A qualitative study to map drug-related problems orthopaedic patients experience within six weeks post discharge

Abstract

Optimal pharmacotherapy is achieved when the following treatment goals are managed: minimal adverse reactions, maximum achievement of the desired effect and maximum patient satisfaction. However, research shows that optimal pharmacotherapy often is not achieved, because of drug-related problems (DRPs) patients experience with their medication use. Objective To assess DRPs orthopaedic patients experience within six weeks post discharge, so that patients’ pharmaceutical support needs can be mapped Setting Orthopaedic department of the Sint Maartenskliniek (SMK) in the Netherlands. Methods Adult orthopaedic patients participated in this qualitative study. In May and June 2021 individual interviews were held. Patients were interviewed two times, one week and six weeks post discharge, to map the DRPs patients experience within six weeks post discharge. A semi-structured interview guide is compiled from the TRIAGE and is based on ten domains: knowledge barriers, concerns, necessity, practical intake problems, adverse reactions, complexity of the medication, social support, costs, being able to understand or apply information and problems with incorporating intake in daily routine. Primary outcome measure Drugrelated problems. Analysis Interviews were analysed and coded independently by two different researchers (AL, EM) in EXCEL version 2105 Results In total 15 patients were interviewed and 29 interviews were conducted. Five main themes derived from the qualitative data: (I) Insufficient knowledge; many patients were not aware of which medication they take and what adverse reactions their medicines could cause (II) Negative cognition; a lot of patients had a negative view when it comes to medication use. Patients worry about what potential side effects their medication could give (III) Practical barriers; mainly arise with the use of antibiotics and thrombosis prophylaxis (IV) Inadequate drug use; could lead to insufficient effect or drug misuse (V) Negative experience; insufficient effect, prescribed medication caused trouble with comorbidity and adverse reactions. Most DRPs are present with the use of oxycodone and antibiotics. Conclusion Orthopaedic patients experience DRPs post discharge. This qualitative study provides insight in which DRPs orthopaedic patients experience post discharge. Patients have difficulty taking their medication adequately due to insufficient knowledge, negative cognition, practical barriers. This may lead to negative experiences with their medication use. Good education about the benefits and risks of medicines is necessary.