Development of a medication status check sheet to identify patients with poor understanding of their medications: A multicenter study in Japan

Abstract

Background: One of the causes of polypharmacy is aimless medication use due to poor understanding of medications. However, some patients do not adequately understand the indication for medications and adverse effects of polypharmacy. This study aimed to develop a screening tool, the medication status check (MSC), to identify patients with poor understanding of their medications to reduce aimless medication use in Japan. Methods: This multicenter, prospective, observational study was conducted in nine hospitals in Japan. Inpatients aged ≥75 years were surveyed between September 2023 and March 2024. A chi-squared test was conducted to determine the relationship of the 19 MSC draft items with poor and good understanding of medications. A receiver operating characteristic (ROC) analysis was then performed using significant questions (i.e., those with a P-value of <0.05), and cut-off values were obtained. Results: Overall, 3 items, comprising 2 of the draft MSC questions and the use of ≥5 medications, were designated as the MSC-3. The area under the ROC curve was 0.686 (95 % confidence interval: 0.582–0.778, P < 0.001), indicating that the MSC-3 was useful as a screening tool. When at least one of the MSC-3 items was met, this approach resulted in a sensitivity of 93.1 % and specificity of 21.7 % in identifying the need for polypharmacy intervention. Conclusions: Use of the MSC-3 will enable pharmacists to intervene at an early stage, potentially contributing to a reduction in the incidence of polypharmacy.

Keywords

• Older individuals
• Polypharmacy
• Medication understanding
• Screening
• Medication adherence
• Medication guidance