[Assessment of a follow-up programme for institutionalised elderly patients on oral anticoagulant treatment]. / Evaluación de un programa de seguimiento de pacientes ancianos institucionalizados en tratamiento con anticoagulantes orales.

OBJECTIVE: To assess an interdisciplinary follow-up programme for institutionalised elderly people on oral anticoagulant treatment. METHOD: The proposed follow-up treatment is of an interdisciplinary nature and includes INR, an interview with the patient and/or carer and an assessment of the treatment plan every week. The quality of drug treatment is assessed by the percentage of time and the percentage of measurements falling within the therapeutic range. The suitability of the programme in comparison to the traditional follow-up was studied in terms of the different proportions for the first variable and by analysing contingency tables for the second. RESULTS: Nine patients were recruited. Six patients (67%) showed a significant increase in the percentage of time they remained within the therapeutic range. 68.5% of INR measurements during the follow-up programme were within therapeutic range. The percentage of INR measurements below the therapeutic range was significantly reduced when compared to the traditional follow up. Thirteen pharmaceutical interventions were documented per patient. CONCLUSIONS: The complexity of oral anticoagulant treatment, the large number of interventions carried out together with elderly patients poor treatment compliance are evidence of the need to introduce follow-up programmes which include the professionals responsible for the patients care.

Evaluación de un programa de seguimiento de pacientes ancianos institucionalizados en tratamiento con anticoagulantes orales / No disponible

en el anciano institucionalizado en tratamiento con anticoagulantes orales. Método: El programa de seguimiento propuesto tiene carácter interdisciplinar e incluye la determinación de INR, una entrevista con el paciente y/o cuidador y la valoración del plan terapéutico con una periodicidad semanal. La calidad farmacoterapéutica se ha valorado mediante el porcentaje de tiempo y el porcentaje de determinaciones en rango terapéutico. La idoneidad del programa, con respecto al seguimiento tradicional, se ha estudiado a través de la diferencia de proporciones para la primera variable y a través del análisis por tablas de contingencia para la segunda. Resultados: Se incluyen nueve pacientes. Seis de los nueve pacientes (67%) presentaron un aumento significativo en el porcentaje de tiempo en rango terapéutico. El 68,5% de las determinaciones de INR durante el programa de seguimiento se sitúan en rango terapéutico. El porcentaje de determinaciones de INR inferiores al rango terapéutico se redujo significativamente con respecto al seguimiento tradicional. Se han documentado 13 actuaciones por paciente. Conclusiones: La complejidad del tratamiento anticoagulante oral, el elevado número de actuaciones realizadas junto con la baja adherencia al tratamiento en pacientes ancianos, pone de manifiesto la necesidad de instaurar programas de seguimiento que cuenten con la participación de los profesionales encargados del cuidado del paciente

Objective: To assess an interdisciplinary follow-up programme for institutionalised elderly people on oral anticoagulant treatment. Method: The proposed follow-up treatment is of an interdisciplinary nature and includes INR, an interview with the patient and/or carer and an assessment of the treatment plan every week. The quality of drug treatment is assessed by the percentage of time and the percentage of measurements falling within the therapeutic range. The suitability of the programme in comparison to the traditional follow-up was studied in terms of the different proportions for the first variable and by analysing contingency tables for the second. Results: Nine patients were recluted. Six patients (67%) showed a significant increase in the percentage of time they remained within the therapeutic range. 68.5% of INR measurements during the follow-up programme were within therapeutic range. The percentage of INR measurements below the therapeutic range was significantly reduced when compared to the traditional follow up. Thirteen pharmaceutical interventions were documented per patient. Conclusions: The complexity of oral anticoagulant treatment, the large number of interventions carried out together with elderly patients’ poor treatment compliance are evidence of the need to introduce follow-up programmes which include the professionals responsible for the patients’ care