• Teresa Molina López, Juan Carlos Domínguez Camacho, Daniel Palma Morgado, María de la O Caraballo Camacho, Juan Carlos Morales Serna, and Soledad López Rubio.
• Servicio de Promoción del Uso Racional del Medicamento, Subdirección de Farmacia, Dirección General de Asistencia Sanitaria, Servicio Andaluz de Salud, Consejería de Salud, Junta de Andalucía, Spain. mariat.molina.sspa@juntadeandalucia.es
• Aten Primaria. 2012 Aug 1; 44 (8): 453460453-60.

ObjectiveTo analyse the effectiveness of a medication review based on intervention directed at improving the appropriateness of drug treatments according to the established guidelines, as well as blood pressure, serum lipid and blood glucose control in elderly patients on multiple medication, and cardiovascular disease or high risk of cardiovascular disease.DesignA randomised controlled trial with blind evaluation.SettingFourteen Primary Health Care centres in AndalusiaParticipantsA total of 323 patients older than 65 on polypharmacy and cardiovascular disease or high risk of cardiovascular disease.InterventionA pharmacist interviewed the patient, reviewed the appropriateness of the drug treatment, taking in account health record data, proposed modifications and communicated them to the general practitioner or nurse. The control group received usual health care.Main MeasurementsPercentage of patients with appropriate use of low doses of acetylsalicylic acid, blood pressure, LDL-cholesterol, HbA(1c), and quality of life scores.ResultsA total of 41% of patients (average age 74, 61% women) had cardiovascular disease. Ten months after the intervention (18.3% withdrawals), more patients in the intervention group used low dose acetylsalicylic acid than in the control group (52.3% vs 38.6%; P=.024). There were no differences between groups in intermediate clinic outcomes. Quality of life scores improve in intervention group by 6.1 points (100 points scale), but was not statistically significant (P=.051).ConclusionClinical medication review improves the appropriateness of antiplatelet treatment in the elderly on polypharmacy and with high risk of cardiovascular disease. No improvement in biochemistry measurements was found.Copyright © 2011 Elsevier España, S.L. All rights reserved.

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