[The impact of Pharmacy Intervention on the treatment of elderly multi-pathological patients].
OBJECTIVE
to analyze the impact of Pharmacy Intervention (PI), within the healthcare team who manages elderly multi-pathological patients, regarding the evolution of Drug Related Problems (DRPs) and Negative Outcomes Associated with Medication (NOMs). To estimate the prevalence of DRPs, NOMs, and Potentially Inappropriate Prescriptions (PIPs), and the drugs involved, considering the characteristics of their healthcare location.


METHODS
multicenter, prospective study, on > 65-year-old patients with multiple pathologies, either institutionalized or hospitalized. The Pharmacist reviewed the chronic medication of the patient in order to detect DRPs and NOMs, and issued recommendations to the physician responsible for the patient, and this intervention was subsequently evaluated. DRPs and NOMs were classified according to the Third Consensus of Granada. The STOPP/START Criteria were used for PIP detection. The primary variables were: number of PIs conducted and accepted by the physician.


RESULTS
338 patients were included, and 326 (96.4%) presented some DRP. 1089 DRPs were detected, with 983 PIs suggested for their solution, and 651 (69.9%) of these were accepted. PIs solved 58.9% of DRPs, and an association was found between PI and the solution for the DRP (p < 0.001). PIs were more accepted in institutionalized than in hospitalized patients (p = 0.002), by physicians with a higher specialization (p < 0.001) and when they involved quantitative safety NOMs (p = 0.042). The STOPP/START Criteria detected 65% of PIPs, and more PIPs not associated with these criteria were found in institutionalized than in hospitalized patients (p < 0.001).


CONCLUSIONS
pharmacy Intervention within the multidisciplinary team can solve in a significant way both DRPs and NOMs in elderly multi-pathological patients, and thus help to improve the quality of their pharmacological therapy. This is the first multicenter clinical trial with these characteristics that has been conducted in Spain.
The CRONOS Group. Spain.. eva.delgado@salud.madrid.org.
Eva
E
Delgado Silveira
The CRONOS Group. Spain.. eva.delgado@salud.madrid.org.
Elia María
EM
Fernandez-Villalba
The CRONOS Group. Spain.. eva.delgado@salud.madrid.org.
María
M
García-Mina Freire
The CRONOS Group. Spain.. eva.delgado@salud.madrid.org.
María Sandra
MS
Albiñana Pérez
The CRONOS Group. Spain.. eva.delgado@salud.madrid.org.
María Pilar
MP
Casajús Lagranja
The CRONOS Group. Spain.. eva.delgado@salud.madrid.org.
Juan Francisco
JF
Peris Martí
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010348:Patient Care Team; D010595:Pharmacists; D010604:Pharmacy; D010607:Pharmacy Service, Hospital; D010820:Physicians; D011446:Prospective Studies; D013030:Spain; D016896:Treatment Outcome