Atencion primaria
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To characterize the time in therapeutic range (TTR) and estimate the incidence rate of complications (PTIRc) in adults with warfarin protocol. ⋯ Despite new anticoagulant treatments, warfarin is useful. As follow-up time increased, control was better and the rate of occurrence of complications decreased; however, the conditions that showed lower TTR and higher rate of occurrence of complications require a thorough review of follow-up especially in patients with functional illiteracy.
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The use of drugs has undeniable benefits to the elderly, but it is not exempt from undesirable effects. Deprescription is the process of systematic medication review with the target of achieving the best risk-benefit ratio based on the best available evidence. This process is especially important for polymedicated elderly patients as well as those overtreated, frail, terminally ill and at the end of life. ⋯ In the decision-making process, it is very important to consider the patient and caregivers opinion, assessing the objectives of the treatment according to the clinical, functional and social situation of the patient. There are multiple tools to make it easier for clinicians to select which drugs to deprescribe (Beers criteria, STOPP-START…). The most susceptible to intervention pharmacological groups are: antihypertensives, antidiabetics, statins, benzodiazepines, antidepressants, anticholinergics, anticholinesterase agents, and neuroleptics.