Evaluation of potentially inappropriate medications and polypharmacy in elderly patients at a university hospital

Authors

  • Fernanda da Silva Neves Departamento de Farmácia Hospitalar, Hospital Universitário, Universidade Federal de Juiz de Fora (HU-UFJF/Ebserh) https://orcid.org/0000-0002-5942-759X
  • Rosana sousa Departamento de Farmácia Hospitalar, Hospital Universitário, Universidade Federal de Juiz de Fora (HU-UFJF/Ebserh) https://orcid.org/0000-0002-3330-2537
  • Felipe Martins Departamento de Farmácia Hospitalar, Hospital Universitário, Universidade Federal de Juiz de Fora (HU-UFJF/Ebserh) https://orcid.org/0000-0002-9453-3961
  • Ana Caroline Costa Pinheiro Pinto Departamento de Farmácia Hospitalar, Hospital Universitário, Universidade Federal de Juiz de Fora (HU-UFJF/Ebserh) https://orcid.org/0000-0002-9432-7201
  • Luana Moratori Pires Departamento de Farmácia Hospitalar, Hospital Universitário, Universidade Federal de Juiz de Fora (HU-UFJF/Ebserh) https://orcid.org/0000-0002-4850-7439
  • Igor Rosa Meurer Departamento de Farmácia Hospitalar, Hospital Universitário, Universidade Federal de Juiz de Fora (HU-UFJF/Ebserh) https://orcid.org/0000-0002-8410-4741

DOI:

https://doi.org/10.34019/1982-8047.2022.v48.36065

Keywords:

Drug Prescriptions, Health of the Elderly, Hospitalization, Polypharmacy, Drug-Related Side Effects and Adverse Reactions

Abstract

Introduction: Brazil, like other countries, has been changing its demographic profile, increasing the number of elderly people, which reflects in changes not only for society, but also for public health. This group of patients is more vulnerable due to the inherent physiology of aging, so they become more likely to use medications that can cause other health problems. This risk probability is a current concern and has led to the creation of methods that guide prescribers to adapt their therapies in this group of patients. One of these methods is the Beers criterion, which is periodically updated with a list of potentially inappropriate medications (PIM) for the elderly. Objective: To evaluate the prescription of elderly patients hospitalized at the University Hospital of Juiz de Fora (HU-UFJF/Ebserh) regarding the prevalence of the use of PIM and polypharmacy, from July to August 2019. Material and Methods: Descriptive and retrospective observational study, whose data were collected from medical records of elderly patients aged 65 years or older to obtain the results that were statistically evaluated. Results: A total of 187 medical records were evaluated, and a prevalence of 80.2% of the prescription of PIMs was observed, the most prevalent being omeprazol and benzodiazepines. Most patients had polypharmacy (95.7%). Conclusion: The results converge, based on the Beers criterion, for the need to suit the therapy of elderly patients. It is also necessary to evaluate the benefits and alternatives regarding the most prevalent PIMs, in addition to conducting observational studies on possible adverse effects that may be a consequence of the use of these medications, aiming to refine pharmacological therapy and improve pharmacoeconomics, thus improving quality of life of elderly patients.

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References

Instituto Brasileiro de Geografia e Estatística (BR). Dados sobre população do Brasil: PNAD (Pesquisa Nacional por Amostra de Domicílios). 2017.

Ramos LR, Tavares NUL, Bertoldi AD, Farias MR, Oliveira MA at al. Polypharmacy and polymorbidity in older adults in Brazil: a public health challenge. Revista de Saúde Pública. 2016; 50(Suppl 2):S1-12.

Minayo MCS, Coimbra Júnior CEA. Entre a liberdade e a depêndencia: reflexões sobre o fenômeno social do envelhecimento. In: Antropologia, saúde e envelhecimento. Rio de Janeiro: Fiocruz; 2002. p. 11-24.

Ciosak SI, Braz E, Costa MFBNA, Nakano NGR, Rodrigues J, Alencar RA, Rocha ACAL. Senescência e senilidade: novo paradigma na atenção básica de saúde. Revista Escola de Enfermagem USP. 2011; 45(Esp 2):1763-8.

Davidoff AJ, Miller EG, Sarpong EM, Yang E, Brandt N, Fick DM. Prevalence of potentially inappropriate medication use in older adults using the 2012 Beers criteria. Journal of the American Geriatrics Society. 2015; 63:486-500.

Nascimento RCRM, Álvares J, Guerra Junior AA, Gomes IC, Silveira MR, Costa AC et al. Polifarmácia: uma realidade na atenção primária do Sistema Único de Saúde, Revista Saúde Pública. 2017; 51(Supl 2):19s.

