[Detection of therapeutic non-compliance and pharmaceutical intervention in institutionalised geriatric patients]

To detect and analyse therapeutic non-compliance in the institutionalised elderly patient who self-administer their own treatment in a geriatric residence. To assess the pharmaceutical intervention with a useful tool to detect non-compliance.

An observational study on a population of 386 residents. A clinical interview was conducted on those who treated themselves by the Pharmacy Department. An individual case report card was prepared to record demographic and clinical data, and incidents found). An interview was conducted on their treatment (drugs, dose, posology, indication and administration form), together with the compliance test validated by Morinsky-Green. Non-compliance was calculated by comparing the responses with the pharmacotherapeutic information from the Pharmacy Department and from the medical prescription of the medical charts.

Eleven per cent of patients administered their own treatment. Their mean age was 84 years and all attended the interview, which detected a non-compliance of 41%. The compliance test only detected 55% of the non-compliers. The main errors were non-compliance to the time, incorrect dosage and not taking treatment when feeling better. There was 39% involuntary non-compliance. The cardiovascular system drug group was the most involved in errors. The error could have a clinically significant repercussion in 44% of the patients.

The interview helped to detect and analyse non-compliance. The test, although specific, was not very sensitive. The main errors were easy to correct and there no problems of acceptance by the patients. With it being fundamental to preserve function and to prevent progression to dependence, and adding to this the administering of drugs, pharmaceutical intervention is a useful tool to detect and correct errors and increase adherence.