Exploring patient participation in reducing health-care-related safety risks

Exploring patient participation in reducing health-care-related safety risks
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Results of the “doctor” pilot
Most of the 50 doctors 26 participating in this study (62%) had the highest level of
specialization, and 22% had no specialty degree (general physician). Sixty-six per cent
were females and the average age of respondents was 49 years.
All doctors (with the exception of one) indicated that they expected patients to provide
detailed information about medications they were currently taking at the first visit.
Eighty-two per cent expected the patient to present a list of medicines taken, with
names and dosages. Although most doctors expected this, it is clear from patients’
informal comments that doctors seldom asked them to prepare such lists and, in most
cases, the lists were created on the patients’ own initiative, reflecting the level of their
health literacy. Such a discrepancy between the assessments of patient and doctor might
reflect the perceived dimension of the doctor–patient dialogue in terms of medications,
in which the doctor is likely to rely mainly on information in the patient’s file while the
patient expects a different level of involvement.
The doctors were asked to list the most important factors to be considered in drug
prescribing. It is worth noting that epidemiological data identify the possibility of
avoiding approximately 30–40% of ADRs (7) if doctors acknowledge risk factors before
prescribing. Results are presented in Fig. 5.5. The risk of interactions between medicines
and dietary supplements taken simultaneously was listed as the most likely risk
occurrence (44%). This is significant, as the background research shows that interactions
between recently taken medications are the major contributing factors to ADRs.
Existing comorbidities that can change the performance of the drugs taken already
(26%) were indicated as next most likely.
Fig . 5 .5 . Most important risk factors regarding drug prescribing, according to doctors
28%
16%
14%
Patient age (8)
Risk of interaction (22)
Risk of adverse
events (7)
Comorbidities that
might affect medicine
outcomes (13)
Number of responses: 49
Only 16% indicated patient age as an important agent, despite it being generally
understood that the process of ageing considerably affects pharmacokinetics of
medicines and increases the risk of ADRs: 14% of respondents recognized the
increasing risk of ADR in the elderly patient population.
26 It is important to note that in Poland, medical doctors practising in PHC are GPs or paediatricians who have specialized in
family medicine.
44%