engleski

Attitudes and knowledge of family physicians regarding patients with multimorbidity in the Republic of Croatia – Pilot Study

Background: Multimorbidity is defined as any combination of chronic disease with at least one additional condition, bio-psycho-social factor or somatic risk factor. Care for such patients requires special skills and knowledge, as well as a proactive, individualized approach in order to improve their quality of life and reduce overtreatment. Research questions: To investigate whether the length of service in family medicine (FM), the number of elderly patients (over 65 years) in care, residency in FM or specialty in family medicine (FMS) correlate with the physicians knowledge about adequate care for patients with multimorbidity. Method: A questionnaire (21 questions about the attitudes and knowledge of family physicians about multimorbidity management) was available online from December 1st to December 21st, 2018 from social networks and sent to the family medicine practitioners' e-mail addresses. The answers were statistically processed with SPSS program. Results: Out of 174 respondents, 137 (78.7%) were female and 37 (21.3%) were male. Ninety two of them all (52.9%) were FMS, 55 (31.6%) were without specialization (FM), 20 (11.5%) were FM residents, and 7 (4%) were complementary specialists (e.g. school medicine). Multimorbidity was correctly defined by 73 (49.6%) of the respondents, significantly more among FMS compared to others (χ2=7.417, p=0.025). Years of service in FM (over 20 years) were significantly associated with frequent checking for potential drug interactions (χ2=12.92, P=0.005) and treatment revisions in patients receiving two or more drugs (χ2=11.71, P=0.008). Higher number of elderly patients in care did not increase the checking rate for potential interactions (χ2=1.99, P=0.574). Conclusions: Management of multimorbidity pertains to the domain of family medicine. Specialization in family medicine and clinical experience markedly improve the understanding and treatment of multimorbidity, particularly concerning rational therapy (e.g. awareness of interactions, control of polypharmacy).

multimorbidity ; polypharmacy ; drug interaction ; chronic therapy audit

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