Evidence map›Paper›PMID 31157038›Full record

ArticleEuropean journal of hospital pharmacy : science and practice2018

Improvement on prescribing appropriateness after implementing an interdisciplinary pharmacotherapy quality programme in a long-term care hospital.

Oreto Ruiz-Millo, Mónica Climente-Martí, José Ramón Navarro-Sanz

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Article in European journal of hospital pharmacy : science and practice, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Oreto Ruiz-MilloServicio de Farmacia, Hospital Universitario Doctor Peset, Valencia, Spain.ORCID 0000-0001-5829-6957
Mónica Climente-MartíServicio de Farmacia, Hospital Universitario Doctor Peset, Valencia, Spain.
José Ramón Navarro-SanzÁrea Médica Integral, Hospital Pare Jofré, Valencia, Spain.
Hospital Universitario Doctor Peset · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo determine the prevalence of inappropriate prescribing in elderly patients with polypharmacy admitted to a long-term care hospital (LTCH) and to evaluate the impact of an interdisciplinary pharmacotherapy quality programme on improvement of prescribing appropriateness.

methodsAn interventional, longitudinal, prospective study was conducted in a Spanish LTCH (October 2013 to July 2014) including 162 elderly (≥70 years) patients with polypharmacy (≥5 medications). Pharmacists conducted the pharmacotherapy follow-up of patients with medication reconciliation, pharmacotherapeutic optimisation and educational interviews from admission to discharge. Reconciliation errors, potentially inappropriate medications (PIMs), potentially prescribing omissions (PPOs) and significant drug interactions rates were calculated. The impact of the programme was evaluated considering the difference between the inappropriateness score per patient (total number of reconciliation errors, PIMs, PPOs and significant drug interactions) before and after implementing pharmacotherapy recommendations.

resultsAt admission, 163 reconciliation errors (median(range), 1(1-6)) in 92 (56.8%) patients (65.6% drug omissions), 335 PIMs (2(1-6)) in 147 (90.7%) patients (39.3% use ≥2 anticholinergic drugs), 43 PPOs (1(1-3)) in 32 (19.8%) patients (48.5% statin omission) and 594 significant drug interactions (4(1-19)) in 130 (80.2%) patients were detected. After implementing pharmacotherapy recommendations, statistically significant reductions in admission reconciliation errors (8.3% to 0.1%), PIMs (17.0% to 12.2%), PPOs (2.2% to 0.7%) and significant drug interactions (30.2% to 26.8%) rates were found. The programme achieved a 31% improvement in prescribing appropriateness, with a statistically significant reduction in the inappropriateness score (6(IQR:4-9) to 4(IQR:2-7)).

conclusionReconciliation errors, PIMs and drug interactions are highly prevalent in elderly patients with polypharmacy admitted to an LTCH. This interdisciplinary pharmacotherapy quality programme seems to be a useful approach in the improvement of prescribing appropriateness in a high-risk older population.

Indexed as

clinical pharmacygeriatric medicinehospital pharmacy educationtherapeutics

Identifiers

PMID31157038
PMCPMC6452358
OpenAlexW2783805305

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.