Implementation of Pharmaceutical Care in Geriatrics: Strategies Adopted and Experiences Acquired

Abstract

Objectives: To describe the steps, strategies adopted, and experiences accumulated during
the implementation of pharmaceutical care in a geriatric ward. Method: A descriptive
mixed-methods study was proposed, carried out in three planned stages for the implemen
tation of pharmaceutical care (medication reconciliation, medication review, and phar
macotherapeutic follow-up) in a geriatric ward at the University of São Paulo Hospital.
In the first stage, a scoping review was conducted using the EMBASE, Web of Science,
and PubMed databases. The second stage consisted of developing a situational diagnosis
of the ward and adjusting procedures. The third stage comprised an intervention method
aimed at identifying and resolving drug-related problems and analyzing associated clinical
outcomes. Results: In the first stage, after screening 3,640 articles on pharmaceutical
interventions in geriatrics, 35 were included in the review. The interventions frequently
used the STOPP/START criteria and the Beers criteria. The main barriers were the lack
of specific training and restrictions on service continuity. This stage provided scientific
support for project development. In the second stage, the situational diagnosis addressed
the ward’s structure and epidemiological profile. Pharmaceutical services were validated
by a multidisciplinary team and well accepted. In the third stage, 88% of patients had at
least one PRP, with an average of 1.4 PRPs per patient. The acceptance rate of pharma
ceutical recommendations was 85%. Conclusion: The planned method was effective in
implementing pharmaceutical care, with the creation of informative materials and eviden
ce-based strategies. Considering the context of geriatric wards, this initiative stands out as
an innovation in a Latin American country and can serve as a model for similar initiatives.