Prevalence and variables associated with the use of potentially inappropriate medications among institutionalized older adults
DOI:
https://doi.org/10.21527/2176-7114.2024.48.15194Keywords:
List of Potentially Inappropriate Medications, Older adults, Long-term care facilities for older individuals, HealthAbstract
The objective of this study was to determine the prevalence and factors associated with the use of Potentially Inappropriate Medications (PIMs) in institutionalized older adults. This is a cross-sectional study conducted with 86 older individuals residing in Long-Term Care Facilities (LTCFs) in Brasília/DF and the city of Salvador/BA. Health and medication data were evaluated through descriptive and inferential analyses (p-value < 0.05). From the sample, 76.7% of the individuals used at least one PIM and 91.8% had one or more diseases, with hypertension being the most common. Psycholeptics were the most frequently prescribed PIMs, with a usage frequency of 28.0%, and psychoanaleptics (34.8%) and psycholeptics (28.1%) were the most frequently prescribed medications that should be used with caution. Regarding associated factors, there was a statistically significant association between cognitive decline and the use of medications that should be used with caution (OR=2.98; p=0.024) and between the number of chronic diseases and the use of potentially inappropriate medications in older adults (OR=2.95; p=0.024). It was concluded that the high prevalence of PIM use by institutionalized older adults indicates the need for a remodeling of medication treatments, as well as an improvement in medical care in Brazilian LTCFs. The high use of psychotropic medications highlights the treatment of dementia and mental disorders as one of the main challenges in care in these services.
References
1 Fick DM et al. By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019 Apr.;67(4):674-694. DOI: 10.1111/jgs.15767. Epub 2019 Jan. 29. PMID: 30693946
2 Sönnerstam E. et al. Potentially inappropriate medications in relation to length of nursing home stay among older adults. BMC Geriatr. 2022;22(1):70.
3 Praxedes MFS et al. Prescrição de medicamentos potencialmente inapropriados para idosos segundo os Critérios de Beers: Revisão Sistemática. Cien Saúde Colet. 2020. Disponível em: http://cienciasesaudecoletiva.com.br/artigos/prescricao-de-medicamentos-potencialmente-inapropriados-para-idosos-segundo-os-criterios-de-beers-revisao-sistematica/17615?id=17615&id=17615
4 Aires JMP et al. Medicamentos potencialmente inapropriados prescritos a pacientes de um centro de referência em atenção à saúde da pessoa idosa. Rev Bras Geriat Geront. 2020;23(4):P.e200144.
5 Oliveira MG et al. Consenso brasileiro sobre medicamentos potencialmente inapropriados para idosos. Geriatr, Gerontol Aging. 2016;10(4):168-181.
6 lohmann MC et al. Hospitalization Risk and Potentially Inappropriate Medications among Medicare Home Health Nursing Patients. J Gen Intern Med. 2017;32(12):1.301-1.308.
7 Varallo FR et al. Avaliação da segurança farmacoterapêutica de prescrições médicas para idosos residentes em instituição de longa permanência. Braz J Pharm Sci. 2012;48(3):477-485.
8 Sangaleti CT, Lentsck MH, Silva DC da, Machado A, Trincaus MR, Vieira MCU, et al. Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care. Rev Bras Enferm. 2023;76:e20220785. DOI: https://doi.org/10.1590/0034-7167-2022-0785
9 Santos APAL et al. Evaluation of the heterogeneity of studies estimating the association between risk factors and the use of potentially inappropriate drug therapy for the elderly: a systematic review with meta-analysis. Eur J Clin Pharmacol. 2015;71(9):1.037-1.050.
10 Lemos CSL et al. Resistências frente à medicalização da existência. Fractal, Rev de Psicol. 2019;31(2):158-164.
11 Leão TM, Ianni AMZ. Judicialização e subpolítica médica. Physis. 2020;30(1):1-20.
12 Gontijo APS, Rangel BD, Victor AFBF, Vieira CP de P, Santana EQ, Duarte AD e, et al. Declínio cognitivo e uso de medicamentos na população de idosos institucionalizados de uma cidade do interior de Minas Gerais, Brasil. Cad Saúde Colet. 2022 abr.;30(2):163-172. DOI: https://doi.org/10.1590/1414-462X20223002040811
13 Gorzoni ML, Rosa RF. Critérios da Beers AGS 2019 em pacientes hospitalizados muito idosos. Rev Assoc Med Bras. 2020;66(7):918-923.
14 Lutz BH et al. Inadequação do uso de medicamentos entre idosos em Pelotas, RS. Rev Saúde Pública. 2017;51-52.
15 Iroldi GF et al. Associações entre estresse, sintomas depressivos e insônia em idosos. J Bras Psiquiatr. 2020;69(4):228-238.
16 Antequera IG et al. Rastreamento de violência contra pessoas idosas: associação com estresse percebido e sintomas depressivos em idosos hospitalizados. Esc Anna Nery. 2021;25(2):1-8.
17 Mendes SBE, Petarli GB, Cattafesta M, Zandonade E, Bezerra OM de PA, Mill JG, et al. Prevalência de uso de medicamentos em população rural brasileira. Cad Saúde Colet [Internet]. 2022 jul.;30(3):361-373. DOI: https://doi.org/10.1590/1414-462X202230030154
18 Moreno CRC et al. Rastreamento de violência contra problemas de sono em idosos estão associados a sexo feminino, dor e incontinência urinária e pessoas idosas: associação com estresse percebido e sintomas depressivos em idosos hospitalizados. Rev Bras Epidemiol. 2018;21(2):e180018.
19 Moriarty F et al. Declínio cognitivo associado a anticolinérgicos, benzodiazepínicos e Z-drogas: achados do Estudo Longitudinal Irlandês sobre o Envelhecimento (TILDA). Br J Clin Pharmacol. 2021;87(7):2.818-2.829.
20 Bertolucci PHF, Brucki SMD, Campacci SR, Juliano Y. O Mini-Exame do Estado Mental em uma população geral: impacto da escolaridade. Arq Neuro-Psiquiatr [Internet]. 1994 Mar;52(1):01–7. DOI: https://doi.org/10.1590/S0004-282X19940001000012121
21 Castelo MS, Coelho Filho JM, Siqueira Neto JI, Noleto JCS, Lima JW de O. Escala de depressão geriátrica com quatro itens: um instrumento válido para rastrear depressão em idosos em nível primário de saúde. Cadernos ESP [Internet]. 16º de setembro de 2019 [citado 10º de abril de 2025];2(1):46-50. Disponível em: https://cadernos.esp.ce.gov.br/index.php/cadernos/article/view/12
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