Using two tools to identify Potentially Inappropriate Medications (PIM) in elderly patients in Southern Chile

Arellano, Camila; Saldivia, Gabriela; Cordova, P; Fernández, P; Morales, Felipe; López, Magdalena; Villa, L

doi:10.1016/j.archger.2016.08.001

Cited by 16 publications

(14 citation statements)

References 22 publications

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“…The use of STOPP/START to screen and address IMU in Europe, Asia, North America, South America, Africa and Australia suggests that the criteria have global relevance. 34–41 In comparison with Beers criteria, patients with STOPP-defined IMU are more likely