Huisman, Francien (2012) PROBLEMEN MET PREVENTIEVE MEDICATIE BIJ HOOGBEJAARDE PATIËNTEN MET MULTIMORBIDITEIT: Een vragenlijstonderzoek bij eerstelijns zorgverleners. thesis, Medicine.
Full text available on request.Abstract
Introduction: The effects of preventive medication in elderly are not well known. Qualitative research indicates that healthcare providers experience problems in managing preventive medication in the very elderly with multimorbidity. To this date no questionnaire is developed to quantify these results. Aim and research question: We want to determine the attitudes and policies of primary healthcare providers about discontinuation of preventive medication in geriatric patients with multimorbidity. The aim of this research is to develop a questionnaire and to obtain first insights into the views of primary healthcare providers. Methods: Based on qualitative research and literature a questionnaire was developed and presented to GPs and practice nurses. In three rounds, a list of 40 questions was developed and validated, including questions on the balance between treatment goals, goals of care, time until benefit, life expectancy and the use of clinical guidelines. Results: A total of 25 GPs and 12 practice nurses responded. Many healthcare providers experience problems with preventive medication in the very elderly patients with multimorbidity. Many GPs consider the NHG-standards not applicable for these patients. In adjusting the guidelines to these patients three groups of caregivers seem to exist: those who find the considerations from a patient perspective most important, those who find the medical-biological considerations most important and a minority who weighs the considerations from a patient perspective and medical-biological considerations equally. On many points the caregivers agree, but there are also differences. Practice nurses take the increased risk of side effects less into account, but are more involved in shared decision making than GP’s and feel less incompetent in this field. Discussion and conclusions: With some adjustments, the developed questionnaire is a good and valid measuring instrument. Although these are preliminary results of a small study, we found clear patterns in points of view. Healthcare providers require tools to handle medication problems in elderly patients. More scientific evidence about the actual effects of treatments in the very elderly with multimorbidity and an improvement in communication skills will enhance safe, effective and individualized prescribing of medication.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleider: and Haaijer-Ruskamp, Prof. Dr. F.M. and Afdeling Klinische Farmacologie, UMCG. Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:04 |
| Last Modified: | 25 Jun 2020 11:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2390 |
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