Medication discrepancy: a concordance problem between dialysis patients and caregivers.
OBJECTIVE
Extensive drug utilization, and non-concordance between the patient and the caregiver about prescriptions and actual medicine intake, are associated with the risk of non-adherence to medication as well as medication-related illness. To achieve reliable estimates of drug use, it is important to consider the patient's self-reported drug utilization as well as to consult his/her medical record. The present multicentre study was conducted with the aim of examining the self-reported drug consumption of dialysis patients and its congruence with medical records.


METHODS
Consumption of pharmaceutical agents was recorded by 204 patients undergoing haemo- or peritoneal dialysis at 10 Swedish clinics. Drug record discrepancies were identified by comparing the self-reported use of prescribed medicines with the subsequently obtained medication lists.


RESULTS
The median drug intake was 11 prescribed medicines and by including on-demand drugs this increased to 12. Discrepancies between the self-reported use of prescribed drugs and the medical record were prevalent in 80.4% of cases, with a median of three discrepancies per patient.


CONCLUSIONS
Dialysis patients have an extensive need for medication but there is an undesirable deviation between consumption and prescription. A single medication list, accessible for the patient and for all prescribers, is a possible solution to achieve concordance but other measures, such as analysis of the reasons for discrepancy and tailored measures, would also benefit concordant medicine-taking.
Lindberg
Magnus
M
Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden. magnus.lindberg@lg.se
Lindberg
Per
P
Wikström
Björn
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000628:therapy; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D054539:Medication Therapy Management / Q000592:standards*; D008875:Middle Aged; D010346:Patient Care Management / Q000592:standards*; D010349:Patient Compliance; D006435:Renal Dialysis; D015203:Reproducibility of Results; D012646:Self Administration