Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Is it possible to reduce polypharmacy in the elderly? A randomised, controlled trial
Autore:
Pitkala, KH; Strandberg, TE; Tilvis, RS;
Indirizzi:
Helsinki Univ Hosp, Dept Med, Geriatr Clin, FIN-00029 Helsinki, Finland Helsinki Univ Hosp Helsinki Finland FIN-00029 IN-00029 Helsinki, Finland
Titolo Testata:
DRUGS & AGING
fascicolo: 2, volume: 18, anno: 2001,
pagine: 143 - 149
SICI:
1170-229X(2001)18:2<143:IIPTRP>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
MEDICATION USE; DRUG-USE; OLDER PERSONS; PHYSICIAN; HOME; INTERVENTIONS; PREDICTORS; MANAGEMENT; POPULATION; DECISIONS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Pitkala, KH Helsinki Univ Hosp, Dept Med, Geriatr Clin, POB 340, FIN-00029Helsinki, Finland Helsinki Univ Hosp POB 340 Helsinki Finland FIN-00029 Finland
Citazione:
K.H. Pitkala et al., "Is it possible to reduce polypharmacy in the elderly? A randomised, controlled trial", DRUG AGING, 18(2), 2001, pp. 143-149

Abstract

Objective: The present trial was originally designed to investigate the effectiveness of comprehensive day hospital care in chronically ill elderly patients. Another aim, reported here, was to investigate to what extent it is possible to reduce polypharmacy and simplify drug regimens during the short term tight control conditions of day hospital care. Patients: All home care patients (n = 174, mean age 77 years) in a rural area, Kirkkonummi-Siuntio, in Finland,Design and setting: Patients were randomised into 2 groups, one of which was offered a 2-month period of day hospital care. Patients assumed to be noncompliant (because they did not want day hospital care) were also includedin order to see the effect of intervention in 'real-life'. The medicationsof all participants were reviewed and counted during an in-home assessmentby a home nurse. In the intervention group, necessary revisions (dose reduction, discontinuation, possible additions) were performed through the tight monitoring of day hospital care and in co-operation with the patient. Thepatients were followed up for 10 months after completion of the intervention programme. Outcome measures: Number of prescribed medications, number of over-the-counter (OTC) drugs, number of doses taken daily by the patients. Assessments were performed at baseline, and after 2, 5 and 12 months. Results: There were no significant changes in the number of prescribed medications. In patients in day hospital care, the number of doses was reducedsignificantly (p = 0.02) during the 2-month day hospital period compared with the control group. However, the patients compensated for the reductionsby increasing the use of OTC drugs during the day hospital period (p = 0.05). In addition, only 3 months after the trial, the number of drugs had already returned to the baseline level. Conclusions: In real life it seems to be difficult to reduce polypharmacy in the elderly. Some drug reductions may be achieved with tight control under trial conditions, but when the intervention ceases the number of drugs used soon returns to its earlier level.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 00:55:41