Patient beliefs about medicines and quality of life after a clinical medication review and follow-up by a pharmaceutical care plan: a study in elderly polypharmacy patients with a cardiovascular disorder

Abstract

Abstract Objective To determine the effect of a clinical medication review, followed up by a pharmaceutical care plan, on the beliefs about medicines and quality of life (QoL) of older patients with polypharmacy and a cardiovascular disorder. Methods Patients were randomly assigned to an intervention or control group. Intervention patients received a clinical medication review with a follow-up that developed a pharmaceutical care plan. Control group patients received care as usual. All patients received two standardised questionnaires: the general part of the Beliefs about Medicines Questionnaire (BMQ) and the EuroQoL EQ-5D questionnaire, at the start of the study (t = 0) and after 1-year follow-up (t = 1). Answers on both questionnaires were linked to patient data. Key findings 512 patients were included from eight primary care settings. Analysis of the BMQ-General questionnaire showed that after 1-year intervention patients were more positive about medicines use, while control patients were more neutral or even more negative compared with baseline. For the first part, general harm, this result is statistically significant for the intervention group (P = 0.014). The EQ-5D questionnaire showed no significant results in QoL. Increasing the number of episodes documented had a significant effect and resulted in more negative patient beliefs about medicines. Advanced age, female gender, increasing number of episodes documented and medicines dispensed resulted in a lower QoL. Conclusion A medication review followed by a pharmaceutical care plan resulted in a significant positive effect on patient beliefs about medicines, but had no significant effect on QoL in elderly patients suffering from cardiovascular diseases. Female patients using multiple medicines, who visit their general practitioner regularly, might benefit most.