Background In some regions, the pharmaceutical services at nursing homes are held by pharmacists from hospitals in the public network.
Purpose To determine the impact of medicines reconciliation on the prevalence of potentially inappropriate medicines (PIMs) in institutionalised elderly patients and to analyse the most frequently PIMs prescribed.
Material and methods Retrospective non-experimental study conducted between December 2014 and February 2015 at four nursing homes: two in which medicines reconciliation was performed and two others where it was not.
The prevalence of PIMs prescribed at the residences in which reconciliation was carried out was compared with the prescription at residences in which it was not. PIM frequency was analysed according to the list of drugs to be avoided in older adults (65 years old or older) included in the 2012 Beers criteria.
Results A total of 521 patients with a mean age of 83 years were included, 224 at nursing homes where reconciliation was conducted and 297 at residences in which it was not. In the first group of residences, there were 142 (63.4%) patients with inappropriate prescriptions compared with 203 (68.3%) in the other group. At homes where medicines reconciliation was carried out, the total number of prescriptions was 2182, and 239 (10.9%) were PIMs. In the other group of patients, the total number of prescriptions was 2849, and 12.8% (365) were inadequate (p < 0.05 vs reconciliation). The total number of different prescribed specialties which were inadequate for patients was 59 for patients in the medicines reconciliation group and 83 in the other group. For comparison of independent proportions, Epidat software version 3.1 was used.
The most frequently prescribed PIMs in the reconciliation group were lorazepam, bromazepam, alprazolam, zolpidem and quetiapine, and in the other group of patients, lorazepam, zolpidem, haloperidol, alprazolam and clorazepate dipotassium.
Conclusion The results of this study show a high prevalence of PIMs in institutionalised elderly patients, although residences with a medicines reconciliation programme had a lower percentage of elderly patients with PIMs and fewer inappropriate prescriptions. The total number of different inadequate specialties was also lower.
Regarding PIMs, lorazepam, zolpidem and alprazolam were among the five most commonly prescribed in both groups.
References and/or Acknowledgements
Beers Criteria Update
References and/or AcknowledgementsNo conflict of interest.
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