Integrated drug management for elderly patients with congestive heart failure:enhancing medication accuracy using the MINE(Medicine IN gEriatric)applicationOA

Background This study evaluated the impact of the Medicine IN Geriatric(MINE)application,which integrates the Integrated Medicine Management(IMM)model and STOPP/START criteria,on improving prescribing practices in elderly patients with congestive heart failure(CHF).Methods A two-phase study was conducted:validation of the IMM model and its implementation via the MINE app.A quasiexperimental pretest-posttest control group design was used in a hospital in East Kalimantan,Indonesia.Patients aged 60-79 years were randomly assigned to the intervention or control group.The intervention group received IMM-based pharmaceutical services,including medication reconciliation,repeated medication reviews,and individualized discharge counseling.The outcomes assessed included polypharmacy rates,potentially inappropriate medications(PIMs),potential prescribing omissions(PPOs),and health-related quality of life,using the EQ-5D-5L and EQ-VAS tools.Results Expert validation showed high content validity,with I-CVI≥0.86 and S-CVI=0.94.During implementation,the use of antiplatelets,statins,angiotensin converting enzyme inhibitors(ACEI),and angiotensin receptorβ-blockers(ARB)declined from admission to discharge.PIMs,such as beta-blockers in patients with conduction disorders and ACE-I/ARBs in those with hyperkalemia,also decreased.The intervention group''s EQ-5D-5L scores improved from 0.552 to 0.664,whereas the control group''s scores declined slightly.EQ-VAS scores also increased significantly in the intervention group.Conclusion The MINE-based IMM intervention effectively reduced inappropriate prescribing and enhanced the quality of life in elderly patients with CHF.This technology-enabled multidisciplinary approach supports safer prescribing in geriatric care.