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1. Introduction
The older, multimorbid population with chronic conditions is expanding globally, and this inevitably means a growth in complex polypharmacy and associated problems [1]. The frequency of medication errors is high in patients with polypharmacy in primary care [2]. Medication errors are a major concern to healthcare systems [3] because they can reduce the therapeutic effectiveness and represent an incremental cost [4]. It is common to analyse the role of professionals in medication errors. However, in the case of primary care, previous studies have also underlined the role that patients and their caregivers play in these mistakes [4,5,6]. Patient medication errors usually have minor consequences or none at all but, in some cases, they have serious health consequences, including hospitalization and death [4].
The quality of communication between the clinician and the patient [7] has been highlighted as one of the key factors in explaining the inappropriate use of medicines by patients, but it is not the only one [4,5]. For this reason, different strategies have been developed to help patients manage their medication, avoid missed doses [6,7], and avoid the most common blunders regarding treatment [8], especially in patients who are elderly, dependent, polymedicated, and multipathological [2,9,10,11]. Any measure that can increase patient safety in primary care will have an immediate multiplier effect in a large number of patients, making this type of intervention very important [3,12]. The aim of this study is to review the published literature on the inappropriate use of medicines and to articulate recommendations on how to reduce it in chronic patients, particularly those who are elderly, polymedicated, or multipathological.
2. Materials and Methods
2.1. Search Strategy and Inclusion Criteria
We carried out a systematic review of articles published from January 2000 to October 2015 and indexed in MEDLINE, EMBASE, PsychInfo, Scopus, The Cochrane Library, and Index Medicus. We followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and used Medical Subject Headings (MeSH), controlled vocabulary, and other key or free text words in our search strategies. The search algorithm used for MEDLINE (via PubMed) was “Attitude of Health Personnel (MeSH) AND Medical Errors” (MeSH) OR “Patient Harm” (MeSH) AND Patient Education as Topic/organization & administration (MeSH) OR (Patient Medication Knowledge/organization & administration* (MeSH),...