Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases
Abstract
1. Introduction
2. Materials and Methods
2.1. Search Strategy and Inclusion Criteria
2.2. Article Screening
2.3. Data Extraction
3. Results
3.1. Frequently Asked Questions (FAQs)
- How many elderly patients with chronic diseases take five or more medications daily?
- 2.
- What are the most common medication errors in elderly patients with chronic diseases?
- 3.
- To what extent do elderly patients taking five or more daily medications understand what they are taking and why?
- 4.
- What level of treatment adherence do elderly patients with chronic diseases have?
- 5.
- What tricks do patients use to remember to take their medication?
- 6.
- Are pill organisers useful?
- 7.
- Is it more difficult for elderly patients to understand written information, for example the information leaflets for medicines?
- 8.
- How many patients have doubts or want to ask their doctor something about their medication?
3.2. Recommendations
3.3. Possible Limitations
4. Conclusions
Author Contributions
Conflicts of Interest
References
- Lavan, A.H.; Gallagher, P.F.; O’Mahony, D. Methods to reduce prescribing errors in elderly patients with multimorbidity. Clin. Interv. Aging 2016, 11, 857–866. [Google Scholar] [PubMed]
- Koper, D.; Kamenski, G.; Flamm, M.; Böhmdorfer, B.; Sönnichsen, A. Frequency of medication errors in primary care patients with polypharmacy. Fam. Pract. 2013, 30, 313–319. [Google Scholar] [CrossRef] [PubMed]
- Lavon, O.; Ben-Zeev, A.; Benturi, Y. Medication Errors outside Healthcare Facilities: A National Poison Centre Perspective. Basic Clin. Pharmacol. Toxicol. 2014, 114, 288–292. [Google Scholar] [CrossRef] [PubMed]
- Mira, J.J.; Lorenzo, S.; Guilabert, M.; Navarro, I.; Pérez-Jover, V. A systematic review of patient medication error on self-administering medication at home. Expert Opin. Drug Saf. 2015, 14, 815–838. [Google Scholar] [CrossRef] [PubMed]
- Summer Meranius, M.; Engstrom, G. Experience of self-management of medications among older people with multimorbidity. J. Clin. Nurs. 2015, 24, 2757–2764. [Google Scholar] [CrossRef] [PubMed]
- Escamilla, J.A.; Castañer, O.; Benito, S.; Ruiz, E.; Burrull, M.; Sáenz, N. Motivos de incumplimiento terapéutico en pacientes mayores polimedicados, un estudio mediante grupos focales. Aten. Primaria 2008, 40, 81–85. [Google Scholar] [CrossRef]
- Ose, D.; Mahler, C.; Vogel, I.; Ludt, S.; Szecsenyi, J.; Freund, T. Let’s talk about medication: Concordance in rating medication adherence among multimorbid patients and their general practitioners. Patient Prefer. Adherence 2012, 6, 839–845. [Google Scholar] [CrossRef] [PubMed]
- Mira, J.J. Pacientes por la seguridad de los pacientes. El papel del paciente en la seguridad de los pacientes. Med. Prev. 2011, XVI, 5–11. [Google Scholar]
- Al Mahdy, H.; Seymour, D.G. How much can elderly patients tell us about their medications? Postgrad. Med. J. 1990, 66, 116–121. [Google Scholar] [CrossRef] [PubMed]
- Metlay, J.P.; Cohen, A.; Polsky, D.; Kimmel, S.E.; Koppel, R.; Hennessy, S. Medication Safety in Older Adults: Home-Based Practice Patterns. J. Am. Geriatr. Soc. 2005, 53, 976–982. [Google Scholar] [CrossRef] [PubMed]
- Sorensen, L.; Stokes, J.A.; Purdie, D.M.; Woodward, M.; Roberts, M. Medication management at home: Medication-related risk factors associated with poor health outcomes. Age Ageing 2005, 34, 626–632. [Google Scholar] [CrossRef] [PubMed]
- Haynes, R.B.; Montague, P.; Oliver, T.; McKibbon, K.A.; Brouwers, M.C.; Kanani, R. Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst. Rev. 2000, 2, 7–9. [Google Scholar]
- Harbour, R.; Miller, J. A new system for grading recommendations in evidence based guidelines. BJM Br. Med. J. 2001, 323, 334–336. [Google Scholar] [CrossRef]
