dc.contributor |
Universitat de Vic - Universitat Central de Catalunya. Centre d'Estudis Sanitaris i Socials |
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dc.contributor |
Universitat de Vic - Universitat Central de Catalunya. Grup de Recerca en Cronicitat de la Catalunya Central (C3RG) |
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dc.contributor |
Universitat de Vic - Universitat Central de Catalunya. Grup de recerca en Reparació i Regeneració Tissular (TR2Lab) |
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dc.contributor |
Hospital Universitari de Vic |
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dc.contributor.author |
Molist Brunet, Núria |
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dc.contributor.author |
Sevilla Sánchez, Daniel |
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dc.contributor.author |
Puigoriol-Juvanteny, Emma |
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dc.contributor.author |
Barneto Soto, Matilde |
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dc.contributor.author |
González Bueno, Javier |
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dc.contributor.author |
Espaulella Panicot, Joan |
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dc.date.accessioned |
2024-02-09T07:43:02Z |
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dc.date.available |
2024-02-09T07:43:02Z |
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dc.date.created |
2022 |
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dc.date.issued |
2022 |
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dc.identifier.citation |
Gonzalez-Bueno, J., Sevilla-Sanchez, D., Puigoriol-Juvanteny, E., Molist-Brunet, N., Codina-Jane, C.,E spaulella-Panicot, J. (2022). Improving medication adherence and effective prescribing through a patient-centered prescription model in patients with multimorbidity. European Journal of Clinical Pharmacology, 78, 127-137. https://doi.org/10.1007/s00228-021-03207-9 |
es |
dc.identifier.issn |
0031-6970 |
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dc.identifier.uri |
http://hdl.handle.net/10854/7783 |
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dc.description |
REVIEW |
es |
dc.description.abstract |
Background Older patients tend to have multimorbidity, represented by multiple chronic diseases or geriatric conditions, which leads to a growing number of prescribed medications. As a result, pharmacological prescription has become a major concern because of the increased difficulties to ensure appropriate prescription in older adults. The study's main objectives were to characterize a cohort of older adults with multimorbidity, carry out a medication review and compare the pharmacological data before and after the medication review globally and according to the frailty index. Methods This was a quasi-experimental (uncontrolled pre-post) study with a cohort of patients >= 65 years old with multimorbidity. Data were collected from June 2019 to October 2020. Variables assessed included demographic, clinical, and pharmacological data, degree of frailty (Frail-VIG index), medication regimen complexity index, anticholinergic and or sedative burden index, and monthly drug expenditure. Finally, a medication review was carried out by an interdisciplinary team (primary care team and a consultant team with a geriatrician and a clinical pharmacist) by applying the Patient-Centered Prescription model to align the treatment with care goals. Results Four hundred twenty-eight patients were recruited [66.6% women; mean age 85.5 (SD 7.67)]. The mean frail index was 0.39 (SD 0.13), corresponding with moderate frailty. Up to 90% of patients presented at least one inappropriate prescription, and the mean of inappropriate prescriptions per patient was 3.14 (SD 2.27). At the three-month follow-up [mortality of 17.7% (n = 76)], the mean chronic medications per patient decreased by 17.96%, varying from 8.13 (SD 3.87) to 6.67 (SD 3.72) (p < 0.001). The medication regimen complexity index decreased by 19.03%, from 31.0 (SD 16.2) to 25.1 (SD 15.1), and the drug burden index mean decreased by 8.40%, from 1.19 (SD 0.82) to 1.09 (SD 0.82) (p < 0.001). A decrease in polypharmacy, medication regimen complexity index, and drug burden index was more frequent among frail patients, especially those with severe frailty (p < 0.001). Conclusions An individualized medication review in frail older patients, applying the Patient-Centered Prescription model, decreases pharmacological parameters related to adverse drug effects, such as polypharmacy, therapeutical complexity, and anticholinergic and, or sedative burden. The benefits are for patients with frailty. |
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dc.format |
application/pdf |
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dc.format.extent |
13 p. |
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dc.language.iso |
eng |
es |
dc.publisher |
BMC |
es |
dc.rights |
Aquest document està subjecte a aquesta llicència Creative Commons |
es |
dc.rights.uri |
https://creativecommons.org/licenses/by/4.0/deed.ca |
es |
dc.subject.other |
Medicaments -- Prescripció |
es |
dc.title |
Improving medication adherence and effective prescribing through a patient-centered prescription model in patients with multimorbidity |
es |
dc.type |
info:eu-repo/semantics/article |
es |
dc.identifier.doi |
https://doi.org/10.1007/s00228-021-03207-9 |
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dc.rights.accessRights |
info:eu-repo/semantics/openAccess |
es |
dc.type.version |
info:eu-repo/publishedVersion |
es |
dc.indexacio |
Indexat a WOS/JCR |
es |
dc.indexacio |
Indexat a SCOPUS |
es |