(B-153) Improving Quality-of-Care and Preventing Iatrogenesis for a Healthy Ageing – A Survey on Portuguese Healthcare Professionals

Background: In Portugal, demographic ageing has been increasing. Older adults are frequently exposed to a high number of medical interventions and polypharmacy, which may contribute to iatrogenesis and/or iatrogenic dependence. To ensure a healthy life in older adults, approaches to minimize and prevent iatrogenic events are required.

Objectives: The main goal of this study was to assess the knowledge of healthcare professionals (HP) on causes of iatrogenesis and guidelines for its prevention.

Methods: Researchers of the collaborative STOP IATRO project (Portugal, Spain and France; Interreg-Sudoe S1/4.5/F0063) developed a questionnaire about iatrogenesis for physicians, nurses, pharmacists, and health assistant technicians (HAT). The study was approved by the Deontology Committee of University of Aveiro and the Ethics Committee of the Clinical Academic Center Egas Moniz Health Alliance. The anonymous questionnaire was made available on paper and online (LimeSurvey) within the Local Health Unit of Aveiro Region, and to community pharmacists from Aveiro and Guarda Regions, last two months of 2024. Before participation, HP provided informed consent. Descriptive statistics (Microsoft Excel): relative and absolute frequencies.

Results: A total of 176 HP participated in the study, including 70 physicians, 25 pharmacists (8 hospital, 17 community), 71 nurses, and 10 HAT. Most HP (77%) are unaware about of WHO’s guidelines to prevent, slow and reverse physical and cognitive decline in older adults. The decline in functional capacity not attributable exclusively to older patients’ health conditions was considered between 1-10% by almost 25% HP, 11-25% and 26-50% by 37% HP, and 51-75% by 15% HP. HP consider that main causes of functional decline were: immobilization (n=65), delirium (n=62), falls (n=58), malnutrition (n=49) and medication effects (n=46). Also, 56 and 27 from 125 of HP consider that 11-30% and 31-50% of serious iatrogenic events, respectively, are due to medication. Moreover, 47 and 35 of them believe that 41-60% and 21-40% of these medication-related serious iatrogenic events, respectively, are preventable. Many HP (61%) never had training on good practices for preventing and managing the effects of drug iatrogenesis. Most HP (89%) are available to participate in pilot actions on management/prevention of drug-associated iatrogenesis.

Conclusions: HP have the perception that a high percentage of serious iatrogenic events occur due to medication and could be avoided. HP have a lack of knowledge of guidelines and specific up-to-date training on iatrogenesis. Most HP are willing to take part in pilot initiatives to manage iatrogenesis and to promote healthy ageing.