Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approach
Background: Aging correlates with increased frailty, multi-morbidity, and chronic diseases. Furthermore, treating the aged often entails polypharmacy to achieve optimal disease management, augmenting medication-related problems (MRPs). Few guidelines and tools address the problem of polypharmacy and...
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| Format: | Article |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1320490/full |
| _version_ | 1827321007706210304 |
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| author | Emilie Anderssen-Nordahl Emilie Anderssen-Nordahl Emilie Anderssen-Nordahl Margarita Sánchez-Arcilla Rosanas Montserrat Bosch Ferrer Montserrat Bosch Ferrer Montserrat Bosch Ferrer Mònica Sabaté Gallego Mònica Sabaté Gallego Mònica Sabaté Gallego Eladio Fernández-Liz Eladio Fernández-Liz Antonio San-José Maria Estrella Barceló-Colomer Maria Estrella Barceló-Colomer |
| author_facet | Emilie Anderssen-Nordahl Emilie Anderssen-Nordahl Emilie Anderssen-Nordahl Margarita Sánchez-Arcilla Rosanas Montserrat Bosch Ferrer Montserrat Bosch Ferrer Montserrat Bosch Ferrer Mònica Sabaté Gallego Mònica Sabaté Gallego Mònica Sabaté Gallego Eladio Fernández-Liz Eladio Fernández-Liz Antonio San-José Maria Estrella Barceló-Colomer Maria Estrella Barceló-Colomer |
| author_sort | Emilie Anderssen-Nordahl |
| collection | DOAJ |
| description | Background: Aging correlates with increased frailty, multi-morbidity, and chronic diseases. Furthermore, treating the aged often entails polypharmacy to achieve optimal disease management, augmenting medication-related problems (MRPs). Few guidelines and tools address the problem of polypharmacy and MRPs, mainly within the institutionalized elderly population. Routine pharmacological review is needed among institutionalized patients. This pharmacological review may improve with a multidisciplinary approach of a collaboration of multiple health professionals. This study aimed to describe institutionalized patients, systematically review their medication plans, and then give recommendations and identify MRPs.Methods: A cross-sectional study was performed using data obtained from patients living in five nursing homes in the northern area of Barcelona, Spain. The inclusion criteria comprised institutionalized patients with public health coverage provided by the Health Department of Catalonia. A detailed description of the clinical characteristics, chronic diseases, pharmacological treatments, recommendations, incomplete data, and MRPs, such as potential drug–drug interactions, therapeutic duplications, contraindications, and drugs deemed inappropriate or of doubtful efficacy, was made. The clinical pharmacologist was the medical doctor specialist who acted as the coordinator of the multidisciplinary team and actively reviewed all the prescribed medications to make recommendations and detect MRPs.Results: A total of 483 patients were included. Patients had a mean age of 86.3 (SD 8.8) years, and 72.0% were female individuals. All patients had at least three health-related problems, with a mean of 17.4 (SD 5.6). All patients, except one, had a minimum of one prescription, with a mean of 8.22 drugs prescribed (SD 3.5) per patient. Recommendations were made for 82.4% of the patients. Of these recommendations, verification of adequate use was made for 69.3% and withdrawal of a drug for 49.5%.Conclusion: This study demonstrates a high prevalence of health-related problems and several prescribed drugs in nursing homes in Catalonia. Many recommendations were made, confirming the increased proportion of polypharmacy, MRPs, and the need for standardized interventions. A multidisciplinary team approach, including general practitioners, geriatric assessments, a clinical pharmacist, and a clinical pharmacologist, should address this problem. |
| first_indexed | 2024-04-25T00:58:50Z |
| format | Article |
| id | doaj.art-f1d8a853cc2844fc901e5bd031006e1d |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-25T00:58:50Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-f1d8a853cc2844fc901e5bd031006e1d2024-03-11T07:25:16ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122024-03-011510.3389/fphar.2024.13204901320490Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approachEmilie Anderssen-Nordahl0Emilie Anderssen-Nordahl1Emilie Anderssen-Nordahl2Margarita Sánchez-Arcilla Rosanas3Montserrat Bosch Ferrer4Montserrat Bosch Ferrer5Montserrat Bosch Ferrer6Mònica Sabaté Gallego7Mònica Sabaté Gallego8Mònica Sabaté Gallego9Eladio Fernández-Liz10Eladio Fernández-Liz11Antonio San-José12Maria Estrella Barceló-Colomer13Maria Estrella Barceló-Colomer14Clinical Pharmacology Service, Vall d’Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, Barcelona, SpainClinical Pharmacology Group, Vall d’Hebron Research Institute, Barcelona, SpainDepartment of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, SpainGeriatric Unit, Internal Medicine Service, Vall d'Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, Barcelona, SpainClinical Pharmacology Service, Vall