- World Health Organization; United Nations Population Fund. Ageing in the Twenty-First Century: A Celebration and a Challenge; United Nations Population Fund: New York, NY, USA, 2012. [Google Scholar]
- Fulton, M.M.; Allen, E.R. Polypharmacy in the elderly: A literature review. J. Am. Acad. Nurse Pract. 2005, 17, 123–132. [Google Scholar] [CrossRef] [PubMed]
- Diz-Lois, F.; Fernández, O.; Pérez, C. El paciente polimedicado. Galicia Clin. 2012, 73, S37–S41. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Lizano-Díez, I.; Modamio, P.; López-Calahorra, P.; Lastra, C.F.; Gilabert-Perramon, A.; Segú, J.L.; Mariño, E.L. Profile, cost and pattern of prescriptions for polymedicated patients in Catalonia, Spain. BMJ Open 2013, 3, e003963. [Google Scholar] [CrossRef] [PubMed]
- Williamson, E.M. Interactions between herbal and conventional medicines. Expert Opin. Drug Saf. 2005, 4, 355–378. [Google Scholar] [CrossRef] [PubMed]
- Meredith, S.; Feldman, P.H.; Frey, D.; Hall, K.; Arnold, K.; Brown, N.J.; Ray, W.A. Possible medication errors in home healthcare patients. J. Am. Geriatr. Soc. 2001, 49, 719–724. [Google Scholar] [CrossRef] [PubMed]
- Gurwitz, J.H.; Field, T.S.; Harrold, L.R.; Rothschild, J.; Debellis, K.; Seger, A.; Cadoret, C.; Fish, L.S.; Garber, L.; Kelleher, M.; et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA 2003, 289, 1107–1116. [Google Scholar] [CrossRef] [PubMed]
- Salvi, F.; Marchetti, A.; D’Angelo, F.; Boemi, M.; Lattanzio, F.; Cherubini, A. Adverse drug events as a cause of hospitalization in older adults. Drug Saf. 2012, 35, 29–45. [Google Scholar] [CrossRef] [PubMed]
- Fernández Lisón, L.C.; Barón Franco, B.; Vázquez Domínguez, B.; Martínez García, T.; Urendes Haro, J.J.; Pujol de la Llave, E. Errores de medicación e incumplimiento terapéutico en ancianos polimedicados. Farm. Hosp. 2006, 30, 280–283. [Google Scholar] [CrossRef]
- Otero, M.J.; Codina, C.; Tamés, M.J.; Pérez, M. Errores de medicación: Estandarización de la terminología y clasificación. Farm. Hosp. 2003, 27, 137–149. [Google Scholar]
- Pérula de Torres, L.A.; Pulido Ortega, L.; Pérula de Torres, C.; González Lama, J.; Olaya Caro, I.; Ruiz Moral, R.; Grupo corporativo Estudio ATEM-AP. Efficacy of motivational interviewing for reducing medication errors in chronic patients over 65 years with polypharmacy: Results of a cluster randomized trial. Med. Clin. 2014, 143, 341–348. [Google Scholar] [CrossRef] [PubMed]
- Leal, M.; Abellán, J.; Casa, M.T.; Martínez, J. Paciente polimedicado: ¿conoce la posología de la medicación?, ¿afirma tomarla correctamente? Aten. Primaria 2004, 33, 451–456. [Google Scholar] [CrossRef]
- Wimmer, B.C.; Johnell, K.; Fastbom, J.; Wiese, M.D.; Bell, J.S. Factors associated with medication regimen complexity in older people: A cross-sectional population-based study. Eur. J. Clin. Pharmacol. 2015, 71, 1099–1108. [Google Scholar] [CrossRef] [PubMed]
- Molina, T.; Caraballo, M.O.; Palma, D.; López, S.; Domínguez, J.C.; Morales, J.C. Prevalencia de polimedicación y riesgo vascular en la población mayor de 65 años. Aten. Primaria 2012, 44, 216–222. [Google Scholar] [CrossRef] [PubMed]
- Mira, J.J.; Martínez-Jimeno, L.; Orozco-Beltran, D.; Iglesias-Alonso, F.; Lorenzo, S.; Nuño, R.; Pérez, P.; Toro, N.; Pérez-Jover, V.; Gil-Guillen, V. What older complex chronic patients need know about the medication they take every day for a safe drug use. Expert Opin. Drug Saf. 2014, 13, 713–721. [Google Scholar] [PubMed]
- Akici, A.; Kalaça, S.; Uğurlu, M.U.; Toklu, H.Z.; Iskender, E.; Oktay, S. Patient knowledge about drugs prescribed at primary healthcare facilities. Pharmacoepidemiol. Drug Saf. 2004, 13, 871–876. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Adherence Long Term Therapies. 2003. Available online: http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=18722&Itemid=270&lang=en (accessed on 16 November 2017).
