RT Journal Article
T1 Shared Decision-Making in Chronic Patients with Polypharmacy: An Interventional Study for Assessing Medication Appropriateness
A1 Coronado Vázquez, María del Valle
A1 Gómez Salgado, Juan
A1 Cerezo Espinosa de los Monteros, Javier
A1 Ayuso Murillo, Diego
A1 Ruiz Frutos, Carlos
AB Potentially inappropriate medications are associated with polypharmacy and polypathology.Some interventions such as pharmacotherapy reviews have been designed to reduce the prescribing ofinappropriate medications. The objective of this study is to evaluate how e ective a decision-makingsupport tool is for determining medication appropriateness in patients with one or more chronicdiseases (hypertension, dyslipidaemia, and/or diabetes) and polypharmacy in the primary caresetting. For this, a quasi-experimental study (randomised, controlled and multicentre) has beendeveloped. The study compares an intervention group, which assesses medication appropriatenessby applying a decision support tool, with a control group that follows the usual clinical practice.The intervention included a decision support tool in paper format, where participants were informedabout polypharmacy, inappropriate medications, associated problems and available alternatives,as well as shared decision-making. This is an informative guide aimed at helping patients withdecision-making by providing them with information about the secondary risks associated withinappropriate medications in their treatment, according to the Beers and START/STOPP criteria. Theoutcome measure was the proportion of medication appropriateness. The proportion of patients whoconfirmed medication appropriateness after six months of follow-up is greater in the intervention group(32.5%) than in the control group (27.9%) p = 0.008. The probability of medication appropriateness,which was calculated by the proportion of drugs withdrawn or replaced according to the STOPP/Beerscriteria and those initiated according to the START criteria, was 2.8 times higher in the interventiongroup than in the control group (OR = 2.8; 95% CI 1.3–6.1) p = 0.008. In patients with good adherenceto the treatment, the percentage of appropriateness was 62.1% in the shared decision-making groupversus 37.9% in the control group (p = 0.005). The use of a decision-making support tool in patientswith potentially inappropriate medications increases the percentage of medication appropriatenesswhen compared to the usual clinical practice.
PB MDPI
SN 2077-0383
YR 2019
FD 2019-06
LK http://hdl.handle.net/10272/16530
UL http://hdl.handle.net/10272/16530
LA eng
NO Coronado Vázquez, V., Gómez Salgado, J., Cerezo Espinosa de los Monteros, J., Ayuso Murillo, D.,  Ruiz Frutos, C. (2019). Shared Decision-Making in Chronic Patients with Polypharmacy: An Interventional Study for Assessing Medication Appropriateness. Journal of Clinical Medicine, 8(6), 904. https://doi.org/10.3390/jcm8060904
DS Repositorio Institucional de la Universidad de Huelva
RD 1 jun 2026