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

Patient safety, rights and medication safety in primary care in Poland
Fig. 5.6 shows a link between the degree of specialization and how much attention
the doctor paid to the risk of drug interactions. Looking at this from the viewpoint of
doctors’ qualifications, those with no specialty degree indicated the risk of interaction as
the major contributing factor when prescribing medicines; the highest (second-degree)
category of specialists claimed to pay most attention to patient age.
Fig . 5 .6 . Relationship between specialization and importance of risk factors
Second-degree specialist
(highest level)
First-degree specialist
Physician
No specialty
%
0 20 40 60 80 100
Patient age
Risk of interaction
Risk of adverse events
Comorbidities that might affect medicine outcomes
The majority of doctors (62%) stated that they do not ask patients about OTC drugs
and diet supplements, which makes comprehensive risk assessment of drug interactions
difficult. However, almost all doctors confirmed that they ask their patients about the
names of the medicines they take – this prevents polypharmacy and drug interactions in
polypharmacotherapy. The few negative responses to this line of questioning (6%) came
from the doctors with no specialist degree.
When asked if they have treated patients for ADRs, 90% confirmed that they had seen
patients experiencing ADRs due to OTC preparation use. This indicates the need for
patient education on the boundaries of safe self-medication. Only doctors with the first
or second degree of specialization claimed to have treated patients with ADRs resulting
from supplements or herbal remedies.
Although 76% “sometimes” asked patients about their medications to establish the
possibility of ADRs before prescribing a new medication, only 10% indicated that
they had never asked. Only the second-degree specialists inquired about ADRs when
prescribing a treatment, but all doctors regardless of specialty level (with one exception)
claimed that they reflected on potential drug interactions when prescribing.
When asked about the number of simultaneously taken medicines, 40% claimed that a
5−7 drug combination presented a demonstrated statistical risk for clinically expressed
interactions. Thirty-two per cent, mostly those in the highly specialized category,
indicated that certainty of drug interactions reaches 100% when more than 8 medications
are taken simultaneously, which has also been scientifically proven (7) (Fig. 5.7).
85