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General and Risk Management, Patient Safety (including: medication errors, quality control)
Comprehensive review of pharmacological treatment in polymedicated elders
  1. J. Gallardo-Anciano,
  2. A. Marauri-Baños,
  3. F. Bonachia-Caballero,
  4. M.J. Aza-Pascual-Salcedo,
  5. C. Saenz-Pastor,
  6. C. Borra-Ruiz,
  7. M. Blazquez-Bea,
  8. M.T. Barajas-Santos
  1. 1San Pedro Hospital, Hospital Pharmacy, Logroño, Spain
  2. 2Consejería Salud, Atención Farmacéutica, Logroño, Spain
  3. 3Consejería Salud, Ordenación Farmacéutica, Logroño, Spain
  4. 4Consejería Salud, Dirección General de Farmacia, Logroño, Spain
  5. 5Medicina Familia, Centro de Salud Labradores, Logroño, Spain


Background The progressive ageing of the population with associated polymedication is an emergent problem of funding and safety. Many drugs handled by general practitioners (GPs) are initiated by specialists.

Purpose To report on the results of a system used in a health centre in which hospital pharmacists review patients' drug treatments in order to improve prescribing and use of drugs in polymedicated older patients.

Materials and methods Reviewing criteria: >75-year-old patients with >6 prescribed medicines. Hospital pharmacists reviewed primary care (PC) and specialist care (SC) clinical histories and prepared a report, including recommendations, on indication, dose, regimen, duration, interactions, duplications, fulfilment of therapeutic goals, monitoring of adverse effects, dosage adjustment in renal insufficiency, more efficient alternatives, suitability based on STOPP/START criteria and adherence. The doctors were invited to change the prescriptions in the light of this information.

GRP101 Table 1

Treatment modifications

Results Study period: March to September 2011. 31 patients were followed up. Mean age: 83 years (76–99), drugs before the review: 8.9 per patient (pp) (6–15), drugs after: 8.1 pp (0–14), pharmacy recommendations: six pp, 57.1% accepted by the physician, €1500 annual savings.

Conclusions A review of the complete treatment was a valid method, since it detected unnecessary medicines, points of improvement in prescribing and resulted in money saved. The hospital pharmacist collated the drug treatments generated by PC and SC which helped in decision making during the prescription process.

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