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Individualized Medication Review in Older People with Multimorbidity: A Comparative Analysis between Patients Living at Home and in a Nursing Home

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  • Núria Molist-Brunet

    (Geriatric Department, Hospital Universitari de la Santa Creu de Vic, 08500 Vic, Spain
    Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Universitat de Vic—University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain)

  • Daniel Sevilla-Sánchez

    (Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Universitat de Vic—University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
    Pharmacy Department, Parc Sanitari Pere Virgili, 08023 Barcelona, Spain)

  • Emma Puigoriol-Juvanteny

    (Epidemiology Department, Hospital Universitari de Vic, 08500 Vic, Spain
    Tissue Repair and Regeneration Laboratory (TR2Lab), Research Group, University of Vic, 08500 Vic, Spain)

  • Lorena Bajo-Peñas

    (Geriatric Department, Hospital Universitari de la Santa Creu de Vic, 08500 Vic, Spain)

  • Immaculada Cantizano-Baldo

    (Geriatric Department, Hospital Universitari de la Santa Creu de Vic, 08500 Vic, Spain)

  • Laia Cabanas-Collell

    (Institut Català de la Salut (ICS), 08551 Tona, Spain)

  • Joan Espaulella-Panicot

    (Geriatric Department, Hospital Universitari de la Santa Creu de Vic, 08500 Vic, Spain
    Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Universitat de Vic—University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
    Geriatric and Palliative Care Department, Hospital Universitari de Vic, 08500 Vic, Spain)

Abstract

(1) Background: aging is associated with complex and dynamic changes leading to multimorbidity and, therefore, polypharmacy. A periodic medication review (MR) in frail older people leads to optimizing medication use. The aims of the study were to perform a comparative analysis of the impact of place of residence (own home versus nursing home) in a cohort of older patients on the characteristics of the baseline therapeutic plan and characteristics of the therapeutic plan after an MR; (2) Methods: Study with paired pre- and post-MR data based on person-centred prescription, with a follow-up assessment at three months. Patients who lived either in their own home or in a nursing home were recruited. We selected patients of 65 years or more with multimorbidity whose General Practitioner identified difficulties with the prescription management and the need for an MR. Each patient’s treatment was analysed by applying the Patient-Centred Prescription (PCP) model; (3) Results: 428 patients. 90% presented at least one inappropriate prescription (IP) in both settings. In nursing homes, a higher number of implemented optimization proposals was detected (81.6% versus 65.7% ( p < 0.001)). After the MR, nursing-home patients had a greater decrease in their mean number of medications, polypharmacy prevalence, therapeutic complexity, and monthly drug expenditure ( p < 0.001); (4) Conclusions: PCP model detected a high number of IP in both settings. However, after an individualized MR, nursing-home patients presented a greater decrease in some pharmacological parameters related to adverse events, such as polypharmacy and therapeutic complexity, compared to those living at home. Nursing homes may be regarded as a highly suitable scenario to carry out a periodic MR, due to its high prevalence of frail people and its feasibility to apply the recommendations of an MR. Prospective studies with a robust design should be performed to demonstrate this quasi-experimental study along with a longitudinal follow-up on clinical outcomes.

Suggested Citation

  • Núria Molist-Brunet & Daniel Sevilla-Sánchez & Emma Puigoriol-Juvanteny & Lorena Bajo-Peñas & Immaculada Cantizano-Baldo & Laia Cabanas-Collell & Joan Espaulella-Panicot, 2022. "Individualized Medication Review in Older People with Multimorbidity: A Comparative Analysis between Patients Living at Home and in a Nursing Home," IJERPH, MDPI, vol. 19(6), pages 1-13, March.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:6:p:3423-:d:770795
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    References listed on IDEAS

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    1. Núria Molist-Brunet & Daniel Sevilla-Sánchez & Emma Puigoriol-Juvanteny & Mariona Espaulella-Ferrer & Jordi Amblàs-Novellas & Joan Espaulella-Panicot, 2021. "Factors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort," IJERPH, MDPI, vol. 18(21), pages 1-17, October.
    2. Catharine Falch & Gilberto Alves, 2021. "Pharmacists’ Role in Older Adults’ Medication Regimen Complexity: A Systematic Review," IJERPH, MDPI, vol. 18(16), pages 1-17, August.
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    Cited by:

    1. Mariona Espaulella-Ferrer & Nuria Molist-Brunet & Joan Espaulella-Panicot & Daniel Sevilla-Sánchez & Emma Puigoriol-Juvanteny & Marta Otero-Viñas, 2023. "Medication Assessment in an Older Population during Acute Care Hospitalization and Its Effect on the Anticholinergic Burden: A Prospective Cohort Study," IJERPH, MDPI, vol. 20(7), pages 1-13, March.
    2. Maria Gabriella Melchiorre & Barbara D’Amen & Sabrina Quattrini & Giovanni Lamura & Marco Socci, 2022. "Caring for Frail Older People Living Alone in Italy: Future Housing Solutions and Responsibilities of Family and Public Services, a Qualitative Study," IJERPH, MDPI, vol. 19(12), pages 1-29, June.
    3. Maria Gabriella Melchiorre & Marco Socci & Sabrina Quattrini & Giovanni Lamura & Barbara D’Amen, 2022. "Frail Older People Ageing in Place in Italy: Use of Health Services and Relationship with General Practitioner," IJERPH, MDPI, vol. 19(15), pages 1-26, July.

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    1. Mariona Espaulella-Ferrer & Nuria Molist-Brunet & Joan Espaulella-Panicot & Daniel Sevilla-Sánchez & Emma Puigoriol-Juvanteny & Marta Otero-Viñas, 2023. "Medication Assessment in an Older Population during Acute Care Hospitalization and Its Effect on the Anticholinergic Burden: A Prospective Cohort Study," IJERPH, MDPI, vol. 20(7), pages 1-13, March.

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