Chiapella Luciana C, Menna Jorgelina Montemarani, Mamprin María Eugenia
Área Farmacología, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, CONICET, Rosario, Santa Fe, Argentina.
Atención Primaria de la Salud, Nodo Rosario, Ministerio de Salud de la Provincia de Santa Fe, Rosario, Santa Fe, Argentina.
Value Health Reg Issues. 2018 Dec;17:119-125. doi: 10.1016/j.vhri.2017.12.009. Epub 2018 Jun 20.
This study aims to compare, both qualitatively and quantitatively, the medication dispensed to elderly patients in a primary health care center (PHC) and a community pharmacy (CP) in Argentina and to identify the prescription of potentially inappropriate medications (PIMs).
A cross-sectional observational study. Data were acquired from 886 prescriptions in the PHC and 2368 in the CP between February and April 2015. Dispensed medications were coded according to the Anatomical, Therapeutic, and Chemical (ATC) classification system. The frequency of prescriptions for each of them was determined. The number and monthly average of drugs dispensed were calculated for each patient. The use of PIMs was identified using Beers Criteria.
In both institutions, the means of medications dispensed per individual and month were similar: 3.69 ± 1.93 in the PHC and 3.46 ± 2.18 in the CP. Most of the medications corresponded to cardiovascular system agents. In the CP, 111 prescriptions (4.69%) dispensed to 51 patients (19.39%) were identified as PIMs. In the PHC, 72 prescriptions (8.13%) dispensed to 27 patients (28.42%) were identified as PIMs. In patients with major polymedication the possibility of consuming these drugs was 2.55 times higher in the CP and 2.60 times higher in the PHC. The percentage of PIM prescriptions was significantly higher in the PHC, although the percentage of patients receiving them did not differ significantly.
The prevalence of PIMs found in this population is relevant enough to implement measures that address the problem in an integral way, to improve the quality of prescriptions and the health outcomes of patients.
本研究旨在定性和定量比较阿根廷一家初级卫生保健中心（PHC）和一家社区药房（CP）为老年患者调配的药物，并识别潜在不适当药物（PIMs）的处方情况。
一项横断面观察性研究。收集了2015年2月至4月期间PHC的886张处方和CP的2368张处方的数据。根据解剖学、治疗学和化学（ATC）分类系统对调配的药物进行编码。确定每种药物的处方频率。计算每位患者调配药物的数量和月平均值。使用Beers标准识别PIMs的使用情况。
在这两家机构中，每位患者每月调配药物的均值相似：PHC为3.69±1.93，CP为3.46±2.18。大多数药物对应心血管系统药物。在CP中，为51名患者（19.39%）调配的111张处方（4.69%）被确定为PIMs。在PHC中，为27名患者（28.42%）调配的72张处方（8.13%）被确定为PIMs。在使用多种药物的患者中，CP中使用这些药物的可能性高2.55倍，PHC中高2.60倍。PHC中PIM处方的百分比显著更高，尽管接受这些处方的患者百分比没有显著差异。
在该人群中发现的PIMs患病率足以实施全面解决该问题的措施，以提高处方质量和患者的健康结局。
