The Burden of Medicines

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (31 January 2019) | Viewed by 21761

Special Issue Editor


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Guest Editor
School of Pharmacy, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
Interests: social and administrative pharmacy; health outcome research; patient-reported outcomes

Special Issue Information

Dear Colleagues,

This Special Issue focuses on the burden of medicines on patients’ lives and the role of pharmacists in helping to reduce that burden.

Drug therapy remains to be the most used intervention to prevent illness, reduce symptoms, and treat disease. Unfortunately, medicines are associated with numerous adverse effects that impact on the quality of life and wellbeing of patients. Non-pharmacological approaches to control disease are preferred over drug treatment, but unfortunately these are sometimes insufficient on their own. Patients on multiple drug therapy (polypharmacy) and those with comorbidities are at high risk of drug-related problems. However, pharmacists could help in reducing the burden of drug therapy through the application of pharmaceutical care (PC). With its patient-centred philosophy of practice, the full application of PC should help patients make the best out of their medicines. Given that patients’ perspectives on issues related to the use of medicines are different from those of health care providers, more attention is now drawn toward assessing the burden of drug therapy from the perspective of the patient. That would provide practitioners with information on what health domains are impacted the most, and what intervention should be made to reduce the negative impact of drug therapy.

We invite you to present your research, reviews, or opinions in relation to the burden of medicines and the role of pharmacy and pharmacists in reducing that burden. If you conducted research focusing on PC, health outcomes, patient-reported outcomes, or any related areas, please consider sharing it with readers through this Special Issue of Pharmacy. We wish to increase awareness about the burden of medicines, strategies to assess that burden, and the role of pharmacists in that effort.

Prof. Dr. Nadir Kheir
Guest Editor

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Keywords

  • medicines
  • medications
  • burden
  • patient-reported outcomes
  • quality of life

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Published Papers (4 papers)

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Research

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9 pages, 196 KiB  
Article
Complexity of Medicine Regimens and Patient Perception of Medicine Burden
by Janet Krska, Sarah A. Corlett and Barbra Katusiime
Pharmacy 2019, 7(1), 18; https://doi.org/10.3390/pharmacy7010018 - 2 Feb 2019
Cited by 20 | Viewed by 3912
Abstract
From the patient perspective, medicine burden is more than the number of medicines, or the complexity of medicine regimens they need to manage. Relationships between the number of medicines, regimen complexity and patient perception of medicine burden are under-researched. This cross-sectional study measured [...] Read more.
From the patient perspective, medicine burden is more than the number of medicines, or the complexity of medicine regimens they need to manage. Relationships between the number of medicines, regimen complexity and patient perception of medicine burden are under-researched. This cross-sectional study measured regimen complexity and determined how this and patient perceived burden are affected by the therapeutic group. Regimen complexity was measured in patients presenting prescriptions to six community pharmacies in South-East England. A sub-sample (166) also completed the Living with Medicines Questionnaire which measures patient perceived burden. The 492 patients were prescribed 2700 medicines (range 1 to 23). Almost half used at least one non-oral formulation. Complexity was correlated strongly with the number of medicines (r = 0.94), number of therapeutic groups (r = 0.84) and number of formulations (r = 0.73). Patients using medicines for skin, eye and respiratory conditions had the highest complexity scores. Increasing the number of medicines, frequency of dosing, number of non-oral formulations and number of different therapeutic groups all increased medicine burden. Although cardiovascular medicines were the most common medicines used by the majority of patients (60%), those for neurological, psychiatric and gastro-intestinal conditions were most strongly associated with high burden. Studies are required to determine medicine burden in different conditions, especially neurological conditions, including chronic pain. Full article
(This article belongs to the Special Issue The Burden of Medicines)
13 pages, 238 KiB  
Article
Polypharmacy and Psychological Distress May Be Associated in African American Adults
by Shervin Assari and Mohsen Bazargan
Pharmacy 2019, 7(1), 14; https://doi.org/10.3390/pharmacy7010014 - 24 Jan 2019
Cited by 15 | Viewed by 4269
Abstract
Background: Compared to Whites, African Americans are at a higher risk of multiple chronic conditions, which places them at a higher risk of polypharmacy. Few national studies, however, have tested whether polypharmacy is associated with psychological distress—the net of socioeconomic status, health status, [...] Read more.
Background: Compared to Whites, African Americans are at a higher risk of multiple chronic conditions, which places them at a higher risk of polypharmacy. Few national studies, however, have tested whether polypharmacy is associated with psychological distress—the net of socioeconomic status, health status, and stress—in African Americans. Aims: In a national sample of African Americans in the US, this study investigated the association between polypharmacy and psychological distress. Methods: The National Survey of American Life (NSAL, 2003) included 3570 African American adults who were 18 years or over. This number was composed of 2299 women and 1271 men. Polypharmacy (using ≥ 5 medications) and hyper-polypharmacy (using ≥ 10 medications) were the independent variables. Psychological distress was the dependent variable. Age, gender, socioeconomic status (education attainment, income, employment, and marital status), health care access (insurance status and usual place of care), and health status (multimorbidity and psychiatric disorders) were the covariates. Linear multivariable regression was applied to perform the data analysis. Results: Both polypharmacy and hyper-polypharmacy were associated with psychological distress. This association was significant after controlling for all the covariates. Conclusions: African Americans with polypharmacy, particularly those with hyper-polypharmacy, are experiencing higher levels of psychological distress, which itself is a known risk factor for poor adherence to medications. There is a need for a comprehensive evaluation of medications as well as screening for psychopathology in African Americans with multiple medical conditions. Full article
(This article belongs to the Special Issue The Burden of Medicines)
10 pages, 238 KiB  
Article
Medication-Related Burden among Patients with Chronic Disease Conditions: Perspectives of Patients Attending Non-Communicable Disease Clinics in a Primary Healthcare Setting in Qatar
by Amani Zidan, Ahmed Awaisu, Maguy Saffouh El-Hajj, Samya Ahmad Al-Abdulla, Dianne Candy Rose Figueroa and Nadir Kheir
Pharmacy 2018, 6(3), 85; https://doi.org/10.3390/pharmacy6030085 - 13 Aug 2018
Cited by 27 | Viewed by 5583
Abstract
This study aimed to assess perceived medication-related burden among patients with multiple non-communicable diseases (NCDs) and to investigate the association between perceived burden and adherence to medication therapy. Using a cross-sectional study in three primary care clinics in Qatar, medication-related burden was measured [...] Read more.
This study aimed to assess perceived medication-related burden among patients with multiple non-communicable diseases (NCDs) and to investigate the association between perceived burden and adherence to medication therapy. Using a cross-sectional study in three primary care clinics in Qatar, medication-related burden was measured using the Living with Medicines Questionnaire (LMQ) among adults with diabetes, with or without other comorbidities. Adherence was measured using the Adherence to Refills and Medications Scale (ARMS). Two hundred and ninety-three eligible patients participated in the study. The majority of them reported experiencing minimal (66.8%) to moderate (24.1%) medication-related burden. There was a significant positive correlation between the scores of the LMQ (medication-related burden) and ARMS (medication adherence), rs (253) = 0.317, p < 0.0005. Full article
(This article belongs to the Special Issue The Burden of Medicines)

