Improving the Quality of Pharmacotherapy in Elderly Primary Care Patients Through Medication Reviews: A Randomised Controlled Study

Milos, Veronica; Rekman, Eva; Bondesson, Åsa Åb; Eriksson, Tommy; Jakobsson, Ulf; Westerlund, Tommy; Midlöv, Patrik

doi:10.1007/s40266-013-0057-0

Cited by 130 publications

(209 citation statements)

References 37 publications

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“…The tendency for the prevalence in the use of psychiatric drugs is observed to rise according to subjects' age range. (11) Such finding corroborates the results found in this study. Thus, the analysis of data showed that the lower prevalence in the use of psychiatric drugs was found for the age range between 18 to 40 years (10.1%), followed by persons between 41 and 59 years of age (31.6%).…”

Section: Discussionsupporting

confidence: 91%

“…Notwithstanding, there is evidence that making use of more than one drug is common among psychiatric drug users. (6,11) Such aspect is particularly important, once those patients have higher risks of suffering from adverse effects and drug interactions. (2,11) The association between psychiatric drugs and Common Mental Disorders, revealed in this study, is confirmed by previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…(6,11) Such aspect is particularly important, once those patients have higher risks of suffering from adverse effects and drug interactions. (2,11) The association between psychiatric drugs and Common Mental Disorders, revealed in this study, is confirmed by previous studies. (5) Despite such association, one cannot help but notice, in this study, the fact that among the people who were negative for Common Mental Disorders, 15.1% made use of psychiatric drugs.…”

Section: Discussionmentioning

confidence: 99%

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Prevalência do uso de psicotrópicos e fatores associados na atenção primária à saúde

et al. 2015

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Objective: Investigating the prevalence in the use of psychotropics and associated factors in primary health care withsocio-demographic and pharmacotherapeutic factors, medical history, and Common Mental Disorders. Methods: A cross-section study which includes 430 primary health care patients. The research instruments were Self-reporting Questionnaires and medical records. A chi-squared test was used in the univariate analysis, and a logistic regression was used in the multivariate analysis. Results: The prevalence in the use of psychotropics was 25.8%. There was an association among the use of psychiatric drugs and common mental disorders, use of non-psychiatric drugs, number of medications prescribed,number of pills a day, clinical pathologies, age, and schooling. In the multivariate analysis, the predictors for the use of psychiatric drugs were: common mental disorders, clinical pathologies, and schooling. Conclusion: The prevalence in the use of psychiatric drugs and the associated factors varied according to the univariate or the multivariate analyses. ResumoObjetivo: Investigar a prevalência de uso de psicotrópicos e fatores associados na atenção primária à saúde com fatores sociodemográficos, farmacoterapêuticos, histórico de saúde e Transtornos Mentais Comuns. Método: Estudo transversal que incluiu 430 pacientes de atenção primária à saúde. O instrumento de pesquisa foi o Self-reporting Questionnaire e prontuários. Para análise, utilizou-se teste Qui-quadrado na análise univariada e regressão logística na multivariada. Resultados: A prevalência de uso de psicotrópicos foi de 25,8%. Houve associação entre uso de psicofármacos e transtornos mentais comuns, uso de medicamentos não psicofármacos, número de medicamentos prescritos, número de comprimidos/dia, patologias clínicas, idade e escolaridade. Na análise multivariada os preditores para uso de psicofármacos foram: transtornos mentais comuns, patologias clínicas e escolaridade. Conclusão: A prevalência de uso de psicofármacos e os fatores associados variaram conforme a análise uni ou multivariada.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalência do uso de psicotrópicos e fatores associados na atenção primária à saúde

et al. 2015

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“…The rate of MTPs identified in this study is a little lower than the rates identified in studies on elderly [23,27,[37][38][39], and much lower than the 8.2 MTPs per person identified in an Australian study on community-dwelling people with mental illnesses [40]. The Australian study used a different categorization of MTPs with a large number of subcategories, which will increase the number of MTPs.…”

Section: Discussionmentioning

confidence: 60%

Improving Safety in the Medicines Use Process for Disabled Persons in Residential Facilities. Results from a Pilot Study

