Knowledge of the pharmacological profile of a patient improves the quality of prescribing, the outcomes of treatment, and the utilization of health services in primary health care

Abstract

Purpose: To evaluate the influence of the pharmacological profile of a patient (PPP) on quality of drug prescribing, treatment effectiveness, safety, and health services utilization in a group of outpatients. Methods: The study was designed as an open, nonrandomized trial of an intervention in health care. The outpatient intervention group (n∈=∈39) received the PPP, and the control group (n∈=∈36) did not. In all cases, the outcomes were observed for a 2-year period in total; in the intervention group 1 year of observation was allocated before and another year after the introduction of the PPP. Results: The PPPs reduced multiple prescriptions by 1. 08∈±∈1.13 drugs per patient, whereas in those who did not receive the PPP, an increase of 1.44∈±∈1.48 drugs per patient occurred (P∈<∈0.001, 95% CI 1.91-3.13). A decrease in the medication appropriateness index score of 0.81∈±∈0.51 per drug per patient in the intervention group was observed (P∈=∈0.001, 95% CI 0.63-0.93), and in the control group an increase was noted (0. 13∈±∈0.40; P∈=∈0.063). The majority of patients with PPP experienced fewer adverse drug reactions (0.96∈±∈0.58 fewer, P∈<∈0.001 vs. controls, 95% CI 1.39-2.13), and they were more likely to have an improvement in health status (OR 22.0, 95% CI 5.87-82.41). Finally, the PPPs decreased both the number of examinations and the number of diagnostic investigations, on average by 2.15 and 2.26 services per patient, respectively. Conclusions: Use of a pharmacological profile of a patient in primary care practice could improve not only prescribing behavior of general practitioners, but also effectiveness and safety of therapy, while reducing utilization of health services. © 2011 Springer-Verlag.