Sicras Mainar A, Peláez de Loño J, Martí López J
Unidad de Farmacia, Región Sanitaria del Barcelonés Norte y Maresme, CatSalut. Badalona, Barcelona, España.
Aten Primaria. 2004 Mar 15;33(4):174-80. doi: 10.1016/s0212-6567(04)79389-0.
To evaluate the impact after one year of a program to improve appropriate prescribing of medications, medical care products and supplies at a group of residential centers for older persons.
Multicenter, controlled, quasi-experimental, before-after study of all outpatient prescriptions charged from each center to the Catalonian Health Service during the study period (reference year 2001, monitoring year 2002).
A total of 107 residential centers in the Barcelonés Norte y Maresme (Barcelona) health region.
After situation analysis the centers were divided into two groups: intervention (n=21) and control (n=86). A total of 4789 older persons were residents at participating centers during the study. Interventions. The actions carried out in the intervention group were: a). letter describing the program; b). face-to-face interview to provide information; c). distribution of printed information about the study's aims and the indicators recorded, and d). monitoring with several follow-up interviews.
We recorded quantitative indicators (general, specific and urinary incontinence products), qualitative indicators (use of medications with high intrinsic pharmacological value and generic pharmaceutical specialties) and relative drug use. The data were analyzed with a program written for Microsoft Access.
In the intervention group we found that pharmaceutical costs were contained, a result we attributed to the greater efficiency achieved with the intervention (interannual increase of 0.7% in the reference period to 16.2% in the monitoring period; P=.000). The contribution of urinary incontinence supplies to cost reductions was noteworthy. Total costs in terms of numbers of packages dispensed for all therapeutic subgroups decreased by 4.8% (P=.000). The use of generic pharmaceutical specialties increased by from 7.9% to 13.1%, and the results for qualitative indictors for antiasthmatics and recommended NSAIDs also revealed improvements in prescribing quality.
The preliminary results of the program show it to be effective in improving the efficiency of drug prescribing at participating nursing homes. The research method was useful in promoting the rational use of medications and improving the quality of prescribing practices.
评估一项旨在改善一组老年人居住中心药物、医疗护理产品及用品合理处方的项目实施一年后的影响。
多中心、对照、准实验性前后研究，研究对象为研究期间（基准年2001年，监测年2002年）各中心向加泰罗尼亚卫生服务机构收取的所有门诊处方。
巴塞罗那北部和马雷斯梅（巴塞罗那）卫生区域的107家居住中心。
经过情况分析，这些中心被分为两组：干预组（n = 21）和对照组（n = 86）。研究期间，共有4789名老年人居住在参与项目的中心。干预措施。在干预组实施的行动包括：a）. 描述该项目的信件；b）. 提供信息的面对面访谈；c）. 分发有关研究目的和记录指标的印刷信息；d）. 通过多次随访访谈进行监测。
我们记录了定量指标（一般、特定及尿失禁产品）、定性指标（具有高内在药理价值的药物和非专利药品的使用）以及相对药物使用情况。数据使用为微软Access编写的程序进行分析。
在干预组中，我们发现药品成本得到了控制，这一结果归因于干预措施取得了更高的效率（基准期年增长率为0.7%，监测期为16.2%；P = 0.000）。尿失禁用品对成本降低的贡献值得注意。所有治疗亚组按配发包装数量计算的总成本下降了4.8%（P = 0.000）。非专利药品的使用从7.9%增加到了13.1%，抗哮喘药和推荐的非甾体抗炎药的定性指标结果也显示处方质量有所改善。
该项目的初步结果表明，它在提高参与研究的养老院药物处方效率方面是有效的。该研究方法有助于促进药物的合理使用并提高处方实践质量。
