Factors affecting the likelihood of documented medication concerns in patients with multimorbidity: a cross-sectional study in primary care.

BACKGROUND

Patients scored as 'high-risk' and with chronic conditions in primary care (PC) often face medication-related problems. A significant but underexplored problem is the patient's medication concern, which may also impact treatment decisions and outcomes.

AIM: This study aimed to describe the characteristics of patients scored as high-risk with chronic conditions in Madrid, Spain who have documented medication concern and to analyse the associated factors.

DESIGN &

SETTING

Descriptive cross-sectional study, conducted within the Innovative Medicines Initiative Horizon 2020 (IMI-H2020) European BEAMER project, including all patients scored as high-risk with chronic conditions in the Madrid region.

METHOD: Patients were identified by the Adjusted Morbidity Groups (AMG) stratification tool in PC electronic clinical records. Variables included sociodemographic, clinical, and pharmacological, along with self-reported medication concerns. Univariate and bivariate analyses and logistic regression models were performed with medication concerns as the dependent variable.

RESULTS

In all, 40 776 (28.56%) reported medication concern. Patients with medication concern were older (84.6 versus 72.7 years), had more chronic conditions (7 versus 6), and medications (9.7 versus 8.7). They were more likely to live alone (8.5% versus 2.7%) and showed higher dependency. The following were associated with medication concern: older age odds ratio (OR) 11.0 (95% confidence interval (CI) = 5.4 to 22.3; P<0.001), polypharmacy OR 3.2 (95% CI = 3.1 to 3.3; P<0.001), living alone OR 1.5 (95% CI = 1.4 to 1.6; P<0.001), Parkinson's OR 1.3 (95% CI = 1.2 to 1.4; P<0.001); chronic pain OR 1.6 (95% CI = 1.2 to 2.1; P = 0.001), and cardiovascular risk factors OR 1.2 (95% CI = 1.1 to 1.3; P = 0.001).

CONCLUSION

Age, polypharmacy, multimorbidity, and social isolation are predictors of medication concern in patients scored as high-risk with chronic conditions in PC. Addressing psychological barriers, simplifying treatment, and strengthening social support through tailored interventions could decrease medication concerns.