- Morales, M.T. Estudio sobre la utilidad del pastillero para mejorar el cumplimiento terapéutico. Aten. Primaria 2009, 41, 185–192. [Google Scholar] [CrossRef] [PubMed]
- Márquez-Contreras, E.; de la Figuera-Von Wichmann, M.; Franch-Nadal, J.; Llisterri-Caro, J.L.; Gil-Guillén, V.; Martín-de Pablos, J.L.; Casado-Martínez, J.J.; Martell-Claros, N. Do Patients with High Vascular Risk Take Antihypertensive Medication Correctly? Cumple-MEMS Study. Rev. Esp. Cardiol. 2012, 65, 544–550. [Google Scholar] [CrossRef] [PubMed]
- Gray, S.L.; Mahoney, J.E.; Blough, D.K. Medication adherence in elderly patients receiving home health services following hospital discharge. Ann. Pharmacother. 2001, 35, 539–545. [Google Scholar] [CrossRef] [PubMed]
- Proupín, N.; Aparicio, M.; Garea, P.; Segade, X.; Arceo, A.; López, L. Polimedicación en pacientes adultos con dolencias crónicas en un centro de salud. Cad. Aten. Primaria 2008, 15, 275–279. [Google Scholar]
- Fuster, V. Un problema alarmante en prevención secundaria: Bajo cumplimiento (estilo de vida) y baja adherencia (farmacológica). Rev. Esp. Cardiol. 2012, 65, 10–16. [Google Scholar] [CrossRef] [PubMed]
- Aronson, J.K. Medication errors resulting from the confusion of drug names. Expert Opin. Drug Saf. 2004, 3, 167–172. [Google Scholar] [CrossRef] [PubMed]
- Van Eijken, M.; Tsang, S.; Wensing, M.; de Smet, P.A.; Grol, R.P. Interventions to improve medication compliance in older patients living in the community: A systematic review of the literature. Drugs Aging 2003, 20, 229–240. [Google Scholar] [CrossRef] [PubMed]
- Vik, S.A.; Maxwell, C.J.; Hogan, D.B. Measurement, Correlates, and Health Outcomes of Medication Adherence among seniors. Ann. Pharmacother. 2004, 38, 303–312. [Google Scholar] [CrossRef] [PubMed]
- Crespillo-García, E.; Rivas-Ruiz, F.; Contreras, E.; Castellano, P.; Suárez, G.; Pérez-Tobar, E. Conocimientos, percepciones y actitudes que intervienen en la adherencia al tratamiento en pacientes ancianos polimedicados desde una perspectiva cualitativa. Rev. Calid. Asist. 2013, 28, 56–62. [Google Scholar] [CrossRef] [PubMed]
- Gellad, W.F.; Grenard, J.L.; Marcum, Z.A. A Systematic Review of Barriers to Medication Adherence in the Elderly: Looking Beyond Cost and Regimen Complexity. Am. J. Geriatr. Pharmacother. 2011, 9, 11–23. [Google Scholar] [CrossRef] [PubMed]
- Midlöv, P.; Holmdahl, L.; Eriksson, T.; Bergkvist, A.; Ljungberg, B.; Widner, H.; Nerbrand, C.; Höglund, P. Medication report reduces number of medication errors when elderly patients are discharged from hospital. Pharm. World Sci. 2008, 30, 92–98. [Google Scholar] [CrossRef] [PubMed]
- Haynes, R.B.; Taylor, D.W.; Sackett, D.L.; Gibson, E.S.; Bernholz, C.D.; Mukherjee, J. Can simple clinical measurements detect patient noncompliance? Hypertension 1980, 2, 757–764. [Google Scholar] [CrossRef] [PubMed]
- Branin, J.J. The role of memory strategies in medication adherence among the elderly. Home Health Care Serv. Q. 2001, 20, 1–16. [Google Scholar] [CrossRef] [PubMed]