Review

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14 pages, 365 KiB  
Review
Current and Potential Roles in Sports Pharmacy: A Systematic Review
by Alison D. Hooper, Joyce M. Cooper, Jennifer Schneider and Therése Kairuz
Pharmacy 2019, 7(1), 29; https://doi.org/10.3390/pharmacy7010029 - 14 Mar 2019
Cited by 20 | Viewed by 7324
Abstract
(1) Background: The objective of this systematic review was to evaluate current and potential roles for pharmacists in sports medicine and to identify key themes in outcomes reported in studies. (2) Methods: EMBASE, MEDLINE, CINAHL, Scopus and the Cochrane Library were [...] Read more.
(1) Background: The objective of this systematic review was to evaluate current and potential roles for pharmacists in sports medicine and to identify key themes in outcomes reported in studies. (2) Methods: EMBASE, MEDLINE, CINAHL, Scopus and the Cochrane Library were searched in January 2019. Peer-reviewed, original research articles were considered for inclusion. Articles published in a language other than English were excluded. Quality appraisal was performed independently by two authors. (3) Results: Findings of 11 eligible articles (10 observational and 1 experimental study design) were grouped into three themes: (i) doping prevention and control, (ii) injury management and first aid, and (iii) educational and curricular needs. Pharmacists were perceived as a good potential source of information about doping and are enthusiastic about counseling athletes, but lack knowledge and confidence in this area. While pharmacists were frequently consulted for advice on managing sprains and strains, their advice was not always guided by current evidence. Pharmacists and pharmacy students recalled limited opportunity for education in sports pharmacy. (4) Conclusion: Pharmacists showed a willingness and an aptitude to counsel athletes. However, lack of knowledge and confidence, and limited educational opportunities, were key barriers. More research is necessary to support pharmacists in this role. Full article
(This article belongs to the Special Issue The Burden of Medicines)
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