens' medication beliefs before and after the campaign could be detected. Likewise, no association between medication beliefs and the use of medication lists, the use of over-the-counter drugs or the use of the tools offered by the campaign could be shown. CONCLUSIONS: A campaign focussing on the risks of drug administration did not change the medication beliefs of the targeted population. Moreover, citizens' general medication beliefs do not seem to be crucial for their decision to use a medication list or over-the-counter drugs. Strategies to improve the use of medication lists by patients should focus on other influential factors, such as individual benefits and barriers and socio-psychological factors.

Use of medication lists: A population-based approach to increase the prevalence of medication lists within a region in Germany. A pre-post study
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OBJECTIVES: Patient-centered medication lists are a useful documentation method to support safe drug treatment, but they are still inconsistently used and are of varying quality. The aim of this study was to evaluate the effects of an information campaign on the prevalence and use of medication lists. MATERIAL AND METHODS: We launched a population-based, low-threshold information campaign within a large region in Germany in order to sensitize the population to the use of medication lists. A survey was sent out at baseline and after 18 months to 5,340 citizens aged ≥ 65 years, covering ~ 4% of the region's population. RESULTS: The response rate was 49.4% (N = 2,640) at baseline and 45.4% (N = 2,427) at follow-up. Sociodemographic details of respondents were similar at both time-points as was the possession rate of a medication list among participants with regular medicine intake (51.6%, N = 1,181/2,288 vs. 51.4%, N = 1,082/2,107). Combining baseline and follow-up data, respondents indicated that their general practitioner was involved in issuing the list most often (N = 1,668/2,263, 73.7%), however, in 195 cases (8.6%), respondents indicated being solely responsible for the list. The majority (90.8%, N = 2,055/2,263) indicated having their list in use for longer than 1 year, but for only half of those, the list was updated within the last year. After the intervention, 6% of the respondents indicated being familiar with the campaign those being more likely to possess a list (69.7% N = 83/119 vs. 50.2% N = 999/1,988). CONCLUSION: The campaign did not change overall possession rate, but respondents who were familiar with the campaign were more likely to possess such a list.

[Benefits of a Medication List from a Citizen's Perspective -A Qualitative Survey]. / Nutzen eines Medikationsplans aus Sicht der Bürger ­ eine qualitative Befragung.

BACKGROUND: Since October 2016, German patients are entitled to get a medication list if using at least 3 drugs. The patient's individual attitude to a medication list is supposed to be relevant for its use und acceptance. STUDY AIM: Because there is little known about those attitudes, this study examined which potential benefits patients see in possessing a medication list, and why certain patients might not use it. METHOD: In a qualitative survey, 375 citizens of the Rhein-Neckar region were interviewed by using a semi-standardized guide. A content analysis of the interviews was done. RESULTS: Most citizens described medication lists as having private and economic benefits such as for health care or safe drug use. But often, they combine potential benefits with requirements such as age, number of prescribed drugs, or health status. Unsatisfied individual needs, excessive demands or an attitude of rejection are possible reasons for non-use. CONCLUSION: For successful implementation of the medication list, the individual attitude of patients should be assessed to be able to provide tailored information and assistance. The views of citizens about a medication list agree with the aims of the so-called German E-Health Act, but differ particularly with regard to named requirements and prioritisation.

An analysis of integrated health care for Internet Use Disorders in adolescents and adults.

Background and aims Although first treatment approaches for Internet Use Disorders (IUDs) have proven to be effective, health care utilization remained low. New service models focus on integrated health care systems, which facilitate access and reduce burdens of health care utilization, and stepped-care interventions, which efficiently provide individualized therapy. Methods An integrated health care approach for IUD intended to (a) be easily accessible and comprehensive, (b) cover a variety of comorbid syndromes, and (c) take heterogeneous levels of impairment into account was investigated in a one-armed prospective intervention study on n = 81 patients, who were treated from 2012 to 2016. Results First, patients showed significant improvement in Compulsive Internet Use over time, as measured by hierarchical linear modeling. Effect sizes of outcome change from baseline to 6-month follow-up ranged from d = 0.48 to d = 1.46. Second, differential effects were found depending on patients' compliance, demonstrating that high compliance resulted in significantly higher rates of change. Third, patients referred to minimal interventions did not differ significantly in amount of change from patients referred to intensive psychotherapy. Discussion Tailored interventions result in higher efficiency through optimized resource allocation and equal amounts of symptom change in all treatment conditions. Moreover, comprehensive, low-threshold interventions seem to increase health service utilization.