- Raehl, C.L.; Bond, C.A.; Woods, T.; Patry, R.A.; Sleeper, R.B. Individualized drug use assessment in the elderly. Pharmacotherapy 2002, 22, 1239–1248. [Google Scholar] [CrossRef] [PubMed]
- Tseng, M.H.; Wu, H.C. A cloud medication safety support system using QR code and Web services for elderly outpatients. Technol. Health Care 2014, 22, 99–113. [Google Scholar] [PubMed]
- Carrillo, I.; Guilabert, M.; Pérez-Jover, V.; Mira, J.J. Valoración de dos aplicaciones para la autogestión de la medicación en pacientes mayores. Estudio cualitativo. Rev. Calid. Asist. 2015, 30, 142–149. [Google Scholar] [CrossRef] [PubMed]
- Mira, J.J.; Guilabert, M.; Carrillo, I.; Fernández, C.; Vicente, M.A.; Orozco, D.; Gil-Guillen, V. Use of QR and EAN-13 codes by older patients taking multiple medications for a safer use of medication. Int. J. Med. Inf. 2015, 84, 406–412. [Google Scholar] [CrossRef] [PubMed]
- Serra-Prat, M.; Bartolomé, M.; Fité, B.; Agustí, C. Eficacia de un sistema personalizado de dosificación (SPD) en la mejoría del cumplimiento terapéutico en ancianos polimedicados. Aten. Primaria 2006, 37, 524–526. [Google Scholar] [CrossRef] [PubMed]
- Llaves, E.; Segura, M.M.; García-Jiménez, E.; Baena, I. Sistemas personalizados de dosificación en el cumplimiento del tratamiento farmacológico de pacientes con hipertensión y dislipemias. Aten. Primaria 2009, 41, 472–473. [Google Scholar] [CrossRef] [PubMed]
- Mira, J.J.; Navarro, I.; Botella, F.; Borrás, F.; Nuño-Solinís, R.; Orozco, D.; Iglesias-Alonso, F.; Pérez-Pérez, P.; Lorenzo, S.; Toro, N. A Spanish pillbox app for elderly patients taking multiple medications: Randomized controlled trial. J. Med. Internet Res. 2014, 16, e99. [Google Scholar] [CrossRef] [PubMed]
- Burda, C.; Haack, M.; Duarte, A.C.; Alemi, F. Medication adherence among homeless patients: A pilot study of cell phone effectiveness. J. Am. Acad. Nurse Pract. 2012, 24, 675–681. [Google Scholar] [CrossRef] [PubMed]
- Morak, J.; Schwarz, M.; Hayn, D.; Schreier, G. Feasibility of mHealth and Near Field Communication technology based medication adherence monitoring. Conf. Proc. IEEE Eng. Med. Biol. Soc. 2012, 2012, 272–275. [Google Scholar] [PubMed]
- Hayakawa, M.; Uchimura, Y.; Omae, K.; Waki, K.; Fujita, H.; Ohe, K. A Smartphone-based Medication Self-management System with Realtime Medication Monitoring. Appl. Clin. Inf. 2013, 4, 37–52. [Google Scholar] [CrossRef] [PubMed]
- Tsai, P.H.; Liu, J.W.S. Intelligent Tools for Reducing Medication Dispensing and Administration Error. In Foundations of Health Information Engineering and Systems; Gibbons, J., MacCaull, W., Eds.; FHIES 2013, Lecture Notes in Computer Science; Springer: Berlin/Heidelberg, Germany, 2014; Volume 8315. [Google Scholar]
- Årsand, E.; Frøisland, D.H.; Skrøvseth, S.O.; Chomutare, T.; Tatara, N.; Hartvigsen, G.; Tufano, J.T. Mobile health applications to assist patients with diabetes: Lessons learned and design implications. J. Diabetes Sci. Technol. 2012, 6, 1197–1206. [Google Scholar] [CrossRef] [PubMed]
