Facing a dilemma in elderly complex and vulnerable patients: to stop or not to stop prevention?

Laura Llobet Vila, Josep Maria Manresa Domínguez, José Manuel Carmona Segado, Alícia Franzi Sisó, Rosa Vallès Balasch, Isabel Martínez Díaz

    Research output: Contribution to journalArticleResearch

    4 Citations (Scopus)

    Abstract

    © 2017 Elsevier España, S.L.U. Objectives: 1-To know the preventive prescription (statin, antiplatelet drugs, bisphosphonates, calcium and vitamin D and Vit B12) of elderly patients previously identified as a CCD (with a complex chronic disease) and ACD (with advanced chronic disease and lifetime expectancy of less than 12 months) who died during 2015. 2-To assess the correct indication of Proton Pump Inhibitors (PPI) to determine potentially avoidable medication. Design: Retrospective observational study. Location: Four Primary Health Centres, Castellar del Vallès (Barcelona). Participants: 128 patients, 70 ACD and 58 PCC. Main measurements: Number of drugs at the time of death from the 6 selected group, deprescription (6 months prior to death due to advanced chronic disease), primary or secondary prevention and inappropriate prescription of PPI. Results: Average age of 85'3 years (10,3). 40% took an antiplatelet drug, avoidable in 60% of the ACD, since they did not present any previous cardiovascular episode. 20% of the patients took statins, in which 48% of the cases were primary prevention. The PPI prescription was 67% with inadequate indication for use in 49% of these cases. 20% took calcium / Vitamin D and 1,6% of the ACD a bisphosphonate. There was a 16% deprescription. Conclusions: A high percentage of our patients with advanced chronic disease and short life expectancy still continue to take preventive and avoidable treatments, potentially dangerous due to their side effects. There is a need to reflect on what we do with these vulnerable patients.
    Original languageEnglish
    Pages (from-to)583-589
    JournalAtención primaria (Barcelona. Ed. impresa)
    Volume50
    DOIs
    Publication statusPublished - 1 Dec 2018

    Keywords

    • Deprescription
    • Inappropriate Prescribing's
    • Patient safety

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