d’Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, Barcelona, SpainClinical Pharmacology Group, Vall d’Hebron Research Institute, Barcelona, SpainDepartment of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, SpainClinical Pharmacology Service, Vall d’Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, Barcelona, SpainClinical Pharmacology Group, Vall d’Hebron Research Institute, Barcelona, SpainDepartment of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, SpainPrimary Healthcare Barcelona, Management of Primary Care and the Community of Barcelona City, Catalan Institute of Health, Barcelona, SpainFoundation University Institute for Research in Primary Healthcare Jordi Gol i Gurina (IDIAPJGol), Barcelona, SpainGeriatric Unit, Internal Medicine Service, Vall d'Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, Barcelona, SpainPrimary Healthcare Barcelona, Management of Primary Care and the Community of Barcelona City, Catalan Institute of Health, Barcelona, SpainFoundation University Institute for Research in Primary Healthcare Jordi Gol i Gurina (IDIAPJGol), Barcelona, SpainBackground: Aging correlates with increased frailty, multi-morbidity, and chronic diseases. Furthermore, treating the aged often entails polypharmacy to achieve optimal disease management, augmenting medication-related problems (MRPs). Few guidelines and tools address the problem of polypharmacy and MRPs, mainly within the institutionalized elderly population. Routine pharmacological review is needed among institutionalized patients. This pharmacological review may improve with a multidisciplinary approach of a collaboration of multiple health professionals. This study aimed to describe institutionalized patients, systematically review their medication plans, and then give recommendations and identify MRPs.Methods: A cross-sectional study was performed using data obtained from patients living in five nursing homes in the northern area of Barcelona, Spain. The inclusion criteria comprised institutionalized patients with public health coverage provided by the Health Department of Catalonia. A detailed description of the clinical characteristics, chronic diseases, pharmacological treatments, recommendations, incomplete data, and MRPs, such as potential drug–drug interactions, therapeutic duplications, contraindications, and drugs deemed inappropriate or of doubtful efficacy, was made. The clinical pharmacologist was the medical doctor specialist who acted as the coordinator of the multidisciplinary team and actively reviewed all the prescribed medications to make recommendations and detect MRPs.Results: A total of 483 patients were included. Patients had a mean age of 86.3 (SD 8.8) years, and 72.0% were female individuals. All patients had at least three health-related problems, with a mean of 17.4 (SD 5.6). All patients, except one, had a minimum of one prescription, with a mean of 8.22 drugs prescribed (SD 3.5) per patient. Recommendations were made for 82.4% of the patients. Of these recommendations, verification of adequate use was made for 69.3% and withdrawal of a drug for 49.5%.Conclusion: This study demonstrates a high prevalence of health-related problems and several prescribed drugs in nursing homes in Catalonia. Many recommendations were made, confirming the increased proportion of polypharmacy, MRPs, and the need for standardized interventions. A multidisciplinary team approach, including general practitioners, geriatric assessments, a clinical pharmacist, and a clinical pharmacologist, should address this problem.https://www.frontiersin.org/articles/10.3389/fphar.2024.1320490/fullmedication reviewfrail elderlynursing homesmedication therapy managementpolypharmacypotentially inappropriate medication list |
| spellingShingle | Emilie Anderssen-Nordahl Emilie Anderssen-Nordahl Emilie Anderssen-Nordahl Margarita Sánchez-Arcilla Rosanas Montserrat Bosch Ferrer Montserrat Bosch Ferrer Montserrat Bosch Ferrer Mònica Sabaté Gallego Mònica Sabaté Gallego Mònica Sabaté Gallego Eladio Fernández-Liz Eladio Fernández-Liz Antonio San-José Maria Estrella Barceló-Colomer Maria Estrella Barceló-Colomer Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approach Frontiers in Pharmacology medication review frail elderly nursing homes medication therapy management polypharmacy potentially inappropriate medication list |
| title | Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approach |
| title_full | Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approach |
| title_fullStr | Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approach |
| title_full_unstemmed | Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approach |
| title_short | Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approach |
| title_sort | pharmacological treatments and medication related problems in nursing homes in catalonia a multidisciplinary approach |
| topic | medication review frail elderly nursing homes medication therapy management polypharmacy potentially inappropriate medication list |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1320490/full |
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