Patient Survey on Polypharmacy in the Clinic and Its Impact on Health Professionals' Management of Polypharmacy: a Before-after Study

Background: Patient awareness surveys on polypharmacy have been reported previously, but no previous study has examined the effects of sending feedback to health professionals on reducing medication use. Our study aimed to conduct a patient survey to examine factors contributing to polypharmacy, feedback the results to health professionals, and analyze the resulting changes in the number of polypharmacy patients and prescribed medications. Methods: Study 1: In July 2016, we conducted a questionnaire survey among adult patients receiving medical care at Minamihama clinic. We examined polypharmacy and its contributing factors by performing logistic regression analysis. Study 2: We sent feedback of survey results to 12 health professionals. Performing a t-test and a chi-square test on medical fee receipts, we analyzed changes in the percentage of polypharmacy patients and the number of prescribed medications during one month before and after the feedback. Results: In the questionnaire survey, significant differences were found in the following 3 items: age (odds ratio (OR)=3.14; 95% confidence interval (CI)=2.01-4.91), number of medical institutions (OR=2.34; 95%CI=1.50-3.64), and patients' difficulty with asking their doctors to deprescribe their medications (OR=2.21; 95%CI=1.25-3.90). After the feedback, the percentage of polypharmacy patients decreased from 21.5% to 20.1% and the mean number of prescribed medications per patient decreased from 8.2 to 7.7 (p<0.001, respectively).Conclusions: Providing feedback to health professionals on polypharmacy survey results may lead to a decrease in the number of polypharmacy patients. Factors contributing to polypharmacy included age (75 years or older), the number of medical institutions (2 or more institutions), and patients' difficulty with asking their physicians to deprescribe their medications. Feedback to health professionals reduced the percentage of polypharmacy patients and the number of prescribed medications. Trial registration: UMIN. Registered 21 June 2020 - Retrospectively registered, https://www.umin.ac.jp/ctr/index-j.htm