title: Adaptation of oral medication in people institutionalized in nursing homes for whom medication is crushed: The ADECUA Study.
abstract: OBJECTIVE
  To evaluate the effect of pharmacist interventions in the adaptation of pharmaceutical forms in elders institutionalized in nursing homes whose medicines are crushed, which may have a clinical relevance.
  
  
  METHODS
  Quasi-experimental, multicenter, transversal and prospective study carried out in 10 nursing homes. Subjects for whom drugs were being crushed were identified. Their treatments were reviewed in order to identify drugs that should not be crushed. In these cases, we proposed an alternative to the physician and we evaluated the degree of acceptance, its association to other variables and the pre-post adaptation index (tablets that can be crushed and capsules that can be opened/ total number of tablets and capsules before and after the intervention). Moreover, health professionals received a training course.
  
  
  RESULTS
  Medication was being crushed for 33% (618/1875) of residents (mean: 5 drugs susceptible of crushing). 220 pharmaceutical interventions were performed, mostly in extended release or gastro-resistant drugs (48% were accepted). Switch was the type of intervention more frequent (79%), mainly to Purpose: To evaluate the effect of pharmacist interventions in the adaptation of pharmaceutical forms in elders institutionalized in nursing homes whose medicines are crushed, which may have a clinical relevance.
  
  
  METHODS
  Quasi-experimental, multicenter, transversal and prospective study carried out in 10 nursing homes. Subjects for whom drugs were being crushed were identified. Their treatments were reviewed in order to identify drugs that should not be crushed. In these cases, we proposed an alternative to the physician and we evaluated the degree of acceptance, its association to other variables and the pre-post adaptation index (tablets that can be crushed and capsules that can be opened/ total number of tablets and capsules before and after the intervention). Moreover, health professionals received a training course.
  
  
  RESULTS
  Medication was being crushed for 33% (618/1875) of residents (mean: 5 drugs susceptible of crushing). 220 pharmaceutical interventions were performed, mostly in extended release or gastro-resistant drugs (48% were accepted). Switch was the type of intervention more frequent (79%), mainly to.
authors.affiliation: General Subdirectorate of Pharmacy and Healthcare Products. SERMAS.. francisco.apolo@salud.madrid.org.
authors.forename: Francisco
authors.initials: F
authors.lastname: Apolo Carvajal
authors.affiliation: General Subdirectorate of Pharmacy and Healthcare Products. SERMAS.. mglez4@gmail.com.
authors.forename: María
authors.initials: M
authors.lastname: González Martínez
authors.affiliation: General Subdirectorate of Pharmacy and Healthcare Products. SERMAS.. francisco.apolo@salud.madrid.org.
authors.forename: Elena
authors.initials: E
authors.lastname: Capilla Santamaría
authors.affiliation: General Subdirectorate of Pharmacy and Healthcare Products. SERMAS.. francisco.apolo@salud.madrid.org.
authors.forename: Betsabé
authors.initials: B
authors.lastname: Cáliz Hernández
authors.affiliation: General Subdirectorate of Pharmacy and Healthcare Products. SERMAS.. francisco.apolo@salud.madrid.org.
authors.forename: Icíar
authors.initials: I
authors.lastname: Cañamares Orbis
authors.affiliation: General Subdirectorate of Pharmacy and Healthcare Products. SERMAS.. francisco.apolo@salud.madrid.org.
authors.forename: Nuria
authors.initials: N
authors.lastname: Martínez Casanova
authors.affiliation: General Subdirectorate of Pharmacy and Healthcare Products. SERMAS.. francisco.apolo@salud.madrid.org.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Martínez Sánchez
authors.affiliation: General Subdirectorate of Pharmacy and Healthcare Products. SERMAS.. francisco.apolo@salud.madrid.org.
authors.forename: Ainhoa
authors.initials: A
authors.lastname: Aranguren Oyarzábal
authors.affiliation: General Subdirectorate of Pharmacy and Healthcare Products. SERMAS.. francisco.apolo@salud.madrid.org.
authors.forename: María José
authors.initials: MJ
authors.lastname: Calvo Alcántara
authors.affiliation: General Subdirectorate of Pharmacy and Healthcare Products. SERMAS.. francisco.apolo@salud.madrid.org.
authors.forename: Encarnación
authors.initials: E
authors.lastname: Cruz Martos
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D002214:Capsules; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000458:organization & administration*; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D011446:Prospective Studies; D013607:Tablets
chemical_list: D002214:Capsules; D004364:Pharmaceutical Preparations; D013607:Tablets