20.500.12556/DKUM-89372 Clinical pharmacist interventions in ambulatory psychogeriatric patients with excessive polypharmacy Psychogeriatric primary care patients are frequently treated with excessive polypharmacy (≥ 10 medications), leading to complications and increased costs. Such cases are rarely included in treatment guidelines and randomized controlled trials. This paper evaluates the impact of clinical pharmacist medication reviews on the quality of pharmacotherapy in primary care psychogeriatric patients with excessive polypharmacy. The retrospective observational multicentric pre-post study included patients (aged 65 or above) treated with at least one psychotropic and ten or more medications. Clinical pharmacists' recommendations were retrieved from medication review forms for the period 2012-2014. The study outcome measures were the number of medications, potentially inappropriate medications in the elderly (PIMs), potential drug-drug interactions which should be avoided (pXDDIs), and adherence to treatment guidelines. The study included 246 patients receiving 3294 medications, of which 14.6% were psychotropics. The clinical pharmacists proposed 374 interventions in psychopharmacotherapy. The general practitioners accepted 45.2% of them (169). Accepting clinical pharmacist recommendations reduced the total number of medications by 7.5% from 13.4 to 12.4 per patient (p < 0.05), the total number of prescribed PIMs by 21.8% from 312 to 244 (p < 0.05), the number of pXDDIs by 54.9% from 71 to 31 (p < 0.05) and also improved treatment guidelines adherence for antidepressants and antipsychotics (p < 0.05). Clinical pharmacist interventions significantly improved the quality of psychopharmacotherapy by reducing the total number of medications, PIMs, and pXDDIs. Accepting clinical pharmacist interventions led to better treatment guidelines adherence. polypharmacy elderly patients clinical pharmacist medications drug-drug interactions psychopharmacotherapy polifarmacija starejši bolniki klinični farmacevt zdravila interakcije med zdravili psihofarmakoterapija true false true Nature Publishing Group Angleški jezik Slovenski jezik Znanstveno delo 2024-07-05 09:53:53 2024-07-05 10:26:53 2024-07-06 04:02:48 0000-00-00 00:00:00 2022 0 0 Str. 1-8 Št. 1, št. članka 11387 Letn. 12 2022 0000-00-00 Zaloznikova Objavljeno NiDoloceno 2022-03-22 2022-06-27 2022-07-06 615-053.9 116499203 10.1038/s41598-022-15657-x 2045-2322 Stuhec-2022-Clinical_pharmacist_interventions.pdf Stuhec-2022-Clinical_pharmacist_interventions.pdf 1 2CCCEA2C7DC6B4B1A91155A8901A9463 9bf4dbfd4956d688488abc192ef297bf85f3140786ed688ae6651bdc6ad1ac78 76714785-3aa6-11ef-bcfd-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=181172 https://doi.org/10.1038/s41598-022-15657-x 0 be9becf7-3aa3-11ef-bcfd-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=181169 Medicinska fakulteta 0 0 0