Revisión multidisciplinar del tratamiento en pacientes mayores institucionalizados en el contexto de la COVID-19

OBJECTIVE: Having a general practitioner in nursing homes during the pandemic by COVID-19 has allowed a multidisciplinary intervention to systematically review medication in institutionalized elderly patients; the objective of this study is to evaluate the impact of this intervention in reducing the number of drugs/patient. METHODS: A prospective multicenter study before-after of an intervention involving general practitioner and primare care pharmacists in 4 nursing homes of less than 50 residents. A review algorithm was used to identify Drug-Related Problems (DRPs) that were part of the primare care pharmacists recommendations. The degree of acceptance by the physician of these recommendations was measured. RESULTS: 121 patients reviewed with a mean age of 86.1 years (SD: 7.2); 87.6% were women. Of 98 patients analyzed, had an average of 9.4 (SD: 4.0) drugs/patient, was reduced by −1.6 [CI 95% −1.3 to −1.9] p < .001 after the intervention, the different was statistically significant. 409 DRPs were identified, an average of 4.2 per patient, who were part of a recommendation of which 316 (77.3%) were accepted. Most of the recommendations concerned deprescription or dose adjustment. Psycholeptics, antihypertensives and analgesics were the therapeutic groups most commonly involved in the detected DRPs. CONCLUSIONS: A statistically significant reduction in the mean number of drugs/patient following intervention has been observed. Many DRPs have been identified through the primare care pharmacists review, which have mostly been accepted by the physician.