Background In our region, the pharmaceutical services at nursing homes (NHs) are run by pharmacists from hospitals in the public network. Furthermore, the prescription system in NHs is based on collaboration between general practitioners (GPs) working at NHs and a team of GPs from the National Health Care System specialising in elderly patients.
Purpose To determine if prescriptions proposed by GPs at NHs are appropriate to the clinical needs of institutionalised elderly patients.
Material and methods This was a prospective study conducted between March and June 2016. NHs in the reference area of two tertiary hospitals were studied. The study population was patients admitted for the first time to one of the NHs. Our pharmacy unit created a database to register the following: home medication, medication proposed at NH and medications proposed for revision. Four revision categories were created: safety, indication, adequacy and other. The team of GPs from the National Health Care System specialising in elderly patients entered the database to indicate if revisions were justified. Justified revisions involved the modification of the prescriptions proposed by GPs from the NHs.
Results 102 patients with a mean age of 81 years were included (72.5% women). 971 prescriptions were studied. Pharmacists registered 505 prescriptions suitable for revision: 25.1% (127) adequacy; 24.6% (124) indication; 17.4% (88) safety; and 32.9% (166) other. 96% of patients had at least one proposed prescription revised. 74.6% of proposed revisions were accepted as justified by the team of GPs specialising in elderly patients. The percentage of acceptance according to each category was 70% (89) adequacy; 64.5% (80) indication; 72.7% (64) safety; and 86.7% (144) other.
Conclusion Prescriptions proposed by GPs at NHs had a high degree of lack of adjustment to the needs of the elderly population due to their special characteristics. Collaboration between hospital pharmacists and a team of specialist GPs is needed for the possibility of improving the pharmacotherapy in elderly populations.
No conflict of interest
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