Intervención farmacéutica en la revisión del tratamiento en pacientes mayores polimedicados institucionalizados

IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Atencion Primaria Pub Date : 2024-05-18 DOI:10.1016/j.aprim.2024.102959
Cristina Peral Bolaños , Isabel Santaolalla García , Isabel Gómez Valbuena , Laura Vega Ruíz , Claudia Iglesias Carabias , Rocío Martín Valero , Fernando Martínez Martínez , Grupo de Trabajo
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Abstract

Objective

To describe the Drug-Related Problems (DRP) and their resolution after pharmacological review in institutionalised elderly patients under polypharmacy.

Design

Descriptive, retrospective cohort study from January to October of 2022.

Location

Twelve nursing homes at the Community of Madrid.

Participants

295 patients aged 65 or older taking at least 5 chronic medications prescribed prior to the treatment review.

Interventions

Medication reviews carried out by the pharmacist and agreed upon in face-to-face meetings between the primary care doctor, the nursing home doctor and the pharmacist.

Main measurements

Detected DRP, types and resolution. A age, sex, and number of medications before and after the intervention. Pharmacological subgroups according to anatomical therapeutic chemical classification system (ATC) and active pharmaceutical ingredients involved in the detected DRPs.

Results

1425 DRP were detected, with a mean of 4.85 (SD 3.33) DRPs/patient. The most frequent DRP was reconciliation error (32.52%), followed by pharmaceutical regimen and dosaje. Among the 1425 improvement proposals, 86.73% of them were accepted.Significant statistically differences were observed between the number of medications per patient prior to the pharmacotherapy review (12.29) and after it (10.20), obtaining an average difference of 2.09 (95%CI: 1.98-2.21; P<.001).

Conclusions

It is found that the intervention of multidisciplinary team in which the pharmacist performs a revision of the medication decreased the number of prescribed medications. Therefore, it reduces polymedication and its associated risks.

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[多药合用的养老院老年患者用药审查中的药物干预]。
目的描述使用多种药物的住院老年患者的药物相关问题(DRP)及其在药物学审查后的解决情况:描述性、回顾性队列研究(2022 年 1 月至 10 月):地点:马德里社区的 12 家养老院。参与者:295 名 65 岁或以上的患者,在治疗审查前至少服用 5 种慢性药物:由药剂师进行药物审查,并在主治医生、疗养院医生和药剂师之间的面对面会议上达成一致:检测到的 DRP、类型和解决方法。干预前后的年龄、性别和用药次数。根据解剖学治疗化学分类系统(ATC)和检测到的DRP所涉及的活性药物成分进行药理学分组:结果:共发现 1425 例 DRP,平均每名患者 4.85 例(标清 3.33 例)。最常见的 DRP 是对账错误(32.52%),其次是药物治疗方案和 dosaje。在 1425 项改进建议中,86.73% 的建议被采纳。在药物治疗回顾之前(12.29)和之后(10.20),每位患者的用药数量在统计学上存在显著差异,平均差异为 2.09(95%CI:1.98-2.21;PC 结论):研究发现,在多学科团队的干预下,药剂师对药物进行了修订,从而减少了处方药的数量。因此,它减少了多重用药及其相关风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Atencion Primaria
Atencion Primaria 医学-医学:内科
CiteScore
2.90
自引率
8.00%
发文量
156
审稿时长
33 days
期刊介绍: Atención Primaria es una revista que publica trabajos de investigación relativos al ámbito de la atención primaria de salud. Desde el punto de vista conceptual, Atención Primaria asume el nuevo modelo de atención primaria de salud, orientado no sólo a la curación de la enfermedad, sino también a su prevención y a la promoción de la salud, tanto en el plano individual como en el de la familia y la comunidad. En estos nuevos aspectos que definen el modelo de atención primaria de salud es en los que se centran los trabajos de investigación que publica Atención Primaria, la primera revista de originales española creada para recoger y difundir la producción científica realizada desde los centros de atención primaria de salud sobre cuestiones como protocolización de la asistencia, programas de prevención, seguimiento y control de pacientes crónicos, organización y gestión de la asistencia primaria, entre otros.
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