@article{ref1,
title="Pharmaceutical intervention to reduce the iatrogenic risk associated with the triple whammy combination",
journal="Atencion Primaria",
year="2016",
author="Arrufat-Goterris, Gemma and do Pazo-Oubiña, Fernando and Malpartida-Flores, María and Rodríguez-Rincón, Raquel María",
volume="49",
number="3",
pages="150-155",
abstract="OBJECTIVE: To analyze the effect of an intervention to reduce the iatrogenic risk associated with concomitant treatment with angiotensin converting enzyme inhibitors (ACEi) and/or angiotensin-II receptor blockers (ARB) with diuretics and nonsteroidal anti-inflamatory drugs (NSAID), combination known as triple whammy (TW). <br><br>DESIGN: Uncontrolled before-after intervention study. LOCATION: 15 health centers from a health area (reference population of 292.746 habitants). PARTICIPANTS: 260 patients ≥18 years old with chronic and concomitant prescriptions of drugs from the therapeutic groups (ATC code): diuretics (C03), ACEi/ARBs (C09) and NSAID (M01) during the month of January 2015 INTERVENTIONS: A double intervention was conducted during February and March 2015: an educational part, which consisted of an informative session, and an individualized part, in which recommendations to general practitioner were assessed after reviewing medical records. MAIN MEASUREMENTS: The number of patients in whom at least one intervention was accepted and the number of patients who continued on TW combination in June 2015, were analyzed. <br><br>RESULTS were analyzed using descriptive statistics and the prevalence of TW was compared with the one in June 2015 using the Newcombe-Wilson's hybrid method. <br><br>RESULTS: 260 patients were included in the study. Recommendations were made in 165 patients (63.5%) and at least one was accepted in 97 (58.8%) patients. In June 2015, 184 patients continued with the TW combination. The TW prevalence decreased by 0.19/1,000 patients (IC 95%: 0.04/1,000 to 0.34/1,000; P=0.017) after the intervention. <br><br>CONCLUSIONS: The intervention improved the prescription and reduced the number of patients on TW combination.<br><br>Copyright © 2016 Elsevier España, S.L.U. All rights reserved.<p /> <p>Language: es</p>",
language="es",
issn="0212-6567",
doi="10.1016/j.aprim.2016.05.007",
url="http://dx.doi.org/10.1016/j.aprim.2016.05.007"
}