Terapêutica crónica em idosos numa Unidade de Saúde Familiar: análise da polimedicação e medicação potencialmente inapropriada

Souto, Márcia Mendonça; Pimentel, Ana Filipa

doi:10.32385/rpmgf.v34i2.12399

Cited by 2 publications

(10 citation statements)

References 19 publications

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“…The majority of respondents (95,0%) lived in the municipality of Valpaços (Table 1). The distribution by gender shows a predominance of females (53,3%), data corroborated by other studies (Cima, et al, 2011;Soares et al, 2011;Souto & Pimentel, 2018) and corresponding to the expected, since in Portugal the longevity of females is higher than the male, although less healthy (INE, 2018;SNS, 2017). It was found that 55,0% of the interviewees were married and 28,3% were widowed, and 71,7% lived accompanied, as well as the results of Monterroso et al (2015) and Souto & Pimentel (2018).…”

Section: Resultssupporting

confidence: 85%

“…The distribution by gender shows a predominance of females (53,3%), data corroborated by other studies (Cima, et al, 2011;Soares et al, 2011;Souto & Pimentel, 2018) and corresponding to the expected, since in Portugal the longevity of females is higher than the male, although less healthy (INE, 2018;SNS, 2017). It was found that 55,0% of the interviewees were married and 28,3% were widowed, and 71,7% lived accompanied, as well as the results of Monterroso et al (2015) and Souto & Pimentel (2018). More than a quarter of respondents (26,7%) had completed primary school, which matches with other studies carried out previously in the same age group (Cima et al, 2011;Serrão et al, 2015).…”

Section: Resultssupporting

confidence: 85%

“…Although not all older adult people require medicines, the existence of multiple chronic diseases in the same person may involve the prescription of drugs from different therapeutic groups. Polymedication has been defined in a number of ways, including the use of several medicinal products, the use of more medicines than indicated, the therapeutic regimen that includes at least one unnecessary medicine and/or the use of medicinal products that may cause adverse reactions/drug interactions (WHO, 2019;Souto & Pimentel, 2018;Rosa & Camargo, 2014). Polymedication can be classified as minor polymedication, from two to four drugs, and major polymedication when five or more drugs are used (Souto & Pimentel, 2018;Rosa & Camargo, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…Polymedication has been defined in a number of ways, including the use of several medicinal products, the use of more medicines than indicated, the therapeutic regimen that includes at least one unnecessary medicine and/or the use of medicinal products that may cause adverse reactions/drug interactions (WHO, 2019;Souto & Pimentel, 2018;Rosa & Camargo, 2014). Polymedication can be classified as minor polymedication, from two to four drugs, and major polymedication when five or more drugs are used (Souto & Pimentel, 2018;Rosa & Camargo, 2014). Overall, these conditions associated with pharmacokinetics and pharmacodynamic changes increase the risks with medications (Delafuente, 2008;WHO, 2019;OMS, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Pharmacotherapy in the Older Adult: Characterization, Medication Adherence and Potentially Inappropriate Medications

2022

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Introduction: Aging is a dynamic process in which biochemical and physiological changes are related to a higher frequency of pathological processes, which ultimately lead the human being to death. Part of these alterations and pathologies are improved using medicines, so older adults are great consumers of medicines. Several instruments have been used to evaluate the use of inappropriate medications in older adults, with Beers Criteria frequently used. The concept of medication adherence has undergone changes over time and represents the degree to which the patient’s behaviour corresponds and agrees with the recommendations of a doctor or other health professional. Medication non-adherence to entails a decrease in the quality of life of the patients and high costs for the health systems. Objectives: To characterize drug therapy in older adult users of a northern Portuguese community pharmacy, as well as to identify the presence of potentially inappropriate medications (PIMs) in the older adult and to assess medication adherence. Methods: Exploratory and descriptive study. The target population was older adult users of a community pharmacy in the municipality of Valpaços, Portugal. The data collection instrument used was a questionnaire applied in the form of a structured interview. The potentially inappropriate medications (PIMs) identification was based on the most recent version of the Beers Criteria published in 2019. The MAT (Measurement of Adherence to Treatments) scale was used to evaluate medication adherence. The statistical treatment included the calculation of absolute and relative frequencies, measures of central tendency and dispersion. Results: 60 older adult people were interviewed, 53.3% of them women. The average age was 78.35 years. Among these, 55.0% were married/had a non-marital partner, 71.7% lived accompanied, 26.7% had primary school education, 40.0% received less than 300 Euros monthly and 95.0% lived in the municipality of Valpaços. Each older adult person consumes on average 6 different types of medication per day. Major polymerization was present in 66.7% of older adults, and 94.2% of the drugs being prescribed by the physician. In 34.7% of the cases, the medication had been used for at least 1 year and only 3.4% reported feeling adverse reactions. Of the total 326 drugs identified, the most prescribed pharmacotherapeutic groups were drugs acting in the cardiovascular system 27.2% and in the digestive system 24.2%. Additionally, 15 drugs classified as potentially inappropriate medication were identified in the older adult. Most of the older adults (76.7%) did not adhere to drug therapy, these being mainly females with primary education, living with a partner and less than 300 euros/month. Conclusion: Polymedication and the use of potentially inappropriate medications are common in older adults. Medication adherence is low.

