Drug use by elderly inpatients of a philanthropic hospital

Abstract

The high incidence of chronic diseases in the elderly leads to increased intermittent drug therapies. The presence of concomitant diseases and prescriptions made out by various health professionals facilitate the practice of polypharmacy, the emergence of iatrogenic diseases, and therapeutic regimens that are inconvenient for patients. The present study was carried out among elderly patients hospitalized at the Hospital Care Foundation of Paraiba, Campina Grande, with the objectives of studying the consumption of drugs by these patients, noting the possible adverse drug reactions (ADR), drug interactions and the presence of high-risk drugs prescribed to this age group. The study had a descriptive and cross-sectional quantitative design and involved a sample of 65 patients accompanied by the Pharmacovigilance Centre of the hospital, from August 2009 to July 2010. Over 90% of the patients were on polypharmacy, and the possible ADR found were related to the gastrointestinal tract where the most frequent interactions were with cardiovascular drugs. Within the context of pharmacoepidemiology, pharmacists can contribute by improving the quality of life of patients and preventing unnecessary expense with erroneous and poorly evaluated treatments. Uniterms:Elderly patients/drugs use. Polypharmacy. Drugs/adverse reactions. Drug interactions.A elevada incidência de doenças crônicas na terceira idade induz ao aumento de terapias medicamentosas intermitentes. A presença de patologias concomitantes e prescrições elaboradas por diversos profissionais de saúde facilitam a prática da polifarmácia, surgimento de doenças iatrogênicas e esquemas terapêuticos pouco cômodos para o paciente. O estudo foi realizado junto aos pacientes idosos internados no Hospital da Fundação Assistencial da Paraíba (FAP), Campina Grande, com objetivo de estudar o consumo de medicamentos por estes pacientes, observando as possíveis reações adversas a medicamentos (RAM), interações medicamentosas apresentadas e a presença de medicamentos de alto risco prescritos para este grupo etário. A pesquisa foi descritiva e transversal, com abordagem quantitativa, constituída por uma amostra de 65 pacientes, acompanhados através do Centro de Farmacovigilância do hospital, no período de agosto de 2009 a julho de 2010. Mais de 90% dos pacientes estavam sob polifarmácia, as possíveis RAM encontradas estavam mais relacionadas ao trato gastrintestinal e as interações foram mais frequentes com os medicamentos de ação cardiovascular. Dentro do contexto da farmacoepidemiologia, o profissional farmacêutico pode contribuir para a melhoria da qualidade de vida dos pacientes e evitar gastos desnecessários devido à terapêuticas errôneas e mal avaliadas.Unitermos: Terceira Idade/uso de medicamentos. Polifarmácia. Medicamentos/reação adversa. Interação medicamentosa.

Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review

“…Of the 47 records resulting from the search strategies, 24 (51.1%) full-text articles were retrieved for review concerning ADR 11 - 18 , 20 , 24 - 25 , 28 - 29 , 34 - 36 , 38 - 40 , 46 , 51 - 52 , 54 , 56 ) , 14 (29.8%) DDI 21 - 23 , 27 , 30 - 33 , 41 , 43 - 45 , 49 , 53 and nine (19.1%) are related to both DDI and ADR 19 , 26 , 37 , 42 , 47 - 48 , 50 , 55 , 57 , according to Figures 2 and 3.…”

“…Initially, different definitions of polypharmacy were utilized in the studies analyzed such as ≥3 33 , ≥5 19 - 20 , 26 - 27 , 29 , 31 , 37 , 42 , 44 , 46 , 51 , ≥6 52 or ≥10 11 - 12 , 15 . In thirty-one studies there was no definition of polypharmacy 13 - 14 , 16 - 18 , 21 - 25 , 28 , 30 , 32 , 34 - 36 , 38 - 41 , 43 , 45 , 47 - 50 , 53 - 57 .…”

Impact of medication use on quality of life of institutionalized elderly in Northeast Brazil

“…Polypharmacy enhances the occurrence of adverse reactions, lack of adherence, drug interactions, geriatric syndromes and reduced functional capacity, risk factors for hospitalization and deaths [8][9][10] . Furthermore, aging substantially alters individual pharmacodynamic and pharmacokinetic parameters, raising the unpredictability of the drug's action 11,12,13 .…”

Polifarmácia Utilizada por Idosos Residentes em Instituições de Longa Permanência do Município de Viamão/RS

“…Isto faz com que esses indivíduos fiquem mais vulneráveis a efeitos adversos (SANTOS et al, 2011;AB-SALON et al, 2011).…”