{
  "abstract": "Background and Importance Potentially inappropriate medication (PIMs) are those prescribed without clinical justification, either by omission or by inappropriate inclusion. Complex chronic patients have evolving therapeutic needs that require continuous reassessment, making them particularly susceptible to PIMs. Deprescribing is a planned and supervised process of reducing or discontinuing medications to improve health outcomes and reduce the risk of adverse side effects.Aim and Objectives To evaluate the impact of a Comprehensive Pharmacotherapy Assessment Program (CPAP) on the prevalence and total number of PIMs in intervention patients, before and after the intervention.Material and Methods Prospective interventional study conducted in the Emergency Department of a tertiary hospital between January 2023 and November 2023. Inclusion criteria: Complex chronic patients attending the Emergency Department who were non-institutionalised and non-palliative. CPAP was performed by a pharmacist in <24 h/48h in the Emergency Department and included medication reconciliation, pharmacotherapy review and pharmacotherapeutic recommendations report. Variables: age, sex, Charlson Comorbidity Index, polypharmacy, hyperpolypharmacy, number of patients with PIMs, total number of PIMs before and after intervention, number of PIMs consistent with STOPP-START criteria, and pharmacotherapeutic groups most frequently associated with PIMs.Results Intervention group (151): Age: 82.9. Sex: 79 male (52.3%). Charlson index: 7. Polypharmacy: 142 (94.0%). Hyperpolypharmacy: 81 (57.4%).At baseline, 146 patients (96.7%) had at least one PIM (545 PIMs; 3.58 PIMs/patient). Of these, 138 (91.4%) were consistent with STOPP-START criteria. At discharge, 88 patients (77.2%) had PIMs (307 total; 3.42 PIMs/patient). Among these, 57 (47.5%) were consistent with STOPP-START criteria.Statistically significant differences were found between baseline and discharge in the number of patients with PIMs (p=0.015), the total number of PIMs (p=0.008), and those consistent with STOPP–START criteria (p=0.015).Pharmacotherapeutic group most frequently associated with PIMs: proton pump inhibitors 64 (11.7%) and vitamins 49 (9.0%).Conclusion and Relevance Nearly all of the patients presented at least one PIM, highlighting a significant safety concern.The implementation of CPAP was associated with a significant reduction in PIMs, suggesting a positive impact on pharmacotherapy optimisation. CPAP reduced by almost 50% the number of PIMs consistent with STOPP–START criteria.The most common pharmacotherapeutic group associated with PIMs were proton pump inhibitors and vitamins.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Universitario Ramon Y Cajal- Irycis. Madrid. Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "C Acosta Cano"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramon Y Cajal- Irycis. Madrid. Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "M Muñoz-Garcia"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramon Y Cajal- Irycis. Madrid. Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "E Delgado-Silveira"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramon Y Cajal- Irycis. Madrid. Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "MD Molina-Mendoza"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramon Y Cajal- Irycis. Madrid. Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "MÁ Parro Martín"
    },
    {
      "affiliations": [
        "Hospital Ramon Y Cajal, Emergency Department, Madrid, Spain"
      ],
      "name": "M Zamorano-Serrano"
    },
    {
      "affiliations": [
        "Sermas, Primary Care East Assitencial Direction, Madrid, Spain"
      ],
      "name": "V Greciano-Greciano"
    },
    {
      "affiliations": [
        "Sermas, Primary Care East Assitencial Direction, Madrid, Spain"
      ],
      "name": "EC López-Díaz"
    },
    {
      "affiliations": [
        "Hospital Universitario Ramon Y Cajal- Irycis. Madrid. Spain, Pharmacy Department, Madrid, Spain"
      ],
      "name": "A Álvarez-Díaz"
    }
  ],
  "title": "5PSQ-110 Deprescribing of potentially inappropriate medication in complex chronic patients",
  "uid": "9877455b-3901-5461-adc5-835b3e647457"
}