How prone are Swedish general practitioners to perform medication reconciliation? A theory-based survey study

TL;DR

This study explores how likely Swedish general practitioners are to perform medication reconciliation for older patients with multiple health conditions.

Contribution

The study applies the Theory of Planned Behaviour to identify key predictors of physicians’ intentions to perform medication reconciliation.

Findings

Physicians' attitudes and perceived control were significant predictors of their intention to perform medication reconciliation.

Female physicians and those with over 10 years of experience showed higher scores in attitudes and perceived control.

The study provides insights for developing interventions to improve medication reconciliation practices.

Abstract

Drug-related problems are common in older individuals. A medication reconciliation has the goal of identifying and maintaining an accurate medication list and can serve to prevent drug-related problems caused by discrepancies.

This study aimed to explore primary care physicians’ intentions towards performing medication reconciliation in patients with multimorbidity using a theory-based questionnaire.

A survey study was conducted from February to March 2024.

An anonymous web-based questionnaire was developed, validated and distributed to 674 primary care physicians in southern Sweden. The questionnaire targeted attitudes, perceived norms, perceived behavioural control and generalised intentions towards performing a medication reconciliation, constructs derived from the theory of planned behaviour and the reasoned action approach theory. Outcome measures were overall scores for predictors, and the correlation between predictors and intentions towards performing a medication reconciliation was analysed using a multiple linear regression model.

With 206 surveys answered, the response rate was 31%. We found items targeting attitudes to have the highest overall mean score on a seven-point Likert scale (6.42), followed by generalised intention (6.17), subjective norms (5.45) and perceived behavioural control (5.15). Women had significantly higher scores for attitudes (p-value 0.001), subjective norms (p-value 0.050) and generalised intention (p-value 0.001). Groups with more than 10 years of work experience had significantly higher overall mean scores for perceived behavioural control (p-value 0.043). The correlation between predictors and generalised intention found attitudes and perceived behavioural control to be significant predictors of intentions to perform medication reconciliation in multimorbid older individuals (p-value < 0.001).

We found attitudes and perceived behavioural control to be significant predictors of primary care physicians’ intention to perform a medication reconciliation in patients with multimorbidity. These findings provide important insights into how future interventions targeting behavioural predictors can be developed.

How likely are Swedish general practitioners to update patients’ medication lists?

Why was the study done?

Older individuals are susceptible to drug-related problems which can be caused by medication lists not being accurate. Medication reconciliation is a process where physicians check and update a patient’s list of medications to avoid errors that could harm the patient. This study aimed to understand why primary care physicians in Sweden might or might not perform medication reconciliations for older patients with multiple health conditions.

What did the researchers do?

The researchers used a theory called the ‘Theory of Planned Behaviour’ to design a survey, focusing on the physicians’ attitudes, social influences, and perceived ability to perform this task. The survey was sent by e-mail to 674 physicians in southern Sweden, with 206 responses.

What did the researchers find?

The results showed that physicians’ attitudes (how they feel about the benefits of medication reconciliation) and their perceived control over the task were the most significant factors predicting whether they intended to perform medication reconciliations. Female physicians and those with more than 10 years of professional experience were more likely to have positive attitudes and feel confident in performing this task.

What do the findings mean?

The study concluded that future efforts to improve medication reconciliation should focus on changing physicians’ attitudes and increasing their confidence in handling this task. This could help prevent medication-related issues in older patients, who are particularly vulnerable to drug-related problems due to their complex health needs.

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