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Farmacia Hospitalaria

On-line version ISSN 2171-8695Print version ISSN 1130-6343


APOLO CARVAJAL, Francisco et al. Adaptation of oral medication in people institutionalized in nursing homes for whom medication is crushed: the ADECUA Study. Farm Hosp. [online]. 2016, vol.40, n.6, pp.514-528. ISSN 2171-8695.

Purpose: To evaluate the effect of pharmacist interventions in the adaptation of pharmaceutical forms in elders institutionalized in nursing homes whose medicines are crushed, which may have a clinical relevance. Methods: Quasi-experimental, multicenter, transversal and prospective study carried out in 10 nursing homes. Subjects for whom drugs were being crushed were identified. Their treatments were reviewed in order to identify drugs that should not be crushed. In these cases, we proposed an alternative to the physician and we evaluated the degree of acceptance, its association to other variables and the pre-post adaptation index (tablets that can be crushed and capsules that can be opened/ total number of tablets and capsules before and after the intervention). Moreover, health professionals received a training course. Results: Medication was being crushed for 33% (618/1875) of residents (mean: 5 drugs susceptible of crushing). 220 pharmaceutical interventions were performed, mostly in extended release or gastro-resistant drugs (48% were accepted). Switch was the type of intervention more frequent (79%), mainly to immediate release forms or to a different drug. The adaptation index increased from 93% to 95% (p < 0.001). Satisfaction amongst health professionals was high. Conclusions: The pharmacist intervention improved the correct administration of drugs, thereby increasing safety and efficacy.

Keywords : Deglutition; Crush; Oral drug administration; Dosage form.

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