title: [How much do patients and health professionals (really) know? The surplus value of a home visit to the patient with polypharmacy by the practice nurse, to support medication reviews in primary care].
abstract: BACKGROUND
  Polypharmacy in older people should be addressed by an annual review of the chronic medication. In the PIL-study this was done by an integrated approach by GP, practice nurse, pharmacist, specialist and patient. All patients were first visited at home by the practice nurse.
  
  
  OBJECTIVE
  What 'over the counter' (OTC) medications do polypharmacy patients use? Do they know the indications of the prescribed medication? Does medication use according to the patient match with medication use according to the records of GP and pharmacist?
  
  
  METHODS
  Inclusion criteria were: age 60 years or older, daily use of five or more chronic medications, mental competence, and adequate command of the Dutch language. All patients were visited at home by the practice nurse, who made an inventory of the actual drug use.
  
  
  RESULTS
  Five hundred fifty patients used a total of 5576 drugs, including 527 (9.4%) OTC medication. Patients knew the indication of 64% of the prescribed medication. The number of prescribed drugs that a patient actually used did not match the numbers known to GP and pharmacist. In 60.4% of all medication prescriptions there was complete agreement between GP, pharmacist and patient. On a patient level agreement was 18.7%.
  
  
  CONCLUSIONS
  Home visits by the nurse practitioner to make an inventory of the medication as reported by the patient seem to have an added value.
authors.affiliation: Huisarts-onderzoeker, Vakgroep huisartsgeneeskunde UM Maastricht, Maastricht, The Netherlands. donna.lenders@maastrichtuniversity.nl
authors.forename: D
authors.initials: D
authors.lastname: Bosch-Lenders
authors.forename: M
authors.initials: M
authors.lastname: van den Akker
authors.forename: H E J H
authors.initials: HE
authors.lastname: Stoffers
authors.forename: H
authors.initials: H
authors.lastname: van der Kuy
authors.forename: J M G A
authors.initials: JM
authors.lastname: Schols
authors.forename: J A
authors.initials: JA
authors.lastname: Knottnerus
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017723:Drug Utilization Review / Q000379:methods*; D005260:Female; D006699:Home Care Services / Q000592:standards*; D006792:House Calls; D006801:Humans; D057970:Inappropriate Prescribing / Q000009:adverse effects; D008297:Male; D008508:Medication Errors / Q000009:adverse effects; D009426:Netherlands; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D019338:Polypharmacy; D055553:Prescription Drugs / Q000009:adverse effects / Q000627:therapeutic use; D011320:Primary Health Care
chemical_list: D055553:Prescription Drugs