Implantación de un programa de polimedicados en el marco de la Estrategia Gallega de Atención Integral a la Cronicidad

Abstract

IntroductionA total of 22.8% of citizens in Galicia are older than 65 years and, compared with the Spanish population as a whole, they represent a more elderly population with a higher prevalence of chronic diseases. The SERGAS 2014 strategy and the Galician Strategy for Integrated Chronic Care envision the development of a specific program to improve the health and quality of life of older polymedicated patients. AimTo describe the program for the improvement of the quality of care of chronic polymedicated patients, as well as the initial results after its implantation. ResultsA pilot program was started in 11 health centers in April 2011. The program was progressively developed, until reaching 100% implantation in 480 health centers and consulting rooms in Galicia. The initial target population consisted of patients chronically taking more than 15 prescribed medications. By 31 December 2013, 20,319 patients were included in the program, representing 88% of the population taking more than 12 medications. The demographic pattern consisted mainly of women (60%) older than 70 years (70%). Evaluation of the results obtained by reviewing the medication and interventions performed in the patients included since the start of the program showed a reduction of 47%, 32.7% and 22% in the number of patients with > 15, > 12 and > 10 chronically prescribed medications, respectively. The primary care pharmacist proposed at least one intervention in 72% of the patients, and > 1 START criterion (Screening Tool to Alert doctors to Right Treatment) was detected in 6% and > 1 STOPP criterion (Screening Tool of Older Persons’ Prescriptions) in 27% of the patients. A total of 35% of the patients included had a nursing medication review (7,092 reports). ConclusionsThe program to improve the quality of care provided to chronic polymedicated patients in Galicia is a timely and necessary initiative, given the high percentage of the population with multiple comorbidities receiving polymediation. The program has clear benefits: the quality of prescription and patient safety improved due to the reduction in the number of medications administered and the detection of potentially inappropriate prescriptions.