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Optimizing drug therapy in patients with advanced dementia: A patient-centered approach

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dc.contributor Universitat de Vic. Càtedra de Cures Pal·liatives
dc.contributor.author Molist Brunet, Núria
dc.contributor.author Sevilla Sánchez, Daniel
dc.contributor.author Amblàs-Novellas, Jordi
dc.contributor.author Codina Jané, Carles
dc.contributor.author Gómez-Batiste, Xavier
dc.contributor.author McIntosh, J.
dc.contributor.author Espaulella Panicot, Joan
dc.date.accessioned 2014-03-05T12:46:34Z
dc.date.available 2014-03-05T12:46:34Z
dc.date.created 2014
dc.date.issued 2014
dc.identifier.citation Molist Brunet, N., Sevilla-Sánchez, D., Amblàs Novellas, J., Codina Jané, C., Gómez-Batiste, X., McIntosh, J., Espaulella Panicot, J. (2014). Optimizing drug therapy in patients with advanced dementia: A patient-centered approach. European Geriatric Medicine, 5 ( 1 ), 66-71. ca_ES
dc.identifier.issn 1878-7649
dc.identifier.uri http://hdl.handle.net/10854/2759
dc.description.abstract Background: Advanced dementia is a prevalent health problem in geriatric patients. These patients usually suffer from several chronic diseases, frequently leading to an end-of-life situation lasting months or years, generating complex and often inappropriate medication regimens. Objectives: Describe the re-orientation of drug therapy in patients with advanced dementia utilizing a systematic medication review process. Methods: This non-experimental pre-post analysis included all patients with advanced dementia admitted to acute geriatric unit (AGU) over one year. Medications were reviewed by a multidisciplinary team and together with the patient caregivers; new therapeutic objectives based on end-of-life care principles were established. Medications were classified as preventive, therapeutic, or symptomatic. The average number of medications per patient pre- and post-admission was compared. Results: We included 73 patients (mean age 86.1 years, mean Barthel Index: 14.5/100). At admission, patients had a mean of 7.27 drugs compared to 4.82 at discharge (66.85% reduction, P < 0.05). The main drugs withdrawn were cardiovascular and hematological (35.76%). Drugs for prevention decreased by 66.85% (from 1.8 to 0.6, P < 0.05) and those for symptomatic care decreased by 17,52% (from 2.34 to 1.93, P < 0.05). Conclusion: Medication therapy plans in patients with advanced dementia often do not meet their therapeutic goals. The proposed methodology is a useful tool to assess therapeutic appropriateness. ca_ES
dc.format application/pdf
dc.format.extent 6 p. ca_ES
dc.language.iso eng ca_ES
dc.publisher Elsevier Masson ca_ES
dc.rights (c) 2014 Elsevier. Published article is available at: http://dx.doi.org/10.1016/j.eurger.2013.10.011
dc.subject.other Demència senil ca_ES
dc.subject.other Medicaments ca_ES
dc.title Optimizing drug therapy in patients with advanced dementia: A patient-centered approach ca_ES
dc.type info:eu-repo/semantics/article ca_ES
dc.identifier.doi https://doi.org/10.1016/j.eurger.2013.10.011
dc.relation.publisherversion http://www.sciencedirect.com/science/article/pii/S1878764913009261
dc.rights.accessRights info:eu-repo/semantics/closedAccess ca_ES
dc.type.version info:eu-repo/publishedVersion ca_ES
dc.indexacio Indexat a SCOPUS
dc.indexacio Indexat a WOS/JCR ca_ES

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