Development of a pharmaceutical care program in progressive stages in geriatric institutions
Author
Mestres Miralles, Concepción
Hernández Hernández, Marta
Agustí, Anna
Puerta, Laura
Llagostera, Blanca
Other authors
Universitat Ramon Llull. Facultat de Ciències de la Salut Blanquerna
Publication date
2018-12Abstract
Background: To introduce and manage a Pharmaceutical care programs in geriatric care institutions presents difficulties such as reduced pharmacy service staff, complexity of the patients or lack of integration of the pharmacist in the health care team. This work describes the evolution of the implementations of a program of pharmaceutical care centered in drug related problems (DRP) in a group of geriatric institutions of different levels of complexity.
Methods: Setting: Long-term and subacute care hospitals (HSS) and Health care teams attending nursing homes (EARs).
Participants: Patients attended in HSS and EARs during different periods between 2010 and 2016.
Interventions: The program was developed in different stages, in which pharmacists made interventions of increasing
complexity.
Results: Between 2010 and 2013, the approach was only to improve the prescription of non-appropriate drugs for the elderly, which was reduced from 19 to 14.5%. Subsequent steps included detection of drug-related problems (DRP), systematization of treatment revisions, recording of pharmacist interventions, improvements in the classification of interventions and the creation of a web-based database for recording in a more efficient way.
During these years, there was an increase in the number of patients included in pharmaceutical care activities and thus
the number of pharmacist interventions (3872 in 2014 vs 5903 in 2016). In 2016, mean age in 2016: 83.2 years old. Mean
number of medicines/patient: 8.4 ± 3.3, and mean interventions/patient: 1.62. Degree of acceptance of the interventions
by physicians improved (68.6% in 2016 vs 45.5% in 2012), even though there is still much work to do.
The Medication Appropriateness Index (MAI) showed that when the interventions were accepted, there was an important
improvement. HSS mean MAI values pre-intervention: 2.52, post-intervention 0.80. In EARs: 5 pre and 1.39 post. In both
cases p < 0.0001.
Conclusions: Approaching the deployment of activities in a progressive way has made us more efficient and able to
confront and solve the problems that have arisen. Even though there has been a very restricted increase in the staff and
budget, we are able to implement a DRP detection programme with guaranties of quality.
Document Type
Article
Published version
Language
English
Subject (CDU)
615 - Pharmacology. Therapeutics. Toxicology
Keywords
Residències de persones grans
Serveis farmacèutics
Pages
8 p.
Publisher
BioMed Central
Is part of
BMC Geriatrics, 2018, vol. 18, núm. 316
This item appears in the following Collection(s)
Rights
© L'autor/a
Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by/4.0/