Potentially inappropriate medication use in a comprehensive therapy management service: clinical outcomes and interventions
Main Author: | |
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Publication Date: | 2022 |
Other Authors: | , , , , , |
Format: | Article |
Language: | eng |
Source: | Brazilian Journal of Pharmaceutical Sciences |
Download full: | https://www.revistas.usp.br/bjps/article/view/205059 |
Summary: | This study aimed to describe potentially inappropriate medication (PIM) use according to the Beers criteria among older adults followed in a comprehensive medication management (CMM) service, the pharmacists´ interventions, and the clinical outcomes of PIM use. All older adults in a CMM service delivered in the Brazilian public primary care system were included in the study (n = 389). Two methodological approaches were developed: (I) cross-sectional - prevalence of PIM use and associated factors were identified (univariate analysis - Pearson’s chi-square; multivariate - logistic regression); (II) documental analysis of the negative clinical outcomes potentially associated with PIM use and pharmacists’ interventions. The prevalence of PIM use was 48.3%, and it was independently and positively associated with the use of ≥ 5 drugs. For 21.3% of PIMs, a potential negative clinical outcome was identified. The most common negative clinical outcome was hypotension (35.1% of the negative outcomes), fractures or diagnosis of osteoporosis (21.1%), and hypoglycemia (14.0%). For most of them (78.9%), an intervention was performed to mitigate harm or discontinue use. A high prevalence of PIM was detected and was associated with polypharmacy. A significant proportion of PIM showed potential negative clinical outcomes that were identified by clinical pharmacists, and the majority of pharmacists’ interventions aimed at its mitigation or deprescription. Overall, our findings reinforce the potential of CMM services for reducing PIM use and the occurrence of negative outcomes. |
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Brazilian Journal of Pharmaceutical Sciences |
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Potentially inappropriate medication use in a comprehensive therapy management service: clinical outcomes and interventionsBrazilAgedMedication therapy managementPotentially inappropriate medication listPharmaceutical careThis study aimed to describe potentially inappropriate medication (PIM) use according to the Beers criteria among older adults followed in a comprehensive medication management (CMM) service, the pharmacists´ interventions, and the clinical outcomes of PIM use. All older adults in a CMM service delivered in the Brazilian public primary care system were included in the study (n = 389). Two methodological approaches were developed: (I) cross-sectional - prevalence of PIM use and associated factors were identified (univariate analysis - Pearson’s chi-square; multivariate - logistic regression); (II) documental analysis of the negative clinical outcomes potentially associated with PIM use and pharmacists’ interventions. The prevalence of PIM use was 48.3%, and it was independently and positively associated with the use of ≥ 5 drugs. For 21.3% of PIMs, a potential negative clinical outcome was identified. The most common negative clinical outcome was hypotension (35.1% of the negative outcomes), fractures or diagnosis of osteoporosis (21.1%), and hypoglycemia (14.0%). For most of them (78.9%), an intervention was performed to mitigate harm or discontinue use. A high prevalence of PIM was detected and was associated with polypharmacy. A significant proportion of PIM showed potential negative clinical outcomes that were identified by clinical pharmacists, and the majority of pharmacists’ interventions aimed at its mitigation or deprescription. Overall, our findings reinforce the potential of CMM services for reducing PIM use and the occurrence of negative outcomes.Universidade de São Paulo. Faculdade de Ciências Farmacêuticas2022-12-19info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/bjps/article/view/20505910.1590/s2175-97902022e19191Brazilian Journal of Pharmaceutical Sciences; Vol. 58 (2022)Brazilian Journal of Pharmaceutical Sciences; v. 58 (2022)Brazilian Journal of Pharmaceutical Sciences; Vol. 58 (2022)2175-97901984-8250reponame:Brazilian Journal of Pharmaceutical Sciencesinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/bjps/article/view/205059/196170Copyright (c) 2022 Brazilian Journal of Pharmaceutical Scienceshttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessMartins, Ursula Carolina de MoraisRamalho de Oliveira, DjenaneNascimento, Mariana Martins Gonzaga doNascimento, Yone de AlmeidaOliveira, Grazielli Cristina Batista de Cid, Annaline StiegertLima, Marina Guimarães2023-04-10T19:14:04Zoai:revistas.usp.br:article/205059Revistahttps://www.revistas.usp.br/bjps/indexPUBhttps://old.scielo.br/oai/scielo-oai.phpbjps@usp.br||elizabeth.igne@gmail.com2175-97901984-8250opendoar:2023-04-10T19:14:04Brazilian Journal of Pharmaceutical Sciences - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Potentially inappropriate medication use in a comprehensive therapy management service: clinical outcomes and interventions |
