Loer, R. (Rowenna) (2019) Polyfarmacie onder depressieve ouderen en mogelijke interventies om dit te reduceren : Implementatie in de huisartspraktijk en apotheek. thesis, Medicine.
Full text available on request.Abstract
Introduction - Depression is a common problem among older patients (: 65 years and older). Recent studies show that depression is often associated with multimorbidity and polypharmacy. This has negative consequences, such as a decrease in the quality of life, an increase in the number of unplanned hospital admissions and, as a consequence, higher healthcare costs. It is important to gain insights into the views of general practitioners regarding this problem and to develop interventions that are applicable and effective in practice to reduce polypharmacy. Aim - To clarify the opinions of general practitioners regarding the applicability and effectiveness of the current interventions to reduce polypharmacy. Second to give insight in possible adjustments of current interventions and new interventions to reduce polypharmacy. Methods - A qualitative study using semi-structured focus groups with general practitioners, general practitioner vocational trainees and pharmacists was conducted. Each focus group discussion was transcribed verbatim, after which two researchers independently analysed and coded the data. Potential discrepancies were discussed until consensus was reached. Thematic analysis was conducted; i.e., data collection and analysis took place simultaneously in an iterative and cyclic process. Results - The participants considered deepening the doctor-patient dialogue important to reduce polypharmacy, a drawback is that this intervention is time-consuming. General practitioners are open to the use of screening tools that are in line with current methods and their medication prescription systems. Unfamiliarity, lack of time and extensiveness of the current screening tools are important causes that general practitioners do not use these in practice. Medication reviews are considered effective by the participants to reduce polypharmacy. In practice, one should be critical when selecting patients, planning sufficient time for the review and paying attention to the design of the review to ensure effectiveness. The participants formulated four new interventions to reduce polypharmacy, which mainly focus on the prescription behaviour and medication control by the general practitioner and the creation of time for the general practitioner by outsourcing tasks. Conclusion - The current interventions to reduce polypharmacy are considered effective by the participants in this study, however in daily practice these interventions do not appear to be fully applicable. Time is mentioned as the most important limiting factor. Within health care there is a major challenge in how to deal with this time pressure and ensure the quality of care at the same time. Interventions to reduce polypharmacy should be designed as efficiently as possible to increase applicability in practice.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleiders: and Verhaak, Prof. dr. P.F.M. and Holvast, Drs. F. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:52 |
| Last Modified: | 25 Jun 2020 10:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1274 |
Actions (login required)
 |
View Item |