Abstract:
Currently, a large portion of the world's population uses medication on a regular
basis and uses health services frequently, mainly due to the increase of
longevity and the growing number of chronic diseases (CD).
Consequently, a correct medication management is needed in order to improve
the responsible use of medicines and health outcomes. Portugal shows a high
prevalence of CD such as hypertension, obesity, dyslipidaemia and diabetes.
Moreover, the Algarve region presents some shortcomings in accessibility to
healthcare.
Therefore, this research project arises with the main aim of establishing a
methodology to analyse the outcomes of the process of medication use (MU)
through medication review (MR) , in a clinical practice setting in Southern
Portugal (AEDMADA clinic), applied in the ReMeD study. Patient´s data was
collected individually and then systematically analysed considering the
humanistic, economic and clinical outcomes.
A questionnaire (SAHL-S&E) was previously adapted for the Portuguese
language aimimg to identify subjects with low health literacy (HL), which was
then used during the MR.
The ReMeD study was conducted in 118 patients, mainly 65 years,
hypertense, diabetic, dyslipidemic and presenting a very high cardiovascular
risk.
Humanistic outcomes showed 25.4% of patients having low medication
knowledge, 43.2% with low HL and about 25% being non-adherent to
medication.
Economic outcomes revealed that most patients were polymedicated (73.8%)
and monitored by 2-3 Physicians, and about 15% suffering hospitalization in the
last year.
Negative clinical outcomes (NCO) were identified in 99.2% of patients, and
74.6% presented risks of developing NCO.
As a whole, the ReMeD methodology seems appropriate to identify situations
from the process of MU, useful to outline new strategies aimed to improve
patient's MU and the empowerment for disease management. Applying this
novel approach enables the conduction of MR in a clinical setting, allowing to
pinpoint modifiable situations, contributing to improve health outcomes.
