The interaction of patient perception of overmedication with drug compliance and side effects.
OBJECTIVE
Little is known about the significance of patient-perceived overmedication. We sought to determine its prevalence and relation to medication compliance, adverse drug reactions, health-related quality of life (HRQOL), and burden of illness.


METHODS
Analysis of self-reported questionnaire data. PATIENTS/PARTICIPANT: There were 1,648 participants in a longitudinal study of male veterans.


METHODS
Participants listed each of their medications with indication, missed doses, adverse reactions, and whether their amount of medication was "too much, the right amount, or too little." The survey included questions about medication adherence, "problems with medications," common symptoms, and screening questions for a number of chronic conditions. We assessed HRQOL with the Multiple Outcomes Study 36-Item Short Form Health Study (SF-36).


RESULTS
Of the 1,256 respondents, 1,007 (80%) had taken medication within 4 weeks. Forty (4%) thought they were taking too much. They reported a 1.6-fold increase in prescription medications, a 5-8 fold increase in adverse effects, a 1.5-2 fold decrease in compliance, an increase in each of seven measured symptoms, and a decrease in six of eight SF-36 domains (p < .05 for all comparisons), the exceptions being the mental health and role-emotional scales. There was also a slight increase in the report of any chronic illness (95% vs 86%, p > .05).


CONCLUSIONS
Patient perception of overmedication correlates with self-report of decreased compliance, adverse drug reactions, decreased HRQOL, and an increase in symptomatology that is compatible with unrecognized side effects of medication. Such patients warrant careful evaluation.
Fincke
B G
BG
Boston University School of Medicine and Department of Medicine, Boston VA Medical Center, Mass 02130, USA.
Miller
D R
DR
Spiro
A
A
D000368:Aged; D000375:Aging; D001294:Attitude to Health; D017281:Cost of Illness; D064420:Drug-Related Side Effects and Adverse Reactions; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D004366:Nonprescription Drugs; D010349:Patient Compliance; D010361:Patients / Q000523:psychology*; D019338:Polypharmacy; D015995:Prevalence; D014728:Veterans
D004366:Nonprescription Drugs