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Diseño observacional, prospectivo y multidisciplinar entre febrero de 2019 y junio de 2020. Se elaboró un checklist con fármacos no recomendados según STOPP/START, Beers y Priscus, y fármacos susceptibles de desprescripción según LESS-CHRON, aplicados diariamente junto con revisión de receta electrónica domiciliaria. Resultados con 621 pacientes y 373 intervenciones, demostrando mejora en seguridad y calidad asistencial.",{"@graph":59,"@context":114},[60,77,97],{"@type":61,"itemListElement":62},"BreadcrumbList",[63,68,71,74],{"item":64,"name":65,"@type":66,"position":67},"https://docshare.wps.com","Home","ListItem",1,{"item":69,"name":9,"@type":66,"position":70},"https://docshare.wps.com/es/document/",2,{"item":72,"name":43,"@type":66,"position":73},"https://docshare.wps.com/es/document/salud-y-atención-médica/",3,{"item":75,"name":55,"@type":66,"position":76},"https://docshare.wps.com/es/document/farmacia-hospitalaria-47-2023-106-112-pharmaceutical-care-for-hospitalized-patients-in-a-multidisciplinary-complex-chronic-patient-unit/460686/",4,{"url":75,"name":55,"@type":78,"image":79,"author":84,"headline":55,"publisher":87,"fileFormat":90,"inLanguage":53,"description":57,"dateModified":91,"datePublished":91,"encodingFormat":90,"isAccessibleForFree":92,"interactionStatistic":93},"DigitalDocument",{"url":80,"@type":81,"width":82,"height":83},"https://docshare.wps.com/thumbnails/farmacia-hospitalaria-47-2023-106-112-pharmaceutical-care-for-hospitalized-patients-in-a-multidisciplinary-complex-chronic-patient-unit/460686.png","ImageObject",300,407,{"name":85,"@type":86},"Ophelia","Person",{"url":64,"name":88,"@type":89},"DocShare","Organization","application/pdf","2026-09-30",true,{"@type":94,"interactionType":95,"userInteractionCount":4},"InteractionCounter",{"@type":96},"ViewAction",{"@type":98,"mainEntity":99},"FAQPage",[100,106,110],{"name":101,"@type":102,"acceptedAnswer":103},"Qué se evalúa en este estudio sobre la atención farmacéutica?","Question",{"text":104,"@type":105},"Se evalúa la contribución del farmacéutico mediante el análisis de prescripción potencialmente inapropiada y la conciliación del tratamiento domiciliario en la unidad de pacientes crónicos complejos.","Answer",{"name":107,"@type":102,"acceptedAnswer":108},"Cómo se identifican los fármacos potencialmente inapropiados y la desprescripción?",{"text":109,"@type":105},"Se elabora un checklist con fármacos no recomendados según STOPP/START, Beers y Priscus, y fármacos susceptibles de desprescripción según criterios LESS-CHRON.",{"name":111,"@type":102,"acceptedAnswer":112},"Qué efecto tiene la integración del farmacéutico en el equipo multidisciplinar?",{"text":113,"@type":105},"La integración del farmacéutico en el equipo multidisciplinar mejora la seguridad del paciente y la calidad de la atención, favoreciendo la desprescripción y la detección de fármacos inadecuados.","https://schema.org",{"og:url":75,"og:type":116,"og:title":55,"og:site_name":88,"og:description":57},"article",{"robots":118,"canonical":75},"index,follow",{"doc_id":120,"site_id":52},460686,1790759102,{"code":4,"msg":5,"data":123},{"doc_id":120,"user_id":124,"nickname":85,"user_avatar":125,"doc_module":4,"category_id":42,"category_name":43,"doc_title":55,"doc_description":57,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":4,"is_deleted":4,"is_public":67,"is_downloadable":67,"audit_status":67,"page_count":131,"language":132,"language_code":53,"site_id":52,"html_lang":53,"table_of_contents":133,"faqs":134,"seo_title":135,"seo_description":57,"update_tm":121,"read_time":136},7971461741311,"https://ap-avatar.wpscdn.com/avatar/74000253aff267980c6?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779345379180704826","Farmacia Hospitalaria 47 (2023) 106–112  \n[www. elsevier. es/farmacia hospitalaria](www. elsevier. es/farmacia hospitalaria)  \nOriginal  \nPharmaceutical care for the patients admitted to a multidisciplinary complex chronic patient unit  \nArantxa Magallón Martíneza, Andrea Pinilla Relloa,⁎, Pilar Casajús Lagranjaa, Alfonso García Arandab,  \nMaría del Carmen Bueno Castelb, Ruth Caballero Asensiob, María Sevil Purasb and María Reyes Abad Sazatornila  \na Servicio de Farmacia, Hospital Universitario Miguel Servet, Zaragoza, Spain  \nb Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain  \narticle info  \nArticle history:  \nReceived 28 June 2022  \nAccepted 10 January 2023  \nAvailable online 25 February 2023  \nKeywords:  \nComplex chronic patients Medication reconciliation Inappropriate prescribing Deprescribing  \nPalabras clave:  \nPacientes crónicos complejos Conciliación de la medicación Prescrición inapropiada Desprescripción  \na b s t r a c t  \n\n| Objective: To assess the pharmacist's contributions by analyzing potentially inappropriate prescription and home treatment reconciliation in the complex chronic patient unit of a tertiary hospital.