Almeida NA, et al. Prevalência e fatores associados à polifarmácia entre os idosos residentes na comunidade. Revista brasileira geriatria e gerontologia. 2017; 20(1):138-48.

American Geriatrics Society. 2015: updated Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society. 2015; 63(11):2227-46.

American Geriatrics Society. 2019: updated AGS Beers criteria® for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society. 2019; 67:674-94.

Gasrke CCD, Cassol D, Morch LM, Schneider APH. Potentially inappropriate medications for elderly dispensed at a basic pharmacy in southern Brazil. Interdisciplinary. Journal of Health Promotion. 2018; 1:95-104.

Munck AKR, Araújo LA. Avaliação dos medicamentos inapropriados prescritos para pacientes idosos em um hospital universitário. Hospital Universitário Revista. 2012; 38:231-40.

Franco LG, Kindermann AL, Tramujas L, Kock KS. Fatores associados à mortalidade em idosos hospitalizados por fraturas de fêmur. Revista Brasileira Ortopedia. 2016; 51(5):509-514.

Santos LF, Morais AE, Furtado AB, Pinto KR, Alves EB et al. Farmacovigilância de polifarmácia e reações adversas medicamentosas em idosos hospitalizados em hospital universitário de Manaus, Amazonas. Revista Vigilância Sanitária em Debate. 2019; 41:41-7.

Rajeev A, Paul G, George S, Vijayakumar P. The study on prevalence of polypharmacy in elderly patients presenting for first time to the geriatric clinic of a tertiary care hospital in Kerala. International Journal of Medical Science and Clinical Invention. 2018; 5:3542-44.

Martins GA, Acurcio FA, Franceschini SCC, Priore SE, Ribeiro AQ. Uso de medicamentos potenciamente inadequados entre idosos no município de Viçosa, Minas Gerais, Brasil: um inquérito de base populacional. Caderno de Saúde Pública. 2015; 31(11):2401-12.

Varallo FR, Nadai TR, Oliveira AR, Mastroianni PC. Potential adverse drug events and nephrotoxicity related to prophylaxis with Omeprazole for digestive disorders: a prospective cohort study. Clinical Therapeutics. 2018; 40(Suppl 6):S973-82.

Kelly OB, Dillane C, Parchett SE, Harewood GC, Murray FE. The inappropriate prescription of oral proton pump inhibitors in the hospital setting: a prospective cross-sectional study. Digestive Diseases and Sciences. 2015; 60:2290-86.

Ryan ME, Barker C, Hawcutt DB. Ranitidine in short supply: why now, and where next? Archives of Disease in Childhood. 2020; 105:382-3.

Galan RC, Garrido FR, Fernández ES, Ruiz SA, Garcia OMA, Padilla MV. Prevalence of potentially inappropriate medication in hospitalized elderly patients by using explicit criteria. Farmacia Hospitalaria. 2014; 38(4):305-16.

Nastasy H, Ribeiro M, Marques ACPR. Abuso e dependência dos benzodiazepínicos. Rio de Janeiro: Associação Brasileira de Psiquiatria; 2008.

Gisev N, Hartikainen S, Chen TF, Korhonen M, Bell JS. Mortality associated with benzodiazepines and benzodiazepine-related drugs among community-dwelling older people in Finland: a population-based retrospective cohort study. Canadian Journal of Psychiatry. 2011; 56:377-81.

Poyares D, Guilleminault C, Ohayon MM, Tufik S. Chronic benzodiazepine usage and withdrawal in insomnia patients. Journal of Psychiatric Research. 2004; 38:327-34.

Assato CP, Borja-oliveira CRB. Psicofármacos potencialmente inapropriados para idosos. Revista Envelhecer. 2015; 20:687-701.

Maciel S, Teotônio PM, Barbosa GG, Lima VGC, De Farias OT. Perfil epidemiológico das quedas em idosos residentes em capitais brasileiras utilizando o Sistema de Informações sobre Mortalidade. Revista Associação Médica do Rio Grande do Sul. 2010; 54:25-31.

Veronese A. Benzodiazepine use in the real world of psychiatric practice: low-dose, long-term drug taking and low rates of treatment discontinuation. Journal Clininal Pharmacology. 2007; 867-73.

Published

2022-03-07

How to Cite

1.
da Silva Neves F, sousa R, Martins F, Costa Pinheiro Pinto AC, Moratori Pires L, Rosa Meurer I. Evaluation of potentially inappropriate medications and polypharmacy in elderly patients at a university hospital. HU Rev [Internet]. 2022Mar.7 [cited 2024Jun.30];48:1-8. Available from: https://periodicos.ufjf.br/index.php/hurevista/article/view/36065

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Artigos Originais