Monitoring polymedicated elderly patients in a health care unit

Abstract

Objective

To implement a coordinated strategy for the family care unit and the pharmacy division in order to enable revising treatment in polymedicated patients. To this end, we have developed a software tool permitting the patient's primary doctor to have a quick, summarised description of the patient's updated pharmacological treatments, and detect iatrogenic risks and/or dosage adjustments and pharmacotherapy advice.

Methods

In this study, polymedicated patients are defined as those taking 10 or more medications during at least one month.

Development phases:

Designing a guide form to assist the family doctor in reviewing treatments.

Developing a drug treatment report (DTR) as a complementary document to assist the doctor in reviewing treatments.

Introducing a coordinated communication system between the family doctor and the pharmacist.

Reviewing work instructions and distributing them to staff members involved.

Results

The target population of the study consists of 1897 polymedicated patients. We issued 1897 reports, containing the following: 8530 recommendations (10% alerts from regulatory authorities, 31% recommendations regarding high-risk drugs in elderly patients, 7% gave information about new treatments and 52% recommendations on proper drug use); 399 had high clinically relevant drug interactions; and 5036 dose adjustment recommendations. These pharmacotherapy reports allow treatment to be revised for nearly 100% of the selected population.

Conclusion

The development and implementation of software tools for monitoring polymedicated patients enables us to create DTRs that facilitate routine medical reviews of pharmacological treatment in a fairly wide range of patients.