Abstract

SICRAS MAINAR, Antoni et al. Effectiveness of an intervention program in the optimization of drug use in elderly nursing homes. Rev Cubana Salud Pública [online]. 2009, vol.35, n.3, pp. 0-0. ISSN 1561-3127.

Objectives To assess the effectiveness of a program aimed at optimizing the drug prescription and its effects as well as accessories used in a group of nursing homes after five years of implementation. Methods A multicentered study before and after the program, which included the recorded prescriptions during the study period (reference: 107 nursing homes, year 2001; comparison: 152 homes, year 2006). The interventions were a) letter of introduction and initial interview b) information provided by the cadres in charge and c) administration of several follow-up interviews. The main measurement were evaluated against a series of quantitative indicators such as cost/container, cost/resident and container/resident, and of general qualitative indicators like high pharmacological intrinsic value, generic specialties, supernight absorbing pads for urinary incontinence, and selection or relative use of drugs per year (ratios of recommended active principles). Multivariate analysis was used for model correction. Results The number of studied patients was 4 795 and 6 350 respectively. The cost per resident amounted to 1 575.61±358.88 euros (reference) and 1 929.03±421.31 euros (comparison), with a rise of 22,4 % (p<0.001). The cost per package increased by 7,9% (p=0.001). The use of generic pharmaceutical specialties rose (7.8 to 27.2 % [p=0.001]) but that of supernight absorbing pads was reduced (58.3 to 32.9% (p=0.001). No conclusive results were reached about the use of anti-hypertensives and of central nervous system medicines. Conclusions This methodology has been useful in promoting the rational use of medication and in improving the quality of prescription profiles. The results of the implemented program were suitable for the increase of drug prescription efficiency in the nursing homes under this intervention.

Keywords : Nursing homes; drug utilization; intervention strategy.

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