Browsing by Subject "lääkityksen ajantasaistus"

Poor adherence to and non-compliant use of medications are common in long-term patients, and it is estimated that only half of medication use worldwide is appropriate. Poor adherence to medication undermines public health, reduces the cost-benefit of resources invested in medication care, and burdens health care. Various interventions have sought to improve adherence to drug treatment, but they have not brought about the desired change in medication adherence. The aim of this master's thesis was to develop a method and pilot it to investigate the reasons for the non-compliant use of medications in the context of the medication reconciliation process. The aim of this new method was to find out the reason for non-compliant use of a medicine in a patient-centered way, and the possibility for the pharmacist to motivate the patient to use the medicine according to the instructions. In addition, it was examined whether the method can measure prevalence of non-compliant use of medicines differs according to the ATC classification of medicines and whether the total number of medicines contributes to the non-compliant use of medicines. The pilot study was carried out as part of a standard pharmacist's medication reconciliation process at Vantaa primary health care. The data required for the study were collected on the electronic HUSeCRF platform. Patients were collected to the extent that we were able to verify the functionality of the method and to plan the reporting of the results of the actual study with larger research data. The data were collected during the year of 2021. The theoretical framework of the study was the Medication-Related Burden model and the iceberg model of non-compliant use of medicines. The research material was analyzed using descriptive statistical analysis in IBM SPSS 27. The analysis of the data was done in terms of the functionality and development of the new method. A total of 8 patients participated in the pilot study (women 63% n = 5). Patients had an average of 16 medications per patient (range 8-22), and the last time their medications were reconciliated was on average 1 year ago. Non-compliant use of medicines was observed in 88% of patients (n = 7). In total, there were non-compliant use of medicines in the data for 21 drugs. The most common medicines which were used non-compliant were for the treatment of cardiovascular diseases. The total number of medicines and the number of non-compliant use correlated with each other (Pearson correlation coefficient 0.472), but the result was not statistically significant (p = 0.238). The most common reason for non-compliant use was a drug-induced side effect. After a motivational discussion which was involved in the medication reconciliation process with pharmacists, in 14 % of non-compliantly used medicines, patients decided to start taking the medication as directed. The pharmacist was able to motivate the patient to use the medicine as directed when the reason for non-compliant use of medicine was unclear instructions. In this study, a method was developed and validated to determine the reasons for non-compliant use of medicines. During medication reconciliation process, the pharmacist was able to find out the reasons for non-compliant use of medicines. Pharmacists may motivate the patient to use the drug as directed, however, most patients did not want to change the use of the medicine as directed. As the total number of medications increase, the probability of non-compliant use of medicines may increase.