title: [Structured medication management in primary care - a tool to promote medication safety].
abstract: Patients with chronic disease usually need to take multiple medications. Drug-related interactions, adverse events, suboptimal adherence, and self-medication are components that can affect medication safety and lead to serious consequences for the patient. At present, regular medication reviews to check what medicines have been prescribed and what medicines are actually taken by the patient or the structured evaluation of drug-related problems rarely take place in Germany. The process of "medication reconciliation" or "medication review" as developed in the USA and the UK aim at increasing medication safety and therefore represent an instrument of quality assurance. Within the HeiCare(®) project a structured medication management was developed for general practice, with medical assistants playing a major role in the implementation of the process. Both the structured medication management and the tools developed for the medication check and medication counselling will be outlined in this article; also, findings on feasibility and acceptance in various projects and experiences from a total of 200 general practices (56 HeiCare(®), 29 HiCMan,115 PraCMan) will be described. The results were obtained from questionnaires and focus group discussions. The implementation of a structured medication management intervention into daily routine was seen as a challenge. Due to the high relevance of medication reconciliation for daily clinical practice, however, the checklists - once implemented successfully - have been applied even after the end of the project. They have led to the regular review and reconciliation of the physicians' documentation of the medicines prescribed (medication chart) with the medicines actually taken by the patient.
authors: Universitätsklinikum Heidelberg, Abteilung Allgemeinmedizin und Versorgungsforschung. Electronic address: cornelia.mahler@med.uni-heidelberg.de.
authors: Cornelia
authors: C
authors: Mahler
authors: Universitätsklinikum Heidelberg, Abteilung Allgemeinmedizin und Versorgungsforschung.
authors: Tobias
authors: T
authors: Freund
authors: Universitätsklinikum Heidelberg, Abteilung Allgemeinmedizin und Versorgungsforschung.
authors: Annika
authors: A
authors: Baldauf
authors: Universitätsklinikum Heidelberg, Medizinische Klinik, Abteilung Klinische Pharmakologie und Pharmakoepidemiologie.
authors: Susanne
authors: S
authors: Jank
authors: Universitätsklinikum Heidelberg, Abteilung Allgemeinmedizin und Versorgungsforschung.
authors: Sabine
authors: S
authors: Ludt
authors: Universitätsklinikum Heidelberg, Abteilung Allgemeinmedizin und Versorgungsforschung.
authors: Frank
authors: F
authors: Peters-Klimm
authors: Universitätsklinikum Heidelberg, Medizinische Klinik, Abteilung Klinische Pharmakologie und Pharmakoepidemiologie.
authors: Walter Emil
authors: WE
authors: Haefeli
authors: Universitätsklinikum Heidelberg, Abteilung Allgemeinmedizin und Versorgungsforschung.
authors: Joachim
authors: J
authors: Szecsenyi
mesh_terms: D057189:Checklist; D002908:Chronic Disease / Q000188:drug therapy*; D003257:Consumer Product Safety; D058006:General Practice / Q000458:organization & administration*; D005858:Germany; D006801:Humans; D054539:Medication Therapy Management / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000458:organization & administration
keywords: Arzneimitteltherapiesicherheit; Hausarztpraxis; Medication safety; Medizinische Fachangestellte; Multimedikation; general practice; medical assistant; polypharmacy; structured medication management; strukturiertes Medikamentenmanagement