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Managing polypharmacy in chronic patients through digital solutions

Authors:

Esteban Manuel Keenoy ,

Kronikgune Institute for Health Service Research, Spain, ES
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Irati Erreguerena Redondo,

Kronikgune Institute for Health Service Research, Spain, ES
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Ane Fullaondo Zabala,

Kronikgune Institute for Health Service Research, Spain, ES
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María Dolores García Martínez,

Osakidetza, ES
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Ricardo Semper Ochotorena,

Osakidetza, ES
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Elena Valverde Bilbao,

Osakidetza, ES
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Carmela Mozo Avellaned,

Osakidetza, ES
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Manuel Vicente Carneiro,

Osakidetza, ES
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Ana Ortega-Gil

Kronikgune Institute for Health Service Research, Spain, ES
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Abstract

Introduction: Population longevity, morbidity and high consumption of medicines, have become polypharmacy a priority health problem due to its high prevalence and problems that can cause: lack of adherence, increased adverse effects and drug interactions, or functional deterioration. Treatment review in polymedicated patients is an essential activity to improve the appropriateness of treatments and avoid potential prescription-related safety problems.

In the EU-funded GATEKEEPER project, the Basque Country region is running the use case “management of people with chronic diseases and polypharmacy”.  It has implemented an intervention through a mobile application and web solution for the management of polypharmacy in multimorbid patients. 

Aims, Objectives, Theory And Methods: This quasi-experimental study (non-randomised, concurrent and controlled study) aimed to assess the effectiveness and user experience of two applications to optimize the detection of inappropriate therapeutic prescriptions (CheckTheMeds) and to improve adherence to treatment in patients (My Treatment) with chronic diseases and polypharmacy.

The intervention is being carried out in 11 Integrated Healthcare Organizations from Osakidetza Basque Health Service. The target is to recruit 1,000 elderly people (500-intervention group and 500 control group) that fits with the inclusion criteria (aged more than 70 years or older, with more than 2 chronic diseases, and more than 9 drugs prescribed).

Highlights Or Results Or Key Findings: Trained Primary Care healthcare professionals will contact 500 candidates for the intervention group, who will be invited to participate in the study and informed about it. After signing the informed consent form, their health status, prescribed drugs, and the adherence to the treatment will be revised and monitored for 9 months. Piloting will last since December 2021 to September 2022.

A mixed methods approach will be employed, integrating quantitative and qualitative technics. Data obtained through different approaches (Questionnaires, administrative data, usage metrics, interviews information), will provide a broad understanding of what each approach has achieved and how or why results have been produced.

Se invitará al paciente a utilizar la App corporativa ""Mi Tratamiento"" que fomentará la adherencia al tratamiento y hará que los pacientes y/o cuidadores sean conscientes de la medicación que tienen prescrita, se hagan cargo de su tratamiento y tengan comunicación con los profesionales sanitarios.

Conclusions: This study pretends to give evidence how a treatment appropriateness, together with greater therapeutic adherence, will result in more effective treatments with fewer drug-related problems and health complications, and thus in improved efficiency in the use of healthcare resources and also increase quality of life of these patients.

Implications For Applicability/Transferability/Sustainability: The use of CheckThemeds and App “Mi Tratamiento” tools will improve the adherence and prescription through the review of medicines that detect potentially inappropriate prescriptions and increase the rate of therapeutic compliance.Osakidetza Basque Health Service will integrate these platforms in the clinical practice as part of the multimorbid patient’s pathway.

 

How to Cite: Keenoy EM, Erreguerena Redondo I, Fullaondo Zabala A, Martínez MDG, Semper Ochotorena R, Valverde Bilbao E, et al.. Managing polypharmacy in chronic patients through digital solutions. International Journal of Integrated Care. 2022;22(S3):166. DOI: http://doi.org/10.5334/ijic.ICIC22318
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Published on 04 Nov 2022.

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