Revision Multidisciplinar Del Tratamiento En Pacientes Mayores Institucionalizados En El Contexto De La Covid-19

Fermoso, Ana Gangoso; Carmen Herrero Domínguez-Berrueta, M; de Pipaon, Mireya Rey Pérez; Dahl, Alicia Barcena; Carreño, Blanca Basagoiti; Alcántara, Ana Díez

Objective: having a general practitioner in nursing homes (NHs) during the pandemic by COVID-19 has allowed a multidisciplinary intervention to systematically review medication in institutionalized elderly patients; the objective of this study is to evaluate the impact of this intervention in reducing the number of drugs/patient. Methods: a prospective multicenter study before-after of an intervention involving general practitioner and primare care pharmacists (PCP) in 4 NHs of less than 50 residents. A review algorithm was used to identify Drug-Related Problems (DRPs) that were part of the PCP recommendations. The degree of acceptance by the physician of these recommendations was measured. Results: 121 patients reviewed with a mean age of 86.1 years (SD:7.2); 87.6% were women. Of 98 patients analyzed, had an average of 9.4 (SD:4.0) drugs/patient, was reduced by -1.6 [CI 95% -1.3 to -1.9] p<0.001 after the intervention, the different was statistically significant. 409 DRPs were identified, an average of 4.2 per patient, who were part of a recommendation of which 316 (77.3%) were accepted. Most of the recommendations concerned deprescription or dose adjustment. Psycholeptics, antihypertensives and analgesics were the therapeutic groups most commonly involved in the detected DRPs. Conclusions: a statistically significant reduction in the mean number of drugs/patient following intervention has been observed. Many DRPs have been identified through the PCP review, which have mostly been accepted by the physician.