Abstract

ORUETA, Ramón et al. Therapeutic appropriateness in chronic patients. Rev Clin Med Fam [online]. 2015, vol.8, n.1, pp.31-47. ISSN 2386-8201.  https://dx.doi.org/10.4321/S1699-695X2015000100005.

Inappropriate prescribing is an important health problem in patients with chronic diseases, usually elderly, due to its association with health deterioration, loss of functional capacity and quality of life, and increased mortality. Although there are multiple variables related to potentially inappropriate prescribing, polypharmacy is the main associated factor. For all of the above, it is necessary to implement actions in daily clinical practice aimed at improving therapeutic appropriateness and reducing inappropriate drug prescription. This strategy should start at the moment of prescription, having different tools to help to review the adequacy of previously prescribed medication. Any intervention must begin with an individualized analysis of the situation, and must have the patient’s approval, especially in the case of drug withdrawal. Furthermore, these review actions should be periodically repeated, given the changing circumstances in the state of health, the therapeutic goals and the patient’s perspective. Various studies have been carried out in order to evaluate such interventions, having demonstrated improvements in intermediate outcomes (reduction of potentially inappropriate prescribing), but with little published data on outcomes in terms of health status. There is consensus on the need to continue with its implementation.

Keywords : Inappropriate Prescribing; Elderly; Drug Utilization Review; Medication Reconciliation.

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