Pollice Maria Giulia, Esposti Luca Degli, Procacci Cataldo, Lenti Salvatore, Ancona Domenica, Nappi Carmela, Lacolare Biagio, Tesse Anna Maria, Leuci Domenico, Masullo Mara, Tricarico Domenico
Department of Pharmacy, Pharmaceutical Sciences, University Aldo Moro, Bari - Italy.
CliCon S.r.l. Società Benefit Health, Economics and Outcomes Research, Bologna - Italy.
Glob Reg Health Technol Assess. 2025 Mar 3;12:61-69. doi: 10.33393/grhta.2025.3194. eCollection 2025 Jan-Dec.
In the Italian healthcare landscape, the management of chronic pathologies is a priority. Often, the elderly patient suffers from several pathologies at once and is commonly on polytherapy: this can easily bring potentially harmful errors in drug therapy. The D.I.Ri.M.O. project took place in an Internal Medicine department and aimed to reduce medication errors and improve the state of health through the Pharmacological Reconciliation procedure.
From June to October 2022, the team archived therapies for 70 hospitalized patients aged over 65 years and suffering from two or more chronic diseases. For each patient enrolled, the team developed a reconciliation board; afterward, the physician and the pharmacist proceeded to remodulate therapies, especially in those patients with serious interactions.
The team collected 287 drug interactions and then classified them according to the Intercheck Web software classification: 36 class D (very serious), 49 class C (major), 174 class B (moderate), and 28 class A (minor). The modified therapies at discharge were 77.14%. This restriction brought about the removal of unnecessary drugs. After six months, the team observed an improvement in the health conditions of the patients enrolled.
By increasing the patient's awareness and reducing the number of potentially inappropriate prescriptions, it is possible to improve the effectiveness of therapies. It is also possible to look at a saving policy to make the economic resources better allocated.
在意大利的医疗环境中，慢性病管理是一项优先任务。老年患者常常同时患有多种疾病，通常接受多种药物联合治疗：这很容易在药物治疗中引发潜在的有害错误。D.I.Ri.M.O.项目在内科开展，旨在通过药物重整程序减少用药错误并改善健康状况。
2022年6月至10月，该团队为70名65岁以上且患有两种或更多种慢性病的住院患者存档治疗方案。对于每名登记的患者，团队制定了一份重整清单；之后，医生和药剂师着手调整治疗方案，尤其是针对那些存在严重相互作用的患者。
该团队收集到287种药物相互作用情况，然后根据Intercheck Web软件的分类进行归类：36种为D级（非常严重），49种为C级（主要），174种为B级（中等），28种为A级（轻微）。出院时调整后的治疗方案占77.14%。这种调整导致停用了不必要的药物。六个月后，该团队观察到登记患者的健康状况有所改善。
通过提高患者的认知并减少潜在不适当处方的数量，可以提高治疗效果。还可以考虑一项节约政策，以便更好地分配经济资源。