Thomsen¹

2014

J Clinic Toxicol

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“…In Sweden, developed and implemented interventions include: the development of national quality prescribing indicators (256); the education of healthcare professionals to geriatric pharmacology and the creation of regional recommendations for drug therapy in the elderly by the Drug and Therapeutic Committees; computerised decision support systems (257); medication review in primary care and nursing homes (258,259); medication reconciliation at hospital discharge (260) and pharmacist-based interventions (261). Moreover, the Swedish government has provided financial incentives that award counties achieving performance targets for certain local prescribing indicators (262).…”

Section: Discussionmentioning

confidence: 99%

Inappropriate prescribing, non-adherence to long-term medications and related morbidities : Pharmacoepidemiological aspects

Hedna

2015

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Aim:The aim of this thesis is to estimate and analyse the burden of potentially inappropriate prescriptions (PIPs) in the elderly and non-adherence to long-term medications among adults across care settings, and to investigate how IUM is associated to DRMs. Methods:A meta-analysis summarised the previous evidence on the percentage of adverse drug reactions (ADRs) associated to IUM across healthcare settings (Study I). From a cohort in the general population, using medical records and register data, the prevalence of PIPs in the elderly and its association with ADRs were estimated retrospectively (Study II). From the same cohort, the factors associated with refill non-adherence to antihypertensive therapy, considering the use of multiple medications, and the association between non-adherence and sub-therapeutic effects (STEs) were investigated (Study III). A survey assessed the refill behaviour to antihypertensive, lipid lowering and oral antidiabetic medications (undersupply, adequate supply and oversupply), and its association with perceived ADRs and STEs (Study IV).Results: IUM was the cause 52% and 45% of ADRs occurring in adult outpatients and inpatients respectively. Across healthcare settings, 46% of the elderly refilled PIPs over a 6-month period;PIPs were considered the cause of 30% of all ADRs; and the elderly who were prescribed PIPs had increased odds to experience ADRs (OR 2.47, 95% CI 1.65-3.69). In total, 35% was nonadherent to the full multidrug therapy and 13% was non-adherent to any medication (complete vi non-adherence). Sociodemographic factors (working age and lower income) were associated with non-adherence to any medication, while clinical factors (use of specialised care, use of multiple medications, and being a new user) with non-adherence to the full multidrug therapy. STEs were associated with non-adherence to any medication a month prior to a healthcare visit (OR 3.27, 95% CI 1.27-8.49), but not with long-term measures of non-adherence. Among survey respondents, 22% of the medications were oversupplied and 12% were undersupplied. Inadequate refill behaviour was not associated with reporting ADRs or STEs (p<0.05). Conclusions:A large proportion of ADRs occurring in hospital is caused by IUM, but more knowledge is needed in other settings. PIPs are common in the elderly general population and associated with ADRs. Therefore decreasing PIPs could contribute towards ADR prevention.Considering the use of multiple medications may help to better understand the factors associated with non-adherence to a multidrug therapy for tailoring the interventions to patient needs.Monitoring the adherence prior to a healthcare visit may facilitate interpreting STEs. Yet, the absence of an association between long-term measures of refill non-adherence with clinical and perceived DRMs suggest the need to enhance the knowledge of this association in clinical practice.In summary, this thesis shows a significant potential for improvements of medication use and outcomes.Key words: Drug-related morbidity, medica...

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Improving the Quality of Pharmacotherapy in Elderly Primary Care Patients Through Medication Reviews: A Randomised Controlled Study

Abstract: Medication reviews involving pharmacists in primary health care appear to be a feasible method to reduce the number of patients with PIMs, thus improving the quality of pharmacotherapy in elderly patients.

Cited by 130 publications

References 37 publications

Prevalência do uso de psicotrópicos e fatores associados na atenção primária à saúde

Prevalência do uso de psicotrópicos e fatores associados na atenção primária à saúde

Improving Safety in the Medicines Use Process for Disabled Persons in Residential Facilities. Results from a Pilot Study

Inappropriate prescribing, non-adherence to long-term medications and related morbidities : Pharmacoepidemiological aspects

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