Adaptation

4452006 | Adaptation | The PAI of attention to pluripathological patients [1] proposes the use of the STOPP-START criteria as the main tool to improve the appropriateness. Always bearing in mind that some START criteria cannot be applied to patients with a PROFUND index greater than 11. These patients are also not recommended to start secondary prevention treatments. It is also not recommended to start primary prevention treatments for patients with multiple pathologies. Preventive treatments should also be desprescribed if the expected benefit exceeds the time horizon of life expectancy. With regard to bisphosphonates and anti-resortives, their suspension is recommended after more than three years of preventive treatment. Opioids are high-risk drugs, so it is recommended: - To evaluate in patients the existence of the following risk factors for respiratory depression: obstructive sleep apnea, morbid obesity with risk of sleep apnea, advanced age, use of other sedative medications, existing pulmonary or cardiac disease, etc. - Avoid the concomitant prescription of minor and major opioids. - In patients at risk of falls, the treatment should be reviewed for increased risk. [1] Ollero Baturone, M., Bernabeu-Wittel, M., Espinosa Almendro, J. M., García Estepa, R., Morilla Herrera, J. C., Pascual de la Pisa, B., ... & Sanz Amores, R. (2018). Atención a pacientes pluripatológicos: proceso asistencial integrado.

http://www.semanticweb.org/parracarlos/ontologies/2019/3/untitled-ontology-31#Adaptation

4452006 | Adaptation |

The PAI of attention to pluripathological patients [1] proposes the use of the STOPP-START criteria as the main tool to improve the appropriateness. Always bearing in mind that some START criteria cannot be applied to patients with a PROFUND index greater than 11. These patients are also not recommended to start secondary prevention treatments. It is also not recommended to start primary prevention treatments for patients with multiple pathologies. Preventive treatments should also be desprescribed if the expected benefit exceeds the time horizon of life expectancy. With regard to bisphosphonates and anti-resortives, their suspension is recommended after more than three years of preventive treatment. Opioids are high-risk drugs, so it is recommended: - To evaluate in patients the existence of the following risk factors for respiratory depression: obstructive sleep apnea, morbid obesity with risk of sleep apnea, advanced age, use of other sedative medications, existing pulmonary or cardiac disease, etc. - Avoid the concomitant prescription of minor and major opioids. - In patients at risk of falls, the treatment should be reviewed for increased risk. [1] Ollero Baturone, M., Bernabeu-Wittel, M., Espinosa Almendro, J. M., García Estepa, R., Morilla Herrera, J. C., Pascual de la Pisa, B., ... & Sanz Amores, R. (2018). Atención a pacientes pluripatológicos: proceso asistencial integrado.

Adaptation

Adaptation

4452006

http://www.semanticweb.org/parracarlos/ontologies/2019/3/untitled-ontology-31#Therapeutic_optimization