[Interventions to optimize pharmacologic treatment in hospitalized older adults: a systematic review].

Abstract:

OBJECTIVE:To summarise the evidence on interventions aimed at optimising the drug treatment of hospitalised elderly patients. MATERIAL AND METHODS:We conducted a search in the main medical literature databases, selecting prospective studies of hospitalised patients older than 65 years who underwent interventions aimed at optimising drug treatment, decreasing polypharmacy and improving the medication appropriateness, health outcomes and exploitation of the healthcare system. RESULTS:We selected 18 studies whose interventions consisted of medication reviews, detection of predefined drugs as potentially inappropriate for the elderly, counselling from a specialised geriatric team, the use of a computer support system for prescriptions and specific training for the nursing team. Up to 14 studies assessed the medication appropriateness, 13 of which showed an improvement in one or more of the parameters. Seven studies measured the impact of the intervention on polypharmacy, but only one improved the outcomes compared with the control. Seven other studies analysed mortality, but none of them showed a reduction in that rate. Only 1 of 6 studies showed a reduction in the number of hospital readmissions, and 1 of 4 studies showed a reduction in the number of emergency department visits. CONCLUSIONS:Despite the heterogeneity of the analysed interventions and variables, we obtained better results in the process variables (especially in medication appropriateness) than in those that measured health outcomes, which had greater variability.

journal_name

Rev Clin Esp

journal_title

Revista clinica espanola

authors

Gutiérrez Valencia M,Martínez Velilla N,Lacalle Fabo E,Beobide Telleria I,Larrayoz Sola B,Tosato M

doi

10.1016/j.rce.2016.01.005

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

205-21

issue

4

eissn

0014-2565

issn

1578-1860

pii

S0014-2565(16)00008-4

journal_volume

216

pub_type

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