[Monitoring polymedicated elderly patients in a health care unit]

Implement a coordinated strategy for the family care unit and the pharmacy division in order to enable revising treatment in polymedicated patients. To this end, we have developed a software tool permitting the patient's primary doctor to have a quick, summarised description of the patient's updated pharmacological treatments, and detect iatrogenic risks and/or dosage adjustments and pharmacotherapy advice.

In this study, polymedicated patients are defined as those taking 10 or more medications during at least one month. Development phases: Design of a guide form to assist the family doctor in reviewing treatments. Development of a pharmacotherapy report (FTR) as a complementary document to assist the doctor in reviewing treatments. Implementation of a coordinated loop between the family doctor and the pharmacist. Review of work instructions and distribution to involved staff members.

The target population of the study consists of 1897 polymedicated patients. We issued 1897 reports, containing the following: 8530 recommendations (10% alerts from regulatory authorities, 31% recommendations regarding high-risk drugs in elderly patients, 7% information on new treatments and 52% recommendations on proper drug use); 399 highly relevant drug interactions; and 5036 recommendations for dose adjustment. These pharmacotherapy reports permit treatment to be revised for nearly 100% of the selected population.

The development and implementation of software tools for monitoring polymedicated patients enables us to create FTRs that facilitate routine medical reviews of pharmacological treatment in a fairly wide range of patients.