Medication review: Patient selection and general practitioner's report of drug-related problems and actions taken in elderly Australians

Objectives: To investigate which patients general practitioners (GPs) selected for medication review based on risk factors for medication problems and patient demographics; to describe drug-related problems and actions taken to solve those problems during medication review consultations based on GPs' self-report. Design: Cross-sectional. Setting: General practices. Participants: Four hundred fifty-two patients recruited from 11 GPs. Measurements: Patients' self-reported risk factors for medication misadventures collected from Medication Risk Assessment Forms; doctors' report of patients' drug-related problems and actions taken to solve those problems collected from Medication Review Checklists. Patients completed a Medication Risk Assessment Form in the waiting room, which they presented to their doctor, who then decided whether the patient needed a medication review. GPs completed a Medication Review Checklist. Results: GPs completed 124 Medication Review Checklists. The group that had a medication review had a lower proportion of individuals aged 65 to 74 than the group that did not (40% vs 56%). The proportion of people with risk factors for medication misadventure was consistently higher for patients who received a medication review. GPs found that 88% (95% confidence interval (CI) =66-97) of patients who had a medication review had at least one problem with use of their medication. GPs reported taking at least one action for 104 (88%) patients (95% CI=65-97) to rectify medication problems. Most common actions taken were monitoring (55%), improving compliance (50%), dose change (37%), cessation of drug (28%), and ordering of a pathology test (26%). Conclusion: A Medication Risk Assessment Form completed by patients can be used to select patients for medication review, and medication reviews conducted by GPs can be beneficial in improving the use of medication in older people living in the community.