Medicine optimization strategy in an acute geriatric unit: The pharmacist in the geriatric team
| Autor: | Mikel Izquierdo, Nicolás Martínez-Velilla, Alvaro Casas-Herrero, Javier Alonso-Renedo, Idoia Beobide-Telleria, Marta Gutiérrez-Valencia, Alexander Ferro-Uriguen |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Medication history Pharmacist Psychological intervention Inappropriate Prescribing Pharmacists 03 medical and health sciences Professional Role 0302 clinical medicine 030502 gerontology Intervention (counseling) medicine Humans Drug Interactions Prospective Studies Medical prescription Prospective cohort study Geriatric Assessment Aged Aged 80 and over Patient Care Team Medication review Polypharmacy business.industry Hospitalization Emergency medicine Female 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | Geriatrics & Gerontology International. 19:530-536 |
| ISSN: | 1447-0594 1444-1586 |
| Popis: | Aim Older patients admitted to acute geriatric units (AGU) frequently use many medications and are particularly vulnerable to adverse drug events, so specific interventions in this setting are required. In the present study, we describe a new medicine optimization strategy in an AGU, and explore its potential in reducing polypharmacy and improving medication appropriateness. Methods The present prospective study included patients aged ≥75 years who were admitted to an AGU in a tertiary hospital. An intervention based on a pharmacist clinical interview, medication history and a structured medication review within a comprehensive geriatric assessment was proposed. The differences regarding polypharmacy as the primary outcome (≥5 chronic drugs), hyperpolypharmacy (≥10), number of drugs, drug-related problems and Screening Tool of Older Person's Prescription/Screening Tool to Alert Doctors to Right Treatment criteria between admission and discharge were evaluated. Results From October 2016 to April 2017, 234 patients were enrolled, aged 87.6 years (SD 4.6 years); 143 (61.1%) were women. The intervention resulted in a statistically significant improvement in polypharmacy (-10.2%, 95% CI -15.3, -5.2), hyperpolypharmacy (-16.6%, 95% CI -22.3 -11.0), number of medications (-1.4, 95% CI -1.8, -1.0), Screening Tool of Older Person's Prescription criteria (-19.2%, 95% CI -24.9, -13.6), Screening Tool to Alert Doctors to Right Treatment criteria (-6.8%, 95% CI -10.1, -3.5) and drug-related problems (-2.7, 95% CI -2.9, -2.4; P ≤ 0.001 for all). Conclusions A systematic pharmacist-led intervention at hospital admission to an AGU within a comprehensive geriatric assessment was associated to a decrease in polypharmacy, drug-related problems and potentially inappropriate prescribing. Geriatr Gerontol Int 2019; 19: 530-536. |
| Databáze: | OpenAIRE |
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