title |
Potentially inappropriate medication use in a comprehensive therapy management service: clinical outcomes and interventions |
spellingShingle |
Potentially inappropriate medication use in a comprehensive therapy management service: clinical outcomes and interventions Martins, Ursula Carolina de Morais Brazil Aged Medication therapy management Potentially inappropriate medication list Pharmaceutical care |
title_short |
Potentially inappropriate medication use in a comprehensive therapy management service: clinical outcomes and interventions |
title_full |
Potentially inappropriate medication use in a comprehensive therapy management service: clinical outcomes and interventions |
title_fullStr |
Potentially inappropriate medication use in a comprehensive therapy management service: clinical outcomes and interventions |
title_full_unstemmed |
Potentially inappropriate medication use in a comprehensive therapy management service: clinical outcomes and interventions |
title_sort |
Potentially inappropriate medication use in a comprehensive therapy management service: clinical outcomes and interventions |
author |
Martins, Ursula Carolina de Morais |
author_facet |
Martins, Ursula Carolina de Morais Ramalho de Oliveira, Djenane Nascimento, Mariana Martins Gonzaga do Nascimento, Yone de Almeida Oliveira, Grazielli Cristina Batista de Cid, Annaline Stiegert Lima, Marina Guimarães |
author_role |
author |
author2 |
Ramalho de Oliveira, Djenane Nascimento, Mariana Martins Gonzaga do Nascimento, Yone de Almeida Oliveira, Grazielli Cristina Batista de Cid, Annaline Stiegert Lima, Marina Guimarães |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Martins, Ursula Carolina de Morais Ramalho de Oliveira, Djenane Nascimento, Mariana Martins Gonzaga do Nascimento, Yone de Almeida Oliveira, Grazielli Cristina Batista de Cid, Annaline Stiegert Lima, Marina Guimarães |
dc.subject.por.fl_str_mv |
Brazil Aged Medication therapy management Potentially inappropriate medication list Pharmaceutical care |
topic |
Brazil Aged Medication therapy management Potentially inappropriate medication list Pharmaceutical care |
description |
This study aimed to describe potentially inappropriate medication (PIM) use according to the Beers criteria among older adults followed in a comprehensive medication management (CMM) service, the pharmacists´ interventions, and the clinical outcomes of PIM use. All older adults in a CMM service delivered in the Brazilian public primary care system were included in the study (n = 389). Two methodological approaches were developed: (I) cross-sectional - prevalence of PIM use and associated factors were identified (univariate analysis - Pearson’s chi-square; multivariate - logistic regression); (II) documental analysis of the negative clinical outcomes potentially associated with PIM use and pharmacists’ interventions. The prevalence of PIM use was 48.3%, and it was independently and positively associated with the use of ≥ 5 drugs. For 21.3% of PIMs, a potential negative clinical outcome was identified. The most common negative clinical outcome was hypotension (35.1% of the negative outcomes), fractures or diagnosis of osteoporosis (21.1%), and hypoglycemia (14.0%). For most of them (78.9%), an intervention was performed to mitigate harm or discontinue use. A high prevalence of PIM was detected and was associated with polypharmacy. A significant proportion of PIM showed potential negative clinical outcomes that were identified by clinical pharmacists, and the majority of pharmacists’ interventions aimed at its mitigation or deprescription. Overall, our findings reinforce the potential of CMM services for reducing PIM use and the occurrence of negative outcomes. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-12-19 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/bjps/article/view/205059 10.1590/s2175-97902022e19191 |
url |
https://www.revistas.usp.br/bjps/article/view/205059 |
identifier_str_mv |
10.1590/s2175-97902022e19191 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/bjps/article/view/205059/196170 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2022 Brazilian Journal of Pharmaceutical Sciences https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2022 Brazilian Journal of Pharmaceutical Sciences https://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Ciências Farmacêuticas |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Ciências Farmacêuticas |
dc.source.none.fl_str_mv |
Brazilian Journal of Pharmaceutical Sciences; Vol. 58 (2022) Brazilian Journal of Pharmaceutical Sciences; v. 58 (2022) Brazilian Journal of Pharmaceutical Sciences; Vol. 58 (2022) 2175-9790 1984-8250 reponame:Brazilian Journal of Pharmaceutical Sciences instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Brazilian Journal of Pharmaceutical Sciences |
collection |
Brazilian Journal of Pharmaceutical Sciences |
repository.name.fl_str_mv |
Brazilian Journal of Pharmaceutical Sciences - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
bjps@usp.br||elizabeth.igne@gmail.com |
_version_ |
1787713373910073344 |