ABSTRACT
Objetivo. Describir la adecuación de la prescripción de pacientes polimedicados mayores de 65 años en un área rural. Material y método. Estudio observacional descriptivo trasversal. El área de estudio corresponde a las unidades asistenciales del Distrito Sanitario rural Valle del Guadalhorce de Málaga en septiembre de 2009. El distrito asiste a una población de 144.993 habitantes y el estudio se dirige a la población mayor de 65 años con 10 o más medicamentos (4.344 pacientes). La variable principal fueron las tasas de prescripción inadecuada o potencialmente inadecuadas. Para ello se clasificaron utilizando los criterios Screening Tool of Older Persons potentially inappropriate Prescriptions (STOPP) y los criterios de la estrategia de abordaje del polimedicado del Servicio Andaluz de Salud (SAS). Se utilizó un aplicativo para la creación de informes individualizados que identificaban los criterios. Por cada paciente se identificaron variables como unidad, tipo de medicamento, medicamento, dosis y expresión del criterio STOPP o SAS. Resultados. El 35,5% presentan una tasa de prescripción inadecuada según los criterios STOPP directos. Según los criterios utilizados por el SAS, la tasa de prescripción potencialmente inapropiada fue del 94%. Si la evaluación se realizaba con el total de criterios STOPP (directos y generales), el 100% de la población de estudio presentaban una prescripción al menos potencialmente inadecuada. Conclusiones. La prevalencia de polimedicación y de prescripción inadecuada es un problema real en la población mayor de 65 años. La ayuda de una herramienta informatizada facilita la identificación y el abordaje de la prescripción inapropiada (AU)
Objective. Describe the inappropriate prescription to polymedicated patients over 65 years old in rural areas. Material and method. An observational, descriptive, cross-sectional study conducted in health care units in the Guadalhorce Valley, a rural area of Malaga, Spain. The district has a catchment population of about 144,993 inhabitants. This study is focused on the population that is older than 65 years, and who use 10 or more medications (4.344 patients). The study has as a primary variable: the rates of inappropriate prescription. These are classified using the Screening Tool of Older Persons potentially inappropriate Prescriptions (STOPP) criteria, as well as the criteria of the strategy of the approach to polymedicated of the Andalusian Health System. An application was used to create individualised forms that identified inappropriate prescribing criteria. For each patient, we used variables, such as the unit, drug group, medications, dose, and use of the STOPP and Andalusian Health System criteria were recorded for each patient. Results. More than one-third (35.5%) of all patients have inappropriate prescription, according to STOPP criteria, related to some health problem (direct problems). The large majority (94%) have potentially inappropriate prescription according to the criteria of the Andalusian Health System. If the criteria directly related to prescribing medication for people over 65 (general) is taken into account, 100% of patients have some form of inappropriate or potentially inappropriate prescribing. Conclusions. The prevalence of polypharmacy and inappropriate prescription is a real problem in the population over 65 years old. An informatics tool provides us with the facilities to identify and approach inappropriate prescribing (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Inappropriate Prescribing/trends , Primary Health Care/methods , Primary Health Care/organization & administration , Primary Health Care/standards , Rural Sanitation , Rural Health/standards , Rural Health/trends , Rural Health Services , Cross-Sectional Studies/methods , Cross-Sectional StudiesABSTRACT
OBJECTIVE: Describe the inappropriate prescription to polymedicated patients over 65 years old in rural areas. MATERIAL AND METHOD: An observational, descriptive, cross-sectional study conducted in health care units in the Guadalhorce Valley, a rural area of Malaga, Spain. The district has a catchment population of about 144,993 inhabitants. This study is focused on the population that is older than 65 years, and who use 10 or more medications (4.344 patients). The study has as a primary variable: the rates of inappropriate prescription. These are classified using the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, as well as the criteria of the strategy of the approach to polymedicated of the Andalusian Health System. An application was used to create individualised forms that identified inappropriate prescribing criteria. For each patient, we used variables, such as the unit, drug group, medications, dose, and use of the STOPP and Andalusian Health System criteria were recorded for each patient. RESULTS: More than one-third (35.5%) of all patients have inappropriate prescription, according to STOPP criteria, related to some health problem (direct problems). The large majority (94%) have potentially inappropriate prescription according to the criteria of the Andalusian Health System. If the criteria directly related to prescribing medication for people over 65 (general) is taken into account, 100% of patients have some form of inappropriate or potentially inappropriate prescribing. CONCLUSIONS: The prevalence of polypharmacy and inappropriate prescription is a real problem in the population over 65 years old. An informatics tool provides us with the facilities to identify and approach inappropriate prescribing.
Subject(s)
Inappropriate Prescribing , Polypharmacy , Rural Health , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Inappropriate Prescribing/prevention & control , Male , Prevalence , SpainABSTRACT
Los cambios en el Sistema Sanitario no están siendo ajenos a nuestro entorno. Actualmente, se debate sobre múltiples aspectos de la Sanidad: financiación, provisión de servicios, innovaciones en gestión, descentralización de responsabilidades. ¿Qué razones configuran un contexto tan cambiante?: las razones de tipo demográfico, la extensión del Estado de Bienestar, el imparable avance tecnológico en el campo de la Salud, el cambio en el rol del usuario respecto a sus expectativas hacia el Sistema Sanitario. Estos factores, han producido un incremento en la demanda de servicios que obliga a buscar fórmulas que permitan la sostenibilidad con las características propias de un servicio público: universalidad, accesibilidad, equidad y solidaridad (AU)
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