Author:
Salom-Garrigues Clara,Aragonès Enric,Giralt Montse,Campabadal Prats Cecília,Bejarano-Romero Ferran,Canadell Laura
Abstract
Abstract
Background
ATDOM is the Catalan home healthcare program at primary care level. Patients in the home care program are usually frail, elderly people with multiple comorbidities. They are often polymedicated, leading to a high risk of drug-related problems (DRPs). Our hypothesis is that the pharmacist-led individualized review of the pharmacotherapeutic plans of ATDOM patients will be effective in improving the quality of treatments by reducing DRPs in terms of indication, adequacy, effectiveness, and safety.
Methods
Aim: To compare the effectiveness of a standardized pharmaceutical intervention for the review and optimization of pharmacological treatments in ATDOM patients with usual management practice.
Design: Pragmatic randomized clinical trial with a comparable control group, with prospective follow-up regarding the intervention on the adequacy of the pharmacological treatment of patients in the ATDOM program.
Setting: Primary care teams in the Camp de Tarragona Primary Care Area, Tarragona, Spain.
Participants: Four hundred and thirty-two ATDOM patients will be recruited, those who are over 65 years old and who are currently undergoing pharmacological treatment.
Measures: Effectiveness of a six-month long intervention in reducing DRPs per patient and polypharmacy. Additionally, in the intervention group we will evaluate the implementation of the proposals for change or improvement made by the responsible physician.
Analysis: The outcomes will be analyzed on an intent-to-treat basis and the analysis units will be the individual patients. Logistic regression and linear regression models will be used to evaluate the effects of the intervention on dichotomous and continuous variables versus the control arm.
Ethics: The protocol was approved by the Research Ethics Committee of the Jordi Gol Primary Care Research Institute (IDIAPJGol), Barcelona, (19/141-P).
Discussion
If the results of the pharmaceutical intervention are favorable, widespread implementation of the program could be possible. It could be extended to all ATDOM patients or outpatients in general. Interdisciplinary teamwork could be strengthened as a result, which would improve the healthcare continuum.
Trial registration
Retrospectively registered. ClinicalTrials.gov Identifier NCT05820945; Registered 21 March, 2023.
Funder
Jordi Gol Primary Care Research Institute (IDIAPJGol), Barcelona, Spain
Publisher
Springer Science and Business Media LLC
Reference44 articles.
1. Comité de Consenso GIAF-UGR, GIFAF-USE, GIF-UGR. Tercer consenso de Granada sobre problemas relacionados con los medicamentos (PRM) y resultados negativos asociados a la medicacion (RNM). Ars Pharm. 2007;48(1):5‑17.
2. Güemes Artiles M, Sanz Alvarez E, Garcia S-C. Reacciones adversas y problemas relacionados con medicamentos en un servicio de urgencia. Rev Esp Salud Publica. 1999;73(4):511–8.
3. Parody Rúa E, Segu Tolosa JL. Efectividad y estimación de costes en una intervención sobre problemas relacionados con los medicamentós en atencion primaria. Aten Primaria. 2005;35(9):472–7.
4. Krähenbühl-Melcher A, Schlienger R, Lampert M, Haschke M, Drewe J, Krähenbühl S. Drug-related problems in hospitals. A review of the recent literature. Drug Safety. 2007;30(5):379–407.
5. Ni XF, Yang CS, Bai YM, Hu ZX, Zhang LL. Drug-related problems of patients in primary health care institutions: a systematic review. Front Pharmacol. 2021;12:698907.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献