- Dayer, L.; Heldenbrand, S.; Anderson, P.; Gubbins, P.O.; Martin, B.C. Smartphone medication adherence apps: Potential benefits to patients and providers. J. Am. Pharm. Assoc. 2013, 53, 172–181. [Google Scholar] [CrossRef] [PubMed]
- Feldman-Stewart, D.; Brundage, M.D.; McConell, B.A. Practical issues in assisting shared decision-making. Health Expect 2000, 3, 46–54. [Google Scholar] [CrossRef] [PubMed]
- Mira, J.J.; Rodríguez-Marín, J. Análisis de las condiciones en las que los pacientes toman decisiones responsables. Med. Clín. 2001, 116, 104–110. [Google Scholar] [CrossRef]
- Dickinson, D.; Raynor, D.K. What information do patients need about drugs? Ask the patients: It may be more than you think. Br. Med. J. 2003, 327, 861. [Google Scholar] [CrossRef] [PubMed]
- Villar, J.; Tizán, L.; Soto, J.; Peiró, S. La satisfacción con el tratamiento. Aten. Primaria 2009, 41, 637–645. [Google Scholar] [CrossRef] [PubMed]
- Entwistle, V.A.; Watts, I.S. Disseminating information about health care effectiveness: A survey of consumer health information services. Q. Health Care 1998, 7, 124–129. [Google Scholar] [CrossRef]
- Kenny, T.; Wilson, R.G.; Purves, I.N.; Clark, J.; Newton, L.D.; Moseley, D.V. A PIL for every ill? Patient information leaflets (PILs): A review of past, present and future use. Fam. Pract. 1998, 15, 471–479. [Google Scholar] [CrossRef] [PubMed]
- Moult, B.; Franck, L.; Brady, H. EQI: Development and preliminary validation of a new instrument to improve the quality of written health care information. Health Expect 2004, 7, 165–175. [Google Scholar] [CrossRef] [PubMed]
- Grime, J.; Blenkinsopp, A.; Raynor, D.K.; Pollock, K.; Knapp, P. The role and value of written information for patients about individual medicines: A systematic review. Health Expect 2007, 10, 286–298. [Google Scholar] [CrossRef] [PubMed]
- Hirsh, D.; Clerehan, R.; Staples, M.; Osborne, R.; Buchbinder, R. Patient assessment of medication information leaflets and validation of the evaluative linguistic framework (ELF). Patient Educ. Couns. 2009, 77, 248–254. [Google Scholar] [CrossRef] [PubMed]
- Raynor, D.K.; Blenkinsopp, A.; Knapp, P.; Grime, J.; Nicolson, D.J.; Pollock, K.; Dorer, G.; Gilbody, S.; Dickinson, D.; Maule, A.J.; et al. A systematic review of quantitative research on the role and effectiveness of written information available to patients about individual medicines. Health Technol. Assess. 2007, 11, 1–160. [Google Scholar] [CrossRef]
- Chubaty, A.; SadowskiCh, C.A. Typeface legibility of patient information leaflets intended for community-dwelling seniors. Age Ageing 2009, 38, 441–447. [Google Scholar] [CrossRef] [PubMed]
- Nicolson, D.; Knapp, P.; Raynor, D.K.; Spoor, P. Written information about individual medicines for consumers. Cochrane Databases Syst. Rev. 2009, 2, CD002104. [Google Scholar] [CrossRef] [PubMed]
- Mira, J.J.; Lorenzo, S.; Pérez-Jover, V.; Navarro, I.; Martín de Rosales, A.; Lara, C. Assessment of the quality of medication information for patients in Spain. Expert Opin. Drug Saf. 2013, 12, 9–18. [Google Scholar] [CrossRef] [PubMed]
- Mira, J.J.; Navarro, I.M.; Nuño, R. Patient Safety in Blogs and Wikis Entries by Patients and For Patients. J. Health Med. Inf. 2014, 5, 172. [Google Scholar]
