دورية أكاديمية
أعرض في EDS

[Facing a dilemma in elderly complex and vulnerable patients: to stop or not to stop prevention?]

التفاصيل البيبلوغرافية
العنوان: [Facing a dilemma in elderly complex and vulnerable patients: to stop or not to stop prevention?]
عنوان ترانسليتريتد: Dilemas en la enfermedad crónica avanzada: ¿prevención o desprescripción?
المؤلفون: Llobet Vila L; ABS Castellar del Vallès, Institut Català de la Salut, Castellar del Vallès, Barcelona, España; Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Sabadell, Barcelona, España. Electronic address: llobetvila@gmail.com., Manresa Domínguez JM; Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Sabadell, Barcelona, España; Departament de Infermeria, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, España., Carmona Segado JM; ABS Sant Llorenç Savall, Institut Català de la Salut, Sant Llorenç Savall, Barcelona, España., Franzi Sisó A; Unitat de Farmàcia, SAP Vallès Occidental, Institut Català de la Salut, Sabadell, Barcelona, España., Vallès Balasch R; ABS Castellar del Vallès, Institut Català de la Salut, Castellar del Vallès, Barcelona, España., Martínez Díaz I; ABS Castellar del Vallès, Institut Català de la Salut, Castellar del Vallès, Barcelona, España.
المصدر: Atencion primaria [Aten Primaria] 2018 Dec; Vol. 50 (10), pp. 583-589. Date of Electronic Publication: 2017 Dec 06.
نوع المنشور: Journal Article; Multicenter Study
اللغة: Spanish; Castilian
بيانات الدورية: Publisher: Elsevier España Country of Publication: Spain NLM ID: 9111075 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1578-1275 (Electronic) Linking ISSN: 02126567 NLM ISO Abbreviation: Aten Primaria Subsets: MEDLINE
أسماء مطبوعة: Publication: Madrid : Elsevier España
Original Publication: Barcelona : Haymarket,
مواضيع طبية MeSH: Chronic Disease* , Deprescriptions* , Primary Prevention* , Secondary Prevention*, Prescription Drugs/*therapeutic use, Aged, 80 and over ; Cross-Sectional Studies ; Humans ; Retrospective Studies ; Severity of Illness Index
مستخلص: Objectives: 1-To know the preventive prescription (statin, antiplatelet drugs, bisphosphonates, calcium and vitamin D and Vit B12) of elderly patients previously identified as a CCD (with a complex chronic disease) and ACD (with advanced chronic disease and lifetime expectancy of less than 12 months) who died during 2015. 2-To assess the correct indication of Proton Pump Inhibitors (PPI) to determine potentially avoidable medication.
Design: Retrospective observational study.
Location: Four Primary Health Centres, Castellar del Vallès (Barcelona).
Participants: 128 patients, 70 ACD and 58 PCC.
Main Measurements: Number of drugs at the time of death from the 6 selected group, deprescription (6 months prior to death due to advanced chronic disease), primary or secondary prevention and inappropriate prescription of PPI.
Results: Average age of 85'3 years (10,3). 40% took an antiplatelet drug, avoidable in 60% of the ACD, since they did not present any previous cardiovascular episode. 20% of the patients took statins, in which 48% of the cases were primary prevention. The PPI prescription was 67% with inadequate indication for use in 49% of these cases. 20% took calcium / Vitamin D and 1,6% of the ACD a bisphosphonate. There was a 16% deprescription.
Conclusions: A high percentage of our patients with advanced chronic disease and short life expectancy still continue to take preventive and avoidable treatments, potentially dangerous due to their side effects. There is a need to reflect on what we do with these vulnerable patients.
(Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)
References: BMJ. 2015 Sep 29;351:h4183. (PMID: 26420598)
Age Ageing. 2010 Nov;39(6):674-80. (PMID: 20952373)
Rev Clin Esp. 2006 Jun;206(6):266-70. (PMID: 16762289)
Drugs Aging. 2014 Jan;31(1):33-45. (PMID: 24234805)
Ann Intern Med. 2016 Jun 21;164(12):836-45. (PMID: 27064677)
BMJ. 2015 Sep 29;351:h4580. (PMID: 26420387)
BMJ. 2010 Jul 29;341:c3691. (PMID: 20671013)
BMJ. 2012 May 28;344:e3502. (PMID: 22645185)
Lancet. 2002 Nov 23;360(9346):1623-30. (PMID: 12457784)
Rev Esp Geriatr Gerontol. 2009 Sep-Oct;44(5):273-9. (PMID: 19540624)
Aten Primaria. 2012 Aug;44(8):478-84. (PMID: 22657738)
Contemp Clin Trials. 2013 Nov;36(2):555-64. (PMID: 24113028)
BMJ. 2010 Sep 16;341:c5028. (PMID: 20847024)
فهرسة مساهمة: Keywords: Deprescription; Desprescripción; Inappropriate Prescribing's; Patient safety; Prescripciones inadecuadas; Seguridad del paciente
المشرفين على المادة: 0 (Prescription Drugs)
تواريخ الأحداث: Date Created: 20171210 Date Completed: 20191024 Latest Revision: 20191121
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC6837059
DOI: 10.1016/j.aprim.2017.05.016
PMID: 29221946
قاعدة البيانات: MEDLINE
الوصف
تدمد:1578-1275
DOI:10.1016/j.aprim.2017.05.016