Evaluación del impacto de la implementación de un protocolo perioperatorio para pacientes con enfermedad de Parkinson en la reducción de la prescripción de medicación contraindicada

Abstract

Due to the progressive increase in the prevalence of Parkinson's disease (PD) and other parkinsonisms associated with population ageing, it is increasingly common to have patients admitted with these pathologies. According to the available evidence, hospitalisations in these patients are more frequent and prolonged, and, regardless of the reason for admission, are associated with a higher risk of complications, such as infectious complications and those related to immobilisation. In addition, during their hospital stay, medication errors are not uncommon, due to irregularities in the usual antiparkinsonian treatment regimen or the use of antidopaminergic drugs. All these factors influence the higher mortality associated with their hospitalisations. Particularly, when these patients are admitted for surgery, the risk of complications and medication errors increases substantially, making it a priority to develop strategies to improve safety in these hospitalisations, which could have an impact on patients' clinical status, their recovery and the length of their hospital stay. In this regard, general recommendations for pharmacological management have been published. At the Hospital General Universitario Gregorio Marañón (HGUGM), a detailed protocol was developed to ensure appropriate pharmacological management in the perioperative period, which was implemented in December 2015. For its implementation, educational sessions were conducted at the hospital, and several complementary tools were developed, such as an Information Sheet for patients and a Pharmacological Alert in the electronic prescription programme, among others...