4CPS-229 Implementation of a stratification model for chronic paediatric patients in outpatient pharmacy
Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Background and Importance The increasing prevalence of chronic patients requires individualised attention focused on patient needs, guaranteeing optimal health outcomes ant the sustainability of the healthcare system. The Spanish Society of Hospital Pharmacy developed a stratification pharmaceutical care model to determine the complexity of chronic paediatric outpatients assisting pharmacists in optimising resources and pharmaceutical interventions. Aim and Objectives To determine the complexity of patients, using the stratification model and identify those most likely to benefit from pharmaceutical interventions. Material and Methods A cross-sectional study was conducted from September 2023 to September 2024. Data were collected from electronic medical records and semi-structured patient/caregiver interviews were carried out. Variables recorded: age, nutritional status, social, economic and cognitive issues, hospital admissions and emergency visits, comorbidities, polypharmacy, adherence, treatment changes, complex pathology (transplant and palliative care), polypharmacy and high-risk medications for the paediatric population. Variables were weighted between 1 and 4 based on its relevance, leading to four stratification levels: level 1 (≥27 points), level 2 (23–26 points), level 3 (18–22 points), and level 4 (≤21 points). Tailored pharmaceutical interventions were implemented according to complexity. Results 166 paediatric patients were stratified, 51% male, median age 11 (1–17). Distribution between medical services was haemato-oncology (59.6%), nephrology (18.7%), infectious diseases (7.8%), neurology (7.8%), gastroenterology (2.4%), endocrinology (1.9%), and allergology (1.8%). 9% belonged to level 1, 15.7% to level 2, 21.5% to level 3, and 54.2% to level 4. 41.7% of level 1 were bone marrow transplant patients. The most significant variables in the level 1 priority group included social issues, frequent hospital admissions, comorbidities (hypertension and renal insufficiency), polypharmacy (>4 drugs), frequent treatment changes and high-risk medications (anticoagulants, antiepileptics, and immunosuppressants). Follow-up plans adapted to the different levels were carried out, prioritising patients included in groups 1 and 2 through medication reconciliation and information during care transitions, integration with the healthcare team, telephone follow-up and coordination with primary care and community pharmacy. Conclusion and Relevance The application of a stratification model and identification of most complex paediatric patients (levels 1 and 2), enables pharmaceutics to develop interventions such as reconciliation during care transitions, close follow-up, and coordination with the team that ensure efficient, safe and high-quality pharmaceutical care. References and/or Acknowledgements Conflict of Interest No conflict of interest
Institution: Hospital General Universitario Gregorio Marañón
Language: English
Subfield: Pharmacology
Domain: Life Sciences
Open Access status: gold
OpenAlex ID: W4408376264