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Section: Resultssupporting

confidence: 85%

Section: Resultssupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pharmacotherapy in the Older Adult: Characterization, Medication Adherence and Potentially Inappropriate Medications

2022

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“…A realização deste estudo permitiu caracterizar a realidade da polimedicação do utente muito idoso na USF em estudo, potenciando a consciencialização indivi-dual e da equipa para esta problemática. A prevalência de doentes polimedicados encontrada foi superior à relatada noutros estudos realizados em contexto de cuidados de saúde primários, [7][8] estudosoriginais Castilho e colaboradores, que revelou uma frequência de polifarmácia na amostra de utentes com idade igual ou superior a 75 anos de 62,3%. 9 Todos os médicos de família sobrestimaram a percentagem de utentes da sua lista medicados com benzodiazepinas.…”

Section: Estudosoriginais Discussão/conclusãounclassified

Polimedicação no idoso: perceção dos médicos de família (projeto de investigação)

Martins,

Mendes,

Luis

et al. 2023

RPMGF

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Introdução: A polimedicação define-se pela utilização simultânea, apropriada ou não, de acordo com as comorbilidades de cada doente, de pelo menos cinco fármacos no mesmo utente. O médico de família (MF) deve identificar e combater, quando clinicamente apropriado, a polifarmácia. Objetivos: Identificar a prevalência de polimedicação e as principais classes farmacológicas potencialmente inapropriadas utilizadas nos utentes muito idosos inscritos na Unidade de Saúde Familiar participante e avaliar a perceção dos MF sobre esta realidade. Método: Estudo observacional transversal analítico na população dos inscritos com idade igual ou superior a 80 anos. Foram excluídos os utentes sem registos clínicos nos últimos três anos. Distribuiu-se um questionário aos MF para avaliar a sua perceção face à polimedicação no seu ficheiro. Os dados relativos à medicação utilizada pelos utentes foram obtidos dos programas SClínico® e PEM® e analisados no Excel®. Resultados: Incluíram-se 386 utentes com idade média de 85,6 anos, 62% do sexo feminino. 79,5% dos utentes estavam polimedicados, com uma média de 7,1±3,1 fármacos por utente. As estatinas corresponderam ao grupo farmacológico mais prescrito (64,2%) dos pesquisados, com as benzodiazepinas e os inibidores da bomba de protões a constituírem as classes potencialmente inapropriadas mais utilizadas em igual proporção (35%). Cinco MF aceitaram participar no estudo; três definiram corretamente polimedicação e evidenciaram perceção aproximada da realidade na respetiva lista de utentes. A percentagem de utilização de benzodiazepinas foi sobrestimada por quatro clínicos; a prescrição de anticoagulantes foi subestimada por três profissionais, contrariamente à utilização de antiagregantes e sulfuniloreias, sobrestimados em igual proporção. Discussão/Conclusão: Este estudo permitiu caracterizar o problema da polimedicação na unidade investigada, potenciando a consciencialização individual e da equipa para esta problemática, sendo que a prevalência se revelou superior à relatada noutros estudos. As investigadoras concluem que é imperativo desenvolver estratégias de combate à polimedicação.

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Terapêutica crónica em idosos numa Unidade de Saúde Familiar: análise da polimedicação e medicação potencialmente inapropriada

Cited by 2 publications

References 19 publications

Pharmacotherapy in the Older Adult: Characterization, Medication Adherence and Potentially Inappropriate Medications

Pharmacotherapy in the Older Adult: Characterization, Medication Adherence and Potentially Inappropriate Medications

Polimedicação no idoso: perceção dos médicos de família (projeto de investigação)

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