AUTHOR=Anderssen-Nordahl Emilie , Sánchez-Arcilla Rosanas Margarita , Bosch Ferrer Montserrat , Sabaté Gallego Mònica , Fernández-Liz Eladio , San-José Antonio , Barceló-Colomer Maria Estrella 

TITLE=Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approach

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1320490

DOI=10.3389/fphar.2024.1320490

ISSN=1663-9812

ABSTRACT=Background: Aging correlates with increased frailty, multimorbidity 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 institutionalized elderly. Routine pharmacological review is needed among institutionalized patients. This pharmacological review may improve with a multidisciplinary approach of multiple health professionals collaborating. This study was aimed to describe institutionalized patients and systematically review their medication plans, to then give recommendations and identify MRPs.A cross-sectional study was performed using data from patients living in 5 nursing homes, in the North area of Barcelona, Spain. The inclusion criteria was 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. All patients had at least 3 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%.This study demonstrates a high prevalence of health-related problems and number of 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 assessment, a clinical pharmacist, and a clinical pharmacologist should address this problem.