A Jiménez Ortiz1, I García García. 1. Gobierno Vasco. Dirección Territorial de Sanidad de Gipuzkoa. Departamento de Farmacia. San Sebastián. España.
Abstract
OBJECTIVE: To analyse the impact of the composition, publication and dissemination of the Geriatric Drug-therapy Guide of Gipuzkoa (GDGG) and monitoring of adherence to it, as an intervention in the community to improve medical prescription in old people s homes (OPH) in Gipuzkoa. DESIGN: Descriptive evaluation <<before and after>> the intervention. SAMPLE: billed prescriptions for pharmaceutical products (PP) from Osakidetza in 1996 (pre-intervention) and 1997-1999 (post-intervention). SOURCE: the prescription data base of the Basque Government. SETTING: 35 OPH in Gipuzkoa (2963 residents). MEASUREMENTS AND RESULTS: Indicators: Adherence percentage=(No. units prescribed of PP with selected active principles)x100/total No. PP prescribed); Mean price per unit (MPU)=(total RSP of units/total No. PP units). Overall adherence rose from 44% in 1996 to 62% in 1999; the groups accounting for 84% of prescription and the sub-groups accounting for 65% of prescription went up in these years from 43% to 64% and from 50% to 67%, respectively. A deceleration of the increase in MPU in OPH was detected, when compared with the figure for primary care. CONCLUSIONS: Overall adherence to the GDGG is high, with an upwards tendency that lasts about three years after the initial intervention. Similarly, the evolution of the MPU for the PP prescribed in OPH is better than the primary care average, with a steady deceleration in the indirect indicator analysed. The community intervention undertaken is an effective tool for improving medical prescription in the old people s homes examined.
OBJECTIVE: To analyse the impact of the composition, publication and dissemination of the Geriatric Drug-therapy Guide of Gipuzkoa (GDGG) and monitoring of adherence to it, as an intervention in the community to improve medical prescription in old people s homes (OPH) in Gipuzkoa. DESIGN: Descriptive evaluation <<before and after>> the intervention. SAMPLE: billed prescriptions for pharmaceutical products (PP) from Osakidetza in 1996 (pre-intervention) and 1997-1999 (post-intervention). SOURCE: the prescription data base of the Basque Government. SETTING: 35 OPH in Gipuzkoa (2963 residents). MEASUREMENTS AND RESULTS: Indicators: Adherence percentage=(No. units prescribed of PP with selected active principles)x100/total No. PP prescribed); Mean price per unit (MPU)=(total RSP of units/total No. PP units). Overall adherence rose from 44% in 1996 to 62% in 1999; the groups accounting for 84% of prescription and the sub-groups accounting for 65% of prescription went up in these years from 43% to 64% and from 50% to 67%, respectively. A deceleration of the increase in MPU in OPH was detected, when compared with the figure for primary care. CONCLUSIONS: Overall adherence to the GDGG is high, with an upwards tendency that lasts about three years after the initial intervention. Similarly, the evolution of the MPU for the PP prescribed in OPH is better than the primary care average, with a steady deceleration in the indirect indicator analysed. The community intervention undertaken is an effective tool for improving medical prescription in the old people s homes examined.