Objective:

People institutionalised in social and healthcare centres (SHCs) are more likely to present more drug related problems (DRPs) than the rest of the population. The aim of this study was to describe the implementation of a process of continuous improvement (PDCA cycle) of the pharmacological prescription of institutionalised patients in private/contracted SHCs to reduce DRPs.

Method:

Following a literature search, recommendations were selected on the most frequently detected DRPs in institutionalised patients in our area (approximately 5,000 residents in 55 SHCs). Those presenting any of the selected DRPs were identified. Subsequently, a multidisciplinary panel of experts was formed to define the objectives of the project, carry out an analysis of causes and determine possible actions for improvement.

Results:

The project was presented to health centres (HCs) and executive committees were set up between primary care pharmacists, professionals from SHCs and their reference HCs to adapt the different improvement actions. The interim analysis shows a 4.5% reduction in the number of patients with DRPs and a 5.2% reduction in the number of prescriptions per patient associated with DRPs. Due to the high number of institutionalised patients, the cross-sectional review of DRPs allows us to reduce drug iatrogenesis. The PDCA cycle will allow us to implement new actions or consider starting the cycle with other DRPs.

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