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Effects of a multifaceted intervention in psychogeriatric patients: one-year prospective study

dc.contributorUniversitat Ramon Llull. Facultat de Ciències de la Salut Blanquerna
dc.contributor.authorHernández Hernández, Marta
dc.contributor.authorMestres Miralles, Concepción
dc.contributor.authorJunyent, Jaume
dc.contributor.authorCosta-Tutusaus, Lluís
dc.contributor.authorModamio Charles, Pilar
dc.contributor.authorFernández Lastra, Cecilia
dc.contributor.authorMariño Hernández, Eduardo L.
dc.date.accessioned2024-01-17T19:45:34Z
dc.date.available2024-01-17T19:45:34Z
dc.date.created2018-06
dc.date.issued2020-06
dc.identifier.urihttp://hdl.handle.net/20.500.14342/3730
dc.description.abstractObjectives The aetiology of behavioural and psychological symptoms (BPSD) could be related to inadequate treatment in patients with dementia. The aim of this study was to determine how a multifaceted intervention based on a medication review and multidisciplinary follow-up could improve treatment and minimise risk in these patients. Methods A prospective interventional study was undertaken between July 2015 and July 2016 of patients with dementia admitted to control BPSD. Patients with previous psychiatric illness or palliative care were excluded. Prescription information was obtained from Aegerus and the Catalonia clinical record HC3. The intervention was conducted by a multidisciplinary team. The Medication Appropriateness Index (MAI) was used to assess the intervention. Results 65 patients (60% women, mean age 84.9±6.7 years) with mild-moderate cognitive impairment (mean 4.5±1.8), moderate-severe functional dependence (mean 43.8±23.9) and a high prevalence of geriatric syndromes and comorbidity were included in the study. 87.7% of the patients were taking ≥5 drugs (mean 9.0±3.1) and 38.5% were taking ≥10. Patients presented with BPSD values of 1.9±0.8 at admission. Common symptoms prompting admission were agitation (47.7%) and irritability (43.1%). A total of 175 drug-related problems (DRPs) were detected (2.97 per patient). Significant differences (p<0.001) were found between the MAI score at admission (4±4.6) and post-intervention (0.5±2.6). Most prevalent MAI criteria were related to interactions (40%), dosage (38.5%) and duplication (26.2%). 55 patients (84.6%) were taking anticholinergic drugs at admission (2.6±1.2 anticholinergic drugs per patient), and the post-intervention reduction was significant (p<0.016). Conclusions The balance between effective treatment and safety is complex in these patients. Medication review in interdisciplinary teams is an essential component to optimise interventions and assessment of safety.ca
dc.format.extent6 p.ca
dc.language.isoengca
dc.publisherBMJ Publishing Groupca
dc.relation.ispartofEuropean Journal of Hospital Pharmacy, 2020, 27:226-231ca
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights© European Association of Hospital Pharmacists
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subject.otherDemència -- Tractamentca
dc.subject.otherMedicaments -- Administracióca
dc.subject.otherMedicaments -- Prescripcióca
dc.titleEffects of a multifaceted intervention in psychogeriatric patients: one-year prospective studyca
dc.titleEffects of a multifaceted intervention in psychogeriatric patients: one-year prospective study
dc.typeinfo:eu-repo/semantics/articleca
dc.rights.accessLevelinfo:eu-repo/semantics/openAccess
dc.embargo.termscapca
dc.subject.udc615ca
dc.subject.udc616.89ca
dc.identifier.doihttps://doi.org/10.1136/ejhpharm-2018-001647ca
dc.description.versioninfo:eu-repo/semantics/acceptedVersionca


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