\u003Cbr>Method: Observational, prospective, multidisciplinary study of patients in the complex chronic patient unit of a hospital during February 2019–June 2020. Multidisciplinary team of the complex chronic developed a checklist with a selection ofnon-recommended drugs based on STOPP/START, Beers and Priscus criteria, and drugs susceptible to deprescription according to LESS-CHRON criteria. The pharmacist applied the checklist daily in patients admitted to the unit, in addition to reconciling home treatment by reviewing the prescribed treatment with that detailed in the electronic home prescription. Therefore, the following variables were collected: age, sex and number of drugs on admission as independent variables, and dependent variables: number of drugs at discharge, type of potentially inappropriate prescription, reasons for reconciliation, drugs involved and degree of acceptance of the recommendation by the prescribing physician to assess the pharmaceutical contribution. The statistical analysis was performed with IBM® SPSS® Statistics22.\u003Cbr>Results: We reviewed 621 patients with a median age of 84 years (56 .4% women), and intervention was performed in 218 (35. 1%). The median number of drugs was 11 (2–26) at admission and 10 (0–25) at discharge.\u003Cbr>373 interventions were performed: 235 for medication reconciliation (78.3% accepted), 71 for non-recommended drugs (57. 7% accepted), 42 for deprescription (61.9% accepted) and 25 for other reasons.\u003Cbr>Statistically significant differences were observed between the number of drugs at discharge and at admission in both intervention patients (n = 218) and complex chronic patients (n = 114) (p b 0.001 in both cases).\u003Cbr>Moreover, statistically significant differences were observed in the number of drugs at admission between patients included in the complex chronic programme and those not included (p = 0.001), and in the number of drugs at discharge (p = 0.006).\u003Cbr>Conclusions: The integration of the pharmacist in the multidisciplinary team of the complex chronic patient unit improves patient safety and quality of care. The selected criteria were useful for detecting inappropriate drugs in this population and favored deprescription.\u003Cbr>© 2023 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)). |\n| --- |\n| Atención farmacéutica al paciente ingresado en una unidad multidisciplinar de paciente crónico complejo\u003Cbr>r e s u m e n |\n\nObjetivo: Evaluar la contribución del farmacéutico mediante el análisis de la prescripción potencialmenteinapropiada y la conciliación del tratamiento domiciliario en la unidad de pacientes crónicos","cbCaibzxPj6FSFwB","https://ap.wps.com/l/cbCaibzxPj6FSFwB","pdf",369055,7,"Spanish","# Objetivo y evaluación de la intervención farmacéutica\n## Métodos\n## Resultados\n## Conclusiones","[{\"question\":\"Qué se evalúa en este estudio sobre la atención farmacéutica?\",\"answer\":\"Se evalúa la contribución del farmacéutico mediante el análisis de prescripción potencialmente inapropiada y la conciliación del tratamiento domiciliario en la unidad de pacientes crónicos complejos.\"},{\"question\":\"Cómo se identifican los fármacos potencialmente inapropiados y la desprescripción?\",\"answer\":\"Se elabora un checklist con fármacos no recomendados según STOPP/START, Beers y Priscus, y fármacos susceptibles de desprescripción según criterios LESS-CHRON.\"},{\"question\":\"Qué efecto tiene la integración del farmacéutico en el equipo multidisciplinar?\",\"answer\":\"La integración del farmacéutico en el equipo multidisciplinar mejora la seguridad del paciente y la calidad de la atención, favoreciendo la desprescripción y la detección de fármacos inadecuados.\"}]","Farmacia Hospitalaria 47 (2023) 106-112 - Atención farmacéutica al paciente ingresado en una unidad multidisciplinar de paciente crónico complejo | PDF",11]