D.I.Ri.M.O. project: deprescription, inappropriateness evaluation and therapeutic reconciliation in hospital medicine

Background: In the Italian healthcare landscape, the management of chronic pathologies is a priority. Often, the elderly patient suffers from several pathologies at once and is commonly on polytherapy: this can easily bring potentially harmful errors in drug therapy. The D.I.Ri.M.O. project took pla...

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Main Authors: Maria Giulia Pollice, Luca Degli Esposti, Cataldo Procacci, Salvatore Lenti, Domenica Ancona, Carmela Nappi, Biagio Iacolare, Anna Maria Tesse, Domenico Leuci, Mara Masullo, Domenico Tricarico
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Language:English
Published: AboutScience Srl 2025-03-01
Series:Global & Regional Health Technology Assessment
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Online Access:https://aboutscience.archicoop.it/index.php/grhta/article/view/3194
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author Maria Giulia Pollice
Luca Degli Esposti
Cataldo Procacci
Salvatore Lenti
Domenica Ancona
Carmela Nappi
Biagio Iacolare
Anna Maria Tesse
Domenico Leuci
Mara Masullo
Domenico Tricarico
author_facet Maria Giulia Pollice
Luca Degli Esposti
Cataldo Procacci
Salvatore Lenti
Domenica Ancona
Carmela Nappi
Biagio Iacolare
Anna Maria Tesse
Domenico Leuci
Mara Masullo
Domenico Tricarico
author_sort Maria Giulia Pollice
collection DOAJ
description Background: In the Italian healthcare landscape, the management of chronic pathologies is a priority. Often, the elderly patient suffers from several pathologies at once and is commonly on polytherapy: this can easily bring potentially harmful errors in drug therapy. The D.I.Ri.M.O. project took place in an Internal Medicine department and aimed to reduce medication errors and improve the state of health through the Pharmacological Reconciliation procedure. Methods: From June to October 2022, the team archived therapies for 70 hospitalized patients aged over 65 years and suffering from two or more chronic diseases. For each patient enrolled, the team developed a reconciliation board; afterward, the physician and the pharmacist proceeded to remodulate therapies, especially in those patients with serious interactions. Results: The team collected 287 drug interactions and then classified them according to the Intercheck Web software classification: 36 class D (very serious), 49 class C (major), 174 class B (moderate), and 28 class A (minor). The modified therapies at discharge were 77.14%. This restriction brought about the removal of unnecessary drugs. After six months, the team observed an improvement in the health conditions of the patients enrolled. Conclusions: By increasing the patient’s awareness and reducing the number of potentially inappropriate prescriptions, it is possible to improve the effectiveness of therapies. It is also possible to look at a saving policy to make the economic resources better allocated.
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spelling doaj-art-a1a337cedfcd443cb36ac08e59c8a0bd2025-08-20T03:00:04ZengAboutScience SrlGlobal & Regional Health Technology Assessment2284-24032283-57332025-03-0112110.33393/grhta.2025.3194D.I.Ri.M.O. project: deprescription, inappropriateness evaluation and therapeutic reconciliation in hospital medicineMaria Giulia Pollice0Luca Degli Esposti1Cataldo Procacci2Salvatore Lenti3Domenica Ancona4Carmela Nappi5Biagio Iacolare6Anna Maria Tesse7Domenico Leuci8Mara Masullo9Domenico Tricarico10Department of Pharmacy-Pharmaceutical Sciences, University Aldo Moro, 70125 Bari, ItalyCliCon S.r.l. Società Benefit Health, Economics and Outcomes Research, Bologna - ItalyPharmaceutical Department of the Barletta-Andria-Trani Local Health Authority, Trani - ItalyInternal Medicine Unit Andria Hospital, Barletta-Andria-Trani Local Health Authority, Andria - ItalyPharmaceutical Department of the Barletta-Andria-Trani Local Health Authority, Trani - ItalyCliCon S.r.l. Società Benefit Health, Economics and Outcomes Research, Bologna - ItalyCliCon S.r.l. Società Benefit Health, Economics and Outcomes Research, Bologna - ItalyInternal Medicine, University of Foggia, Foggia - ItalyInternal Medicine Unit Andria Hospital, Barletta-Andria-Trani Local Health Authority, Andria - ItalyClinical Risk Management, Quality and Bed Management, Barletta-Andria-Trani Local Health Authority, Trani - ItalyDepartment of Pharmacy, Pharmaceutical Sciences, University Aldo Moro, Bari - ItalyBackground: In the Italian healthcare landscape, the management of chronic pathologies is a priority. Often, the elderly patient suffers from several pathologies at once and is commonly on polytherapy: this can easily bring potentially harmful errors in drug therapy. The D.I.Ri.M.O. project took place in an Internal Medicine department and aimed to reduce medication errors and improve the state of health through the Pharmacological Reconciliation procedure. Methods: From June to October 2022, the team archived therapies for 70 hospitalized patients aged over 65 years and suffering from two or more chronic diseases. For each patient enrolled, the team developed a reconciliation board; afterward, the physician and the pharmacist proceeded to remodulate therapies, especially in those patients with serious interactions. Results: The team collected 287 drug interactions and then classified them according to the Intercheck Web software classification: 36 class D (very serious), 49 class C (major), 174 class B (moderate), and 28 class A (minor). The modified therapies at discharge were 77.14%. This restriction brought about the removal of unnecessary drugs. After six months, the team observed an improvement in the health conditions of the patients enrolled. Conclusions: By increasing the patient’s awareness and reducing the number of potentially inappropriate prescriptions, it is possible to improve the effectiveness of therapies. It is also possible to look at a saving policy to make the economic resources better allocated. https://aboutscience.archicoop.it/index.php/grhta/article/view/3194ComorbidityDeprescriptionElderly patientHospitalizationPharmacological reconciliationPolytherapy
spellingShingle Maria Giulia Pollice
Luca Degli Esposti
Cataldo Procacci
Salvatore Lenti
Domenica Ancona
Carmela Nappi
Biagio Iacolare
Anna Maria Tesse
Domenico Leuci
Mara Masullo
Domenico Tricarico
D.I.Ri.M.O. project: deprescription, inappropriateness evaluation and therapeutic reconciliation in hospital medicine
Global & Regional Health Technology Assessment
Comorbidity
Deprescription
Elderly patient
Hospitalization
Pharmacological reconciliation
Polytherapy
title D.I.Ri.M.O. project: deprescription, inappropriateness evaluation and therapeutic reconciliation in hospital medicine
title_full D.I.Ri.M.O. project: deprescription, inappropriateness evaluation and therapeutic reconciliation in hospital medicine
title_fullStr D.I.Ri.M.O. project: deprescription, inappropriateness evaluation and therapeutic reconciliation in hospital medicine
title_full_unstemmed D.I.Ri.M.O. project: deprescription, inappropriateness evaluation and therapeutic reconciliation in hospital medicine
title_short D.I.Ri.M.O. project: deprescription, inappropriateness evaluation and therapeutic reconciliation in hospital medicine
title_sort d i ri m o project deprescription inappropriateness evaluation and therapeutic reconciliation in hospital medicine
topic Comorbidity
Deprescription
Elderly patient
Hospitalization
Pharmacological reconciliation
Polytherapy
url https://aboutscience.archicoop.it/index.php/grhta/article/view/3194
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