Appropriateness of medication prescribing in nursing homes: A collaboration project between pharmacy and geriatric departments.

Autor:	Carrión Madroñal IM; Specialist Physician in Hospital Pharmacy, Department of Pharmacy, Hospital Universitario de Guadalajara, Spain. Electronic address: isacarmad@gmail.com., Martín Alcalde E; Specialist Physician in Hospital Pharmacy, Department of Pharmacy, Hospital Universitario de Guadalajara, Spain., Bartolomé Martín I; Specialist Physician in Geriatric Medicine, Department of Geriatrics, Hospital Universitario de Guadalajara, Spain., Febres Pánez DF; Specialist Physician in Geriatric Medicine, Department of Geriatrics, Hospital Universitario de Guadalajara, Spain., Colato López CA; Specialist Physician in Geriatric Medicine, Department of Geriatrics, Hospital Universitario de Guadalajara, Spain., Rodriguez-Miñón Otero MI; Specialist Physician in Geriatric Medicine, Department of Geriatrics, Hospital Universitario de Guadalajara, Spain.
Jazyk:	angličtina
Zdroj:	Revista espanola de geriatria y gerontologia [Rev Esp Geriatr Gerontol] 2023 Mar-Apr; Vol. 58 (2), pp. 68-74. Date of Electronic Publication: 2023 Feb 17.
DOI:	10.1016/j.regg.2023.01.008
Abstrakt:	Purpose: To evaluate the appropriateness of medication prescribing and to analyze interventions carried out in polymedicated elderly patients in nursing homes (NHs). Methods: Prospective study of potentially inappropriate medication prescribing in polymedicated older adults living in NHs, implemented via a collaborative project between NHs and the geriatric and pharmacy departments of a university hospital. The pharmacist reviewed patients' active medical prescriptions and prepared an individualized report with proposals aimed at therapeutic optimization that was sent for evaluation to the geriatrician in charge of the NH. The drug-related problems (DRPs) were classified according to the Third Consensus of Granada and the potentially inappropriate prescriptions (PIPs) were identified by explicit criteria (STOPP/START, BEERS, LESS-CHRON), implicit criteria (MAI) and CheckTheMeds® software. It was measured the degree of acceptance of the interventions carried out, and the economic impact was calculated from the direct costs of the discontinued drugs. Results: Of the 210 patients reviewed by the pharmacy department, 105 patients from 10 NHs were analyzed. A total of 510 prescriptions with possible DRPs were identified (38.5% of all prescribed drugs). According to STOPP/START/BEERS or LESS-CHRON criteria, 41.2% were PIPs. The main DRPs identified were: unfavorable risk-benefit ratio, inappropriate dose/regimen, inappropriate treatment duration, probability of adverse events, medication not indicated, and duplicate therapy. Interventions were proposed for 81.5% of the DRPs detected, of which 73.3% were accepted. This resulted in a 23.1% reduction in the number of drugs prescribed per patient and an economic saving of €16,218 per 6-month period. Conclusion: The appropriateness of medication prescribing in polymedicated older adults living in NHs by the pharmacist has made it possible to reduce DRPs and PIPs and to save costs thanks to the high degree of acceptance by geriatricians. (Copyright © 2023 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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