ABSTRACT
El objetivo de este trabajo es recopilar, evaluar e interpretar las evidencias disponibles sobre la relación existente entre el grado de longitudinalidad en atención primaria (AP) y la prevalencia de polifarmacia y sus problemas asociados. Siguiendo la declaración PRISMA realizamos una revisión sistemática de la literatura en las bases de datos PubMed y Scopus. El cribado por títulos y resúmenes, y la revisión de referencias realizados de forma independiente por 2 autores detectó 16 trabajos de potencial interés. Tras la revisión independiente de todos los originales, 4 fueron descartados por no satisfacer los criterios de inclusión. Los 12 trabajos seleccionados, 9 estudios de cohortes retrospectivos y 3 estudios transversales, estudiaban la relación de la longitudinalidad en AP, medida con diversos índices cuantitativos, con la prevalencia de polifarmacia y otros problemas terapéuticos asociados, como las prescripciones inadecuadas, las duplicidades o las interacciones medicamentosas. Todos mostraban una relación significativa, frecuentemente fuerte (RR>2 o<0,5), entre los indicadores de longitudinalidad y las diversas variables dependientes. Aunque nuestro conocimiento podría mejorar mediante estudios prospectivos que evaluaran directamente la longitudinalidad y su repercusión en los problemas por exceso de medicación, con las evidencias existentes, se puede afirmar que la protección y la promoción de la longitudinalidad en la AP es un elemento clave para el control de la polifarmacia y los problemas asociados (AU)
The aim of this work was to collect, evaluate and interpret the available evidence on the relationship between continuity in primary care (i.e., longitudinality), and the prevalence of polypharmacy and its associated problems. Following the PRISMA reporting statement, we carried out a systematic review of the literature searching PubMed and Scopus databases. The screening of titles and summaries and the review of references carried out independently by two authors detected 16 works of potential interest, of which 4 were discarded after the independent review of all the originals because they did not meet inclusion criteria. The 12 papers selected studied the relationship between Longitudinality, measured with various quantitative indices, and the rate of polypharmacy or various associated problems, such as duplicate drugs, inadequate prescriptions or drug interactions. They all showed a significant relationship, often strong (RR>2 or<0.5), between longitudinality indicators and the various dependent variables. Although our knowledge could be improved by prospective studies that more directly evaluate longitudinality and its impact on problems due to excess medication, with the existing evidence, we can affirm that the protection and promotion of continuity in primary care can be a key element for the control of polypharmacy and associated problems (AU)
Subject(s)
Humans , Primary Health Care , Inappropriate Prescribing , Deprescriptions , PolypharmacyABSTRACT
The aim of this work was to collect, evaluate and interpret the available evidence on the relationship between continuity in primary care (i.e., longitudinality), and the prevalence of polypharmacy and its associated problems. Following the PRISMA reporting statement, we carried out a systematic review of the literature searching PubMed and Scopus databases. The screening of titles and summaries and the review of references carried out independently by two authors detected 16 works of potential interest, of which 4 were discarded after the independent review of all the originals because they did not meet inclusion criteria. The 12 papers selected studied the relationship between Longitudinality, measured with various quantitative indices, and the rate of polypharmacy or various associated problems, such as duplicate drugs, inadequate prescriptions or drug interactions. They all showed a significant relationship, often strong (RR>2 or<0.5), between longitudinality indicators and the various dependent variables. Although our knowledge could be improved by prospective studies that more directly evaluate longitudinality and its impact on problems due to excess medication, with the existing evidence, we can affirm that the protection and promotion of continuity in primary care can be a key element for the control of polypharmacy and associated problems.
