Klin Farmakol Farm. 2006;20(3):135-139

QUALITY INDICATORS OF PHARMACOTHERAPY IN GERIATRICS

Martin Wawruch⁵, Tatiana Foltánová¹, Martina Žikavská⁵, Magdaléna Kuželová¹, doc. MUDr. Pavel Weber CSc², Jana Tisoňová⁵, Beáta Mladosievičová³, Peter Krutý⁴, Milan Kriška^5,6

¹ Katedra farmakológie a toxikológie, Farmaceutická fakulta UK, Bratislava

² klinika geriatrie FN, Brno

³ Ústav patologickej fyziológie, Považská Bystrica

⁴ -

⁵ Farmakologický ústav Lekárskej fakulty UK, Bratislava

⁶ Nemocnica s poliklinikou Považská Bystrica

The improvement of the health care quality represents a common goal of professionals at different levels of health care and a prominent public priority. The inseparable part of the health care is pharmacotherapy. The unbiased comparison and evaluation of trends of pharmacotherapy quality require a quantitative analysis using quality indicators. Quality indicator is defined as a measurable element of prescribing performance for which there is evidence or consensus that it can be used to assess quality, and hence in changing the quality of care provided. They can be classified according to their focus (structure, process and outcome indicators) and their content (drug, disease and patient oriented indicators). Optimal indicators are based on the evidence–based medicine. In cases, when there is little evidence to draw unequivocal recommendations, the indicators based on combination of evidence and expert opinion consensus are used (Delphi technique, RAND appropriateness method). The development and opinion on the relevance of quality indicators are still in progress. They are used in descriptive assessment of pharmacotherapy and as a tool for improvement of its quality. The aim of the article was to provide information about this developing topic and to describe an example on their application in the practice. For example we provide an evaluation of a group of 600 patients aged ≥ 65 years from the point of view of potentially inappropriate drug use in elderly. Inappropriate drugs were defined by modified Beers 2003 criteria that were created by Delphi technique. In the evaluated group at least one potentially inappropriate drug occurred in 121 (20.2 %) and 120 (20 %) patients at the time of hospital admission and discharge, respectively.

Keywords: Key words: quality indicators, classification, pharmacotherapy, elderly patients, potentially inappropriate medication.

Published: January 1, 2007  Show citation