Effectiveness of Pharmacist Interventions in Improving Medication Use in Hospitalised Older Patients Diagnosed With Cardiovascular Diseases: INFAR Before-and-After Study
Romana Santos Gama, Luiz Carlos Passos, Welma Wildes Amorim, Renato Morais Souza, Marcio Galvão Oliveira
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Abstract
Objectives
This study aimed to assess the effectiveness of pharmacist interventions to reduce the omission of evidence-based cardiovascular medication, as well as polypharmacy and promote the deprescribing of potentially inappropriate medications in hospitalised older patients diagnosed with cardiovascular diseases.
Methods
This before-and-after study was conducted among patients aged ≥ 60 years (n = 319) at a cardiovascular hospital in Brazil. Pharmacists conducted medication reviews for these patients. The first prescription on hospital admission and that at discharge were collected and compared for prescribing omission, polypharmacy, and prescribing of potentially inappropriate medications.
Results
The mean patient age was 68.9 (±6.2) years. The mean incidences of prescribing potentially inappropriate medications and omissions decreased from 0.90 at admission to 0.10 at discharge (p < 0.001) and from 0.65 to 0.30 (p < 0.001), respectively. The number of potentially inappropriate medications prescribed decreased significantly, from 291 at admission to 28 at discharge, reflecting a 90% reduction. Additionally, the mean number of medications prescribed decreased from 9.8 to 6.5 (p < 0.001).
Conclusion
This study emphasises the role of medication reviews by clinical pharmacists in reducing polypharmacy, prescribing omissions, and inappropriate prescribing in older adults with cardiovascular diseases, demonstrating that targeted pharmacist interventions improve medication safety.
期刊介绍：
The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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