- Charnock, D.; Shepperd, S.; Needham, G.; Gann, R. DISCERN: An instrument for judging the quality of written consumer health information on treatment choices. J. Epidemiol. Commun. Health 1999, 53, 105–111. [Google Scholar] [CrossRef]
- Svarstad, B.L.; Mount, J.K.; Tabak, E.R. Expert and consumer evaluation of patient medication leaflets provided in US pharmacies. J. Am. Pharm. Assoc. 2003, 45, 443–451. [Google Scholar] [CrossRef]
- Kirksey, O.; Harper, K.; Thompson, S.; Pringle, M. Assessment of selected patient educational materials of various chain pharmacies. J. Health Commun. 2004, 9, 91–93. [Google Scholar] [CrossRef] [PubMed]
- Ballesteros-Peña, S.; Fernández-Aedo, I. Análisis de la legibilidad lingüística de los prospectos de los medicamentos mediante el índice de Flesch-Szigriszt y la escala Inflesz. An. Sist. Sanit. Navar. 2013, 36, 397–406. [Google Scholar] [CrossRef] [PubMed]
- Basara, L.R.; Juergens, J.P. Patient package insert readability and design. Am. Pharm. 1994, 34, 48–53. [Google Scholar] [CrossRef]
- Lewis, M.A.; Newton, J.T. An evaluation of the quality of commercially produced patient information leaflets. Br. Dent. J. 2006, 201, 114–117. [Google Scholar] [CrossRef] [PubMed]
- Barrio-Cantalejo, I.M.; Simón-Lorda, P. ¿Pueden leer los pacientes lo que pretendemos que lean? Un análisis de la legibilidad de materiales escritos de educación para la salud. Aten. Primaria 2003, 31, 409–414. [Google Scholar] [CrossRef]
- March, J.C.; Prieto, M.A.; Ruiz, A.; Simón, P.; Barrio, I.; Danet, A. Mejora de la información sanitaria contenida en prospectos de los medicamentos: Expectativas de pacientes y de profesionales sanitarios. Aten. Primaria 2010, 42, 22–27. [Google Scholar] [CrossRef] [PubMed]
- Mira, J.J.; Carrillo, I.; Navarro, I.M.; Orozco, D.; Gil, V.; Guilabert, M. Efectos de la edad y de la formación académica en la comprensión de la información escrita que entregamos habitualmente a nuestros pacientes. Aten. Primaria 2015, 47, 126–127. [Google Scholar] [CrossRef] [PubMed]
- Mira, J.J.; Rodríguez-Marín, J.; Peset, R.; Ybarra, J.; Pérez-Jover, V.; Palazón, I.; Llorca, E. Causas de satisfacción y de insatisfacción de los pacientes en hospitales y atención primaria. Rev. Calid. Asist. 2002, 17, 273–283. [Google Scholar] [CrossRef]
- Davison, J.; Degner, L.; Morgan, T. Information and decision-making preferences of men with prostate cancer. Oncol. Nurs. Forum 1995, 22, 1401–1408. [Google Scholar] [PubMed]
- Sculper, M.J.; Dwyer, N.; Browing, J.; Horsley, S.; Cullimore, J. A survey of women’s preferences regarding alternative surgical treatments for menorrhagia. Health Expect. 1998, 1, 96–105. [Google Scholar] [CrossRef]
- Ashbury, F.; Findlay, H.; Reynolds, B.; McKerracher, K. A Canadian survey of cancer patients’ experiences: Are their needs being met? J. Pain Symptom Manag. 1998, 16, 298–306. [Google Scholar] [CrossRef]
- Mira, J.J.; Guilabert, M.; Pérez-Jover, V.; Lorenzo, S. Barriers for an effective communication around clinical decision making: An analysis of the gaps between doctors’ and patients’ point of view. Health Expect. 2014, 17, 826–839. [Google Scholar] [CrossRef] [PubMed]
- Barca, I.; Parejo, R.; Gutiérrez, P.; Fernández, F.; Alejandre, G.; López, F. La información al paciente y su participación en la toma de decisiones clínicas. Aten. Primaria 2004, 3, 361–367. [Google Scholar] [CrossRef]
- Mira, J.J.; Nebot, C.; Lorenzo, S.; Pérez-Jover, V. Patient report on information given, consultation time and safety in primary care. Q. Saf. Health Care 2010, 19, 1–4. [Google Scholar] [CrossRef] [PubMed]
Main Topic (n) | Country (n) | Evidence Levels * (n) |
---|---|---|
Adverse Drugs Events (7) | Canada (1) | |
Italy (1) | 2++ B (2) | |
United Kingdom (1) | 2+ C (4) | |
USA (2) | ||
Spain (2) | ||
Medication Adherence and Misuse (12) | Austria (1) | 2++ B (2) |
Canada (1) | 2+ B (1) | |
Germany (1) | 2+ C (6) | |
Spain (4) | 2− C (1) | |
The Netherlands (1) | 4 D (2) | |
USA (4) | ||
Medication Errors (13) | Austria (1) | 2++ B (3) |
Ireland (1) | 2+ B (1) | |
Israel (1) | 2+ C (6) | |
United Kingdom (1) | 2− C (2) | |
USA (2) | 3 D (1) | |
Spain (6) | ||
Sweden (1) | ||
Medication Management (12) | Australia (2) | 1− B (1) |
USA (3) | 2+ B (1) | |
Spain (6) | 2+ C (6) | |
Tokyo (1) | 2− C (2) | |
4 D (2) | ||
Medication Safety Information (20) | Australia (1) | 4 D (6) |
Canada (2) | 2++ B (2) | |
United Kingdom (7) | 2+ B (2) | |
USA (5) | 2+ C (5) | |
Spain (5) | 2− C (5) | |
Medication Safety Tools (9) | Norway (1) | 2++ B (1) |
USA (3) | 2+ C (3) | |
Spain (2) | 2− C (2) | |
Taiwan (2) | 3 D (2) | |
United Kingdom (1) | 4 D (1) | |
Patient Medication Knowledge (7) | Hong Kong (1) | |
Spain (2) | 2++ B (2) | |
Turkey (1) | 2+ C (3) | |
United Kingdom (1) | 2− C (2) | |
USA (2) |
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Pérez-Jover, V.; Mira, J.J.; Carratala-Munuera, C.; Gil-Guillen, V.F.; Basora, J.; López-Pineda, A.; Orozco-Beltrán, D. Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases. Int. J. Environ. Res. Public Health 2018, 15, 310. https://doi.org/10.3390/ijerph15020310
Pérez-Jover V, Mira JJ, Carratala-Munuera C, Gil-Guillen VF, Basora J, López-Pineda A, Orozco-Beltrán D. Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases. International Journal of Environmental Research and Public Health. 2018; 15(2):310. https://doi.org/10.3390/ijerph15020310
Chicago/Turabian StylePérez-Jover, Virtudes, José J. Mira, Concepción Carratala-Munuera, Vicente F. Gil-Guillen, Josep Basora, Adriana López-Pineda, and Domingo Orozco-Beltrán. 2018. "Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases" International Journal of Environmental Research and Public Health 15, no. 2: 310. https://doi.org/10.3390/ijerph15020310
APA StylePérez-Jover, V., Mira, J. J., Carratala-Munuera, C., Gil-Guillen, V. F., Basora, J., López-Pineda, A., & Orozco-Beltrán, D. (2018). Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases. International Journal of Environmental Research and Public Health, 15(2), 310. https://doi.org/10.3390/ijerph15020310