Why medicines are used differently from prescribed: a protocol for a prospective patient-oriented observational case study to investigate reasons for non-adherence in primary care.

Content Provider	Europe PMC
Author	Kvarnström, Kirsi Westerholm, Aleksi Airaksinen, Marja SA Liira, Helena
Copyright Year	2022
Abstract	IntroductionPatients do not always tell the physician if they have used medicines differently from prescribed. The challenges that patients experience in medication self-management and adherence have been prioritised globally as among the most crucial factors influencing the effectiveness and safety of pharmacotherapies.Methods and analysisThis study protocol presents a new patient-oriented method to investigate reasons for non-adherence using pharmacist-conducted medication reconciliation in a primary care clinic as data collection point. By interviewing, the pharmacist will learn how the patient has been taking the prescribed medicines and whether any non-prescription medicines and food supplements have been used for self-medication. The pharmacist will document the findings of the conversation to the electronic patient record in a structured format. The pharmacist will collect data related to the characteristics of the patients and outpatient clinics, patients’ diseases and medications, and medication discrepancies. These data will be analysed for descriptive statistics to identify (1) the number of discrepancies between the physician’s prescription orders and the patient’s self-reported use of the medicines, (2) what kind of discrepancies there are, (3) which are high-risk medicines in terms of non-adherence and (4) why medicines were taken differently from prescribed; based on the results, (5) a preliminary conceptual model of patient-reported reasons for non-adherence will be constructed.Trial registration numberNCT05167578.
Journal	BMJ Open
Volume Number	12
PubMed Central reference number	PMC9772666
Issue Number	12
PubMed reference number	36549723
e-ISSN	20446055
DOI	10.1136/bmjopen-2022-065363
Language	English
Publisher	BMJ Publishing Group
Publisher Date	2022-12-22
Publisher Place	London
Access Restriction	Open
Rights License	This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Subject Keyword	PRIMARY CARE Protocols & guidelines Quality in health care Risk management Adverse events
Content Type	Text
Resource Type	Article
Subject	Medicine