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Medication discrepancies and potentially inadequate prescriptions in elderly adults with polypharmacy in ambulatory care

OBJECTIVES: The objective of this study is to describe the frequency and type of medication discrepancies (MD) through medication reconciliation and to describe the frequency of potentially inadequate prescription (PIP) medications using screening tool of older persons’ prescriptions criteria. DESIG...

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Autores principales: Franco, Juan Víctor Ariel, Terrasa, Sergio Adrián, Kopitowski, Karin Silvana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5629905/
https://www.ncbi.nlm.nih.gov/pubmed/29026754
http://dx.doi.org/10.4103/2249-4863.214962
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author Franco, Juan Víctor Ariel
Terrasa, Sergio Adrián
Kopitowski, Karin Silvana
author_facet Franco, Juan Víctor Ariel
Terrasa, Sergio Adrián
Kopitowski, Karin Silvana
author_sort Franco, Juan Víctor Ariel
collection PubMed
description OBJECTIVES: The objective of this study is to describe the frequency and type of medication discrepancies (MD) through medication reconciliation and to describe the frequency of potentially inadequate prescription (PIP) medications using screening tool of older persons’ prescriptions criteria. DESIGN: Cross-sectional comparison of electronic medical record (EMR) medication lists and patient's self-report of their comprehensive medication histories obtained through telephone interviews. INCLUSION CRITERIA: Elderly individuals (>65 years old) with more than ten medications recorded in their EMR, who had not been hospitalized in the past year and were not under domiciliary care, affiliated to a private community hospital. OUTCOME MEASURES: The primary outcomes were the proportion of patients with MD and PIP. Secondary outcomes were the proportion of types of discrepancies and PIP. We analyzed possible associations between these variables and other demographic and clinical variables. RESULTS: Out of 214 randomly selected individuals, 150 accepted to participate (70%). The mean number of medications referred to be consumed by patients was 9.1 (95% confidence interval [CI] =8.6–9.6), and the mean number of prescribed medications in their EMR was 13.9 (95% CI = 13.3–14.5). Ninety-nine percent had at least one discrepancy (total 1252 discrepancies); 46% consumed at least one prescription not documented in their EMR and 93% did not consume at least one of the prescriptions documented in their EMR. In 77% of the patients, a PIP was detected (total 186), 87% of them were at least within one of the following categories: Prolonged used of benzodiazepines or proton pump inhibitors and the use of aspirin for the primary prevention of cardiovascular disease. CONCLUSIONS: There was a high prevalence of MD and PIP within the community of elderly adults affiliated to a Private University Hospital. Future interventions should be aimed at reducing the number of PIP to prevent adverse drug events and improve EMR accuracy by lowering medications discrepancies.
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spelling pubmed-56299052017-10-12 Medication discrepancies and potentially inadequate prescriptions in elderly adults with polypharmacy in ambulatory care Franco, Juan Víctor Ariel Terrasa, Sergio Adrián Kopitowski, Karin Silvana J Family Med Prim Care Original Article OBJECTIVES: The objective of this study is to describe the frequency and type of medication discrepancies (MD) through medication reconciliation and to describe the frequency of potentially inadequate prescription (PIP) medications using screening tool of older persons’ prescriptions criteria. DESIGN: Cross-sectional comparison of electronic medical record (EMR) medication lists and patient's self-report of their comprehensive medication histories obtained through telephone interviews. INCLUSION CRITERIA: Elderly individuals (>65 years old) with more than ten medications recorded in their EMR, who had not been hospitalized in the past year and were not under domiciliary care, affiliated to a private community hospital. OUTCOME MEASURES: The primary outcomes were the proportion of patients with MD and PIP. Secondary outcomes were the proportion of types of discrepancies and PIP. We analyzed possible associations between these variables and other demographic and clinical variables. RESULTS: Out of 214 randomly selected individuals, 150 accepted to participate (70%). The mean number of medications referred to be consumed by patients was 9.1 (95% confidence interval [CI] =8.6–9.6), and the mean number of prescribed medications in their EMR was 13.9 (95% CI = 13.3–14.5). Ninety-nine percent had at least one discrepancy (total 1252 discrepancies); 46% consumed at least one prescription not documented in their EMR and 93% did not consume at least one of the prescriptions documented in their EMR. In 77% of the patients, a PIP was detected (total 186), 87% of them were at least within one of the following categories: Prolonged used of benzodiazepines or proton pump inhibitors and the use of aspirin for the primary prevention of cardiovascular disease. CONCLUSIONS: There was a high prevalence of MD and PIP within the community of elderly adults affiliated to a Private University Hospital. Future interventions should be aimed at reducing the number of PIP to prevent adverse drug events and improve EMR accuracy by lowering medications discrepancies. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5629905/ /pubmed/29026754 http://dx.doi.org/10.4103/2249-4863.214962 Text en Copyright: © 2017 Journal of Family Medicine and Primary Care http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Franco, Juan Víctor Ariel
Terrasa, Sergio Adrián
Kopitowski, Karin Silvana
Medication discrepancies and potentially inadequate prescriptions in elderly adults with polypharmacy in ambulatory care
title Medication discrepancies and potentially inadequate prescriptions in elderly adults with polypharmacy in ambulatory care
title_full Medication discrepancies and potentially inadequate prescriptions in elderly adults with polypharmacy in ambulatory care
title_fullStr Medication discrepancies and potentially inadequate prescriptions in elderly adults with polypharmacy in ambulatory care
title_full_unstemmed Medication discrepancies and potentially inadequate prescriptions in elderly adults with polypharmacy in ambulatory care
title_short Medication discrepancies and potentially inadequate prescriptions in elderly adults with polypharmacy in ambulatory care
title_sort medication discrepancies and potentially inadequate prescriptions in elderly adults with polypharmacy in ambulatory care
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5629905/
https://www.ncbi.nlm.nih.gov/pubmed/29026754
http://dx.doi.org/10.4103/2249-4863.214962
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