Background and importance High alert medications are those that, when they are not being properly used, are more likely to cause serious or even fatal harm to patients. Chronic patients are especially vulnerable to these possible errors because of their comorbidity and polypharmacy. The Ministry of Health, Social Services and Equality of Spain promotes the implementation of improving safe practices for those patients. In 2014, a panel of experts developed a list of high alert drugs for chronic patients to prioritise practices for improving safety in these patients. This list was named the HAMC list (high alert medications for patients with chronic illnesses) and was published by the Ministry of Health, Social Services and Equality of Spain.
Aim and objectives To analyse the prevalence of prescribed medications included in the HAMC list in a nursing home.
Material and methods A descriptive, transversal, retrospective study was carried out in September 2020 that included all residents with chronic illnesses in a nursing home assigned to our pharmacy service. Variables recorded were: demographic data, number of prescribed medicaments, and number and type of prescribed medicaments included in the HAMC list.
Results 81 patients were included (59 men) with a mean age of 72 (56–94) years. 721 drugs were prescribed, and 186 were included in the HAMC list. At least 1 HAMC was prescribed in 86% of patients, with a mean of 3 HAMC per patient (1–7). The therapeutic groups of the drugs on the HAMC that were prescribed were: benzodiazepines (63% of patients), inhibitors of platelet aggregation (36%), antipsychotics (26%), beta-adrenergic blockers (26%), oral hypoglycaemics agents (26%), loop diuretics (19%), oral anticoagulants (11%), antiepileptics (9%), opioids (9%), including minor and major opioids, insulin (7%), eplerenone/spironolactone (7%), immunosuppressants (1%) and non-steroidal anti-inflammatory drugs (1%).
Conclusion and relevance HAMC were widely prescribed. Benzodiazepines were the therapeutic group most prescribed from the HAMC list in our population, followed by antiplatelets and antipsychotics. The HAMC list is a useful tool for a first approach in the detection of patients who may be at a higher risk of serious harms if medication errors occur. Implementation of specific safe practices for those drugs could reduce potential or real errors in these patients.
Conflict of interest No conflict of interest
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