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Påverkar patientens ålder antalet aktuella respektive inaktuella läkemedelsordinationer i läkemedelslistan?
Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
2012 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Felaktig läkemedelsanvändning är i dagens samhälle en betydande orsak till både morbiditet och mortalitet. Feldoseringar och dubbletter, vilka båda faller inom ramen för felaktig läkemedelsanvändning, skulle kunna undvikas med hjälp av läkemedelsavstämningar tillsammans med en farmaceut.  En mycket stor del av alla läkemedelslistor innehåller minst en inaktuell ordination eller dubblett. Antalet av dessa och även aktuella ordinationer ökar med stigande ålder. Ungefär en fjärdedel av alla expedierade läkemedel i Sverige konsumeras av patienter över 75 år. Syftet med detta examensarbete är att undersöka ålderns inverkan på antalet aktuella respektive inaktuella ordinationer i det ordinationsunderlag patienten erhåller från sjukvården (läkemedelslistan). Studien gjordes på tre hälsocentraler med två parallella grupper av patienter. Före ett läkarbesök gjorde den ena gruppen en egenavstämning av sin läkemedelslista, medan den andra gruppen gjorde en läkemedelsverifiering (jämförde aktuella ordinationer mot angivna ordinationer) av sin läkemedelslista tillsammans med en farmaceut.                                                                                                                                         Studien visade att patienter i en yngre åldergrupp har något färre aktuella ordinationer än patienter i en äldre åldersgrupp. Vidare visade den att antalet inaktuella ordinationer på läkemedelslistorna liksom andelen patienter med inaktuella ordinationer på sina läkemedelslistor kan minskas med hjälp av både egenavstämning och läkemedelsverifiering. 

Abstract [en]

In today´s society misuse of drugs is a major cause of morbidity as well as of mortality. A large proportion of all admissions in emergency wards is due to drug-related problems (e.g. incorrect medication use) and could probably have been avoided. Incorrect medication use that depends on dosage errors and duplicate ordinations is a big problem and could be avoided by drug verifications together with a pharmacist. A large number of medication records contain at least one incorrect ordination or a duplicate. This gives rise to incorrect medication use and approximately 40 % of these can cause moderate to severe impairment of patients’ wellbeing.    

Of all drugs dispensed inSweden, patients older than 75 years old consume one fourth. The number of prescribed drugs as well as the number of discrepancies in medication records increases with age.   

This study was conducted during the spring of 2012 and took places in three Primary health care centers in thecountyofKalmar. It was randomized, controlled and with two parallel groups of patients. The first group had their medication record sent home before they had a medical visit at the Primary health care center. These patients compared their current medication with the ordinations in the medication record. The other group met a pharmacist before their scheduled doctor visit to make a comparison of ordinations in the medications records and the medicines the patients stated they used.

The proportion of patients with differences between what was noted in their medication records, in the age group <75 years, compared with what the patients stated they used was initially 85.2% but decreased to 50.8% after the doctor visit. In the age group ≥ 75 years, this discrepancy was initially 76.4% but decreased to 31.9%. In the age group <75 years, 29.0 % of all ordinations were incorrect compared to 20.8 % of all prescriptions in the other group. The patients in the age group <75 years, they had in average of 1.23 fewer discrepancies per patient than the patients in the age group ≥75 years old.The proportion of patients aged <75 years with duplicates were 14.8% while the proportion aged ≥ 75 years were 13.9%. 

Patients’ medication records can be improved in both age groups. This can be achieved with either self-review or drug verification with a pharmacist. If the effort of updating the medication records will continue, then the incorrect medication use would probably decrease and hence also the drug-related problems. This would yield benefits especially on patients’ health and their well-being but also for the county councils economy. 

Place, publisher, year, edition, pages
2012. , 33 p.
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-19585OAI: oai:DiVA.org:lnu-19585DiVA: diva2:531350
Subject / course
Pharmacy
Educational program
Bachelor of Science Programme in Pharmacy, 180 credits
Uppsok
Medicine
Supervisors
Examiners
Available from: 2012-06-15 Created: 2012-06-06 Last updated: 2012-06-15Bibliographically approved

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