Poster presented at the Pharmaceutical Care Network Europe (PCNE) Working Symposium: Medication review, Drug-related problems, Standards and Guidelines, 2014, Sliema (Malta)Egas Moniz - Cooperativa de Ensino Superior CRL; Ordem dos Farmacêuticos

Carneiro, C.

Cavaco Silva, P.

Costa, F. A.

Fernandes, A. I.

Miranda, I.

Periquito, C.

Silvestre, L.

Taveira, N.

English

Poster presented at the Pharmaceutical Care Network Europe (PCNE) Working Symposium: Medication review, Drug-related problems, Standards and Guidelines, 2014, Sliema (Malta)Egas Moniz - Cooperativa de Ensino Superior CRL; Ordem dos Farmacêuticos.SOS Pharma Idos

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Changes have been made according to difficulties encountered so far., e.g. Recruitment sites and patients age. Medicines review in the elderlyCosta, F.A.1,2, Miranda, I. 1, Periquito, C. 1, Silvestre, L. 1, Cavaco Silva, P. 1,2, Fernandes, A.I. 1,2, Carneiro, C. 1, Taveira, N. 11ISCSEM, 1,2CiiEMBackground ResultsAimsDiscussionReferencesPortuguese population is  double-aging, with a current aging index of 129.4%, the 5th highest in Europe1. Old age is often associated with a high comorbidity index, polymedication and various DRPs, including adherence problems and potentially inappropriate medications (PIMs). Pharmacists have a role in medicines review of these patients and several tools have been developed to assist  them in such task2,4 .  • To develop a university-based programme where students actively engage in managing the medication of elderly patients. • To test the feasibility of such approach.•To evaluate the impact of medication review on patient outcomes (clinical and humanistic).Multicentred trialResidentialfacilitiesDay CareCentresCommunityPharmaciesPatients’ inclusion criteriaAge ≥ 65 y.o.Taking ≥ 5 medsAge ≥ 65 y.o.Taking ≥ 5 medicinesLiving alone or with spouseConscientiously agreeing to participateStudy designRCT Quasi-experimentalMethodsInterventions1)Identificationof DRPs22)Identification ofPIMs3,4 andPotentially OmitMedicines(POMs)41, 2 and 3) multicompartimentaladherence aids (DAA system) to be delivered weekly1. Pordata. Contemporanous Portugal Database. “Aging Index in Europe”. [Visited01/2014] Availableat http://www.pordata.pt/Europa/Indice+de+envelhecimento-16092. Comite de Consenso GIAF-UGR, GIFAF-USE, GIF-UGR. Third Consensus of Granada on Drug Related Problems (DRP) and Negative Outcomes associated with Medication (NOM). Ars Pharm 2007; 48 (1): 5-173. Campanelli , C.M. American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults: The American Geriatrics Society 2012 Beers Criteria Update Expert Panel. J Am Geriatr Soc. 2012 April ; 60(4): 616–6314. Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D. STOPP (screening tool ofolder person’s prescriptions and START (screening tool to alert doctors to righttreatment). Consensus validation. Int J Clin Pharmacol Ther 2008; 46: 72-83.Patient follow-up=3 monthsOutcome measures: adherence (pill-count and MMAS-4); PIMs detected and removed; POMs detected and added; proxy measures when appropriate (e.g. Glycemia, B.P.)Invited to participate4 Residentialfacilities3 Day CareCentres28 CommunityPharmaciesAccepted to participateServices offered are provided bysociologists (n=2)Too many researchprojects (n=1)Intervention(n=7)Control (n=5)Total # patients= 226# patientsmeetinginclusioncriteria=163Intervention(n=82)Control(n=81)While the interventions designed were planned to be theoretically more useful for patients livingalone, the difficulty found in recruitment sites is shifting the focus from home medicinesreview to residential medicines review.Students are motivated with this project and haveoffered to become active parts in site recruitment.Working Symposium of the Pharmaceutical Care Network Europe (PCNE). Malta, 14-15 March 20144 Residentialfacilities0 Day CareCentres12 CommunityPharmaciesShort of staff (n=3)Waiting for decision (n=13)Table 1: Baseline characteristics of residential patients (3 facilities) Intervention Control p  n (%) n (%)  Gender (female) 31 (48.4%) 33 (51.6%) 0.547  M (SD) M (SD)  Age 84.91 (6.738) 83.72 (6.825) 0.413 Comoribidities 4.09 (1.998) 4.45 (2.050) 0.409 Number of medicines 9.89 (4.877) 9.67 (3.797) 0.816 Daily dosages 11.39 (7.268) 11.70 (4.998) 0.819  

Medicines review in the elderly

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Medicines review in the elderly

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