Factors affecting the likelihood of documented medication concerns in patients with multimorbidity: a cross-sectional study in primary care

Background High-risk patients with chronic conditions in Primary Care often face medication-related problems. A significant but underexplored problem is the patient's medication concern, which may also impact treatment decisions and outcomes.

Aim This study aims to describe the characteristics of high-risk patients with chronic conditions in Madrid, Spain, who have documented medications concern and to analyze the associated factors.

Design & setting Descriptive cross-sectional study, conducted within the IMI-H2020 European BEAMER project, including all high-risk patients with chronic conditions in the Madrid region.

Method Patients were identified by the Adjusted Morbidity Groups stratification tool in Primary Care electronic clinical records. Variables included sociodemographic, clinical, and pharmacological, along with self-reported medication concerns. Univariate and bivariate analyses, and logistic regression models, were performed with medication concern as the dependent variable.

Results In all, 40 776 (28.56%) reported medication concern. Patients with medication concern were older (84.64 vs 72.69 years), had more chronic conditions (7 vs 6) and medications (9.7 vs 8.7). They were more likely to live alone (8.5% vs 2.7%) and showed higher dependency. Older age OR 11.0 (95%CI:5.4-22.3; P-value<0.001), polypharmacy OR 3.2 (95%CI:3.1-3.3; P-value<0.001), living alone OR 1.5 (95%CI: 1.4-1.6; P-value<0.001), Parkinson’s OR 1.3 (95%CI: 1.2-1.4; P-value<0.001); chronic pain OR 1.6 (95%CI:1.2-2.1; P-value=0.001), and cardiovascular risk factors OR 1.2 (95%CI: 1.1-1.3; P-value=0.001) were associated with medication concern.

Conclusion Age, polypharmacy, multimorbidity, and social isolation are predictors of medication concern in high-risk chronic patients in Primary Care. Addressing psychological barriers, simplifying treatment, and strengthening social support through tailored interventions could decrease medication concerns.