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Background <p>Studies have shown considerable discrepancies between the medication lists reported by patients, physicians, and pharmacists.</p> Objective <p>To investigate discrepancies in prescribed medications as reported by patients, general practitioners (GPs), and community pharmacists (CPs) in older patients with polypharmacy.</p> Methods <p>Study design: Cross-sectional analysis. Setting: Twenty-four GP centres and 17 associated community pharmacies in the Netherlands. Data sources: Postal questionnaires, home visits, and the electronic patient record systems of the GPs and CPs. We defined a medication discrepancy as any inconsistency between the patient’s, GP’s, or CP’s medication list. For fixed medications, we included inconsistencies in the medication’s name, dose, or frequency; for variably used medications, we included only inconsistencies in the medication’s name. Logistic regression analyses and GEE were performed to identify discrepancy-related patient and medication characteristics.</p> Results <p>Data from 751 patients (mean age 72.9 years (SD 7.6), 47.3% female) using 5989 prescribed medications (average 8, range 3–19) were analysed. The overall patient-GP-CP discrepancy was 71.9% at the patient level and 21.8% at the medication level. Statistically significant associations with discrepancy included various medication characteristics, e.g. any additional medication (OR 1.45, 95% CI 1.33–1.59) and variable medication usage (varying ORs 1.61–5.78), and the patient characteristic ‘Living in a residential care home’ (OR 0.42, 95% CI 0.18–0.997).</p> Conclusion <p>We found a high patient-GP-CP discrepancy, with a 72% discrepancy in prescribed medication at the patient level and a 22% discrepancy at the medication level. ‘Living in a residential care home’ reduced the chance of medication discrepancy, whereas medication characteristics, such as variable medication usage, increased it.</p> Trial registration <p>NLOMON32535 (<a href="https://onderzoekmetmensen.nl/en/trial/32535">https://onderzoekmetmensen.nl/en/trial/32535</a> registered 15th December 2009).</p>

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Discrepancies in prescribed medications as reported by patients, general practitioners, and community pharmacists in older patients with polypharmacy in primary care

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  • 发表日期：

    2026年4月30日

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  • Donna Bosch-Lenders,
  • Henri E. J. H. ‘Jelle’ Stoffers,
  • Bjorn Winkens,
  • Mascha Twellaar,
  • Wouter J.M. Hufen,
  • Hugo P. van der Kuy,
  • J. André Knottnerus,
  • Marjan van den Akker

摘要

Background

Studies have shown considerable discrepancies between the medication lists reported by patients, physicians, and pharmacists.

Objective

To investigate discrepancies in prescribed medications as reported by patients, general practitioners (GPs), and community pharmacists (CPs) in older patients with polypharmacy.

Methods

Study design: Cross-sectional analysis. Setting: Twenty-four GP centres and 17 associated community pharmacies in the Netherlands. Data sources: Postal questionnaires, home visits, and the electronic patient record systems of the GPs and CPs. We defined a medication discrepancy as any inconsistency between the patient’s, GP’s, or CP’s medication list. For fixed medications, we included inconsistencies in the medication’s name, dose, or frequency; for variably used medications, we included only inconsistencies in the medication’s name. Logistic regression analyses and GEE were performed to identify discrepancy-related patient and medication characteristics.

Results

Data from 751 patients (mean age 72.9 years (SD 7.6), 47.3% female) using 5989 prescribed medications (average 8, range 3–19) were analysed. The overall patient-GP-CP discrepancy was 71.9% at the patient level and 21.8% at the medication level. Statistically significant associations with discrepancy included various medication characteristics, e.g. any additional medication (OR 1.45, 95% CI 1.33–1.59) and variable medication usage (varying ORs 1.61–5.78), and the patient characteristic ‘Living in a residential care home’ (OR 0.42, 95% CI 0.18–0.997).

Conclusion

We found a high patient-GP-CP discrepancy, with a 72% discrepancy in prescribed medication at the patient level and a 22% discrepancy at the medication level. ‘Living in a residential care home’ reduced the chance of medication discrepancy, whereas medication characteristics, such as variable medication usage, increased it.

Trial registration

NLOMON32535 (https://onderzoekmetmensen.nl/en/trial/32535 registered 15th December 2009).