Cristina Peral Bolaños , Isabel Santaolalla García , Isabel Gómez Valbuena , Laura Vega Ruíz , Claudia Iglesias Carabias , Rocío Martín Valero , Fernando Martínez Martínez , Grupo de Trabajo
{"title":"[多药合用的养老院老年患者用药审查中的药物干预]。","authors":"Cristina Peral Bolaños , Isabel Santaolalla García , Isabel Gómez Valbuena , Laura Vega Ruíz , Claudia Iglesias Carabias , Rocío Martín Valero , Fernando Martínez Martínez , Grupo de Trabajo","doi":"10.1016/j.aprim.2024.102959","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To describe the Drug-Related Problems (DRP) and their resolution after pharmacological review in institutionalised elderly patients under polypharmacy.</p></div><div><h3>Design</h3><p>Descriptive, retrospective cohort study from January to October of 2022.</p></div><div><h3>Location</h3><p>Twelve nursing homes at the Community of Madrid<strong>.</strong></p></div><div><h3>Participants</h3><p>295 patients aged 65 or older taking at least 5 chronic medications prescribed prior to the treatment review.</p></div><div><h3>Interventions</h3><p>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.</p></div><div><h3>Main measurements</h3><p>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.</p></div><div><h3>Results</h3><p>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%<span>C</span>I: 1.98-2.21; <em>P</em><.001).</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021265672400101X/pdfft?md5=3c36672597d352846ebe71c6d0a8645a&pid=1-s2.0-S021265672400101X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Intervención farmacéutica en la revisión del tratamiento en pacientes mayores polimedicados institucionalizados\",\"authors\":\"Cristina Peral Bolaños , Isabel Santaolalla García , Isabel Gómez Valbuena , Laura Vega Ruíz , Claudia Iglesias Carabias , Rocío Martín Valero , Fernando Martínez Martínez , Grupo de Trabajo\",\"doi\":\"10.1016/j.aprim.2024.102959\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To describe the Drug-Related Problems (DRP) and their resolution after pharmacological review in institutionalised elderly patients under polypharmacy.</p></div><div><h3>Design</h3><p>Descriptive, retrospective cohort study from January to October of 2022.</p></div><div><h3>Location</h3><p>Twelve nursing homes at the Community of Madrid<strong>.</strong></p></div><div><h3>Participants</h3><p>295 patients aged 65 or older taking at least 5 chronic medications prescribed prior to the treatment review.</p></div><div><h3>Interventions</h3><p>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.</p></div><div><h3>Main measurements</h3><p>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.</p></div><div><h3>Results</h3><p>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%<span>C</span>I: 1.98-2.21; <em>P</em><.001).</p></div><div><h3>Conclusions</h3><p>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. 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Intervención farmacéutica en la revisión del tratamiento en pacientes mayores polimedicados institucionalizados
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.
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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