PS-053 Prescription quality indicators of the antihypertensive treatment of elderly people in the socio-sanitary sector

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Abstract

Background

The patient profile in the socio-sanitary sector is a fragile elderly person aged 80 years or older, whose most common pathology is arterial hypertension. There is controversy over the benefit of antihypertensive treatment in these patients, which must be implemented individually.

Purpose

To define and develop a set of prescription quality indicators for the appropriate use of antihypertensive medication in elderly patients in the socio-sanitary sector, to be used as a useful tool in the pharmacotherapeutic monitoring of these patients.

Material and methods

A scientific evidence review was accomplished through studies and meta-analyses, searching in Medline, consensus documents, protocols and clinical practice guides (CPG). The definition and presentation of each indicator were based on the Joint Commission on Accreditation of Healthcare Organisations’ recommendations.

Results

27 prescription quality indicators in the socio-sanitary sector for antihypertensive medication in elderly patients were made. The type of indicators made were process indicators, which showed what should be done to prevent safety problems and to guarantee pharmacotherapeutic quality. They were mainly related to treatment, initial evaluation and its monitoring. At the same time, these indicators were classified into 5 sections: initial treatment evaluation (ie, lifestyle changes and pharmacologic treatment indication); contraindications (beta-adrenergic blockers, diuretics, calcium antagonists, alpha adrenergic blocking agents, ACEI and ARB); evaluation of treatment strategy (ie, initial doses, response to treatment, therapeutic strategy); treatment in special situations (ie, diabetes mellitus, proteinuria, osteoporosis); and monitoring (ie, dose reduction and treatment suppression, adherence and treatment follow-up).

Conclusion

The prescription quality indicators for antihypertensive therapy in institutionalised elderly which have been prepared will constitute a useful tool, easy to use in clinical practice for the expert pharmacist in the socio-sanitary field, as all the most important aspects of antihypertensive therapy have been considered in this clinical setting, in addition to the most up to date recommendations from the leading CPG.

References and/or acknowledgements

European Guidelines on cardiovascular disease prevention in clinical practice, 2016.

References and/or acknowledgements

ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly.

References and/or acknowledgements

Joint Commission on Accreditation of Healthcare Organisations.

References and/or acknowledgements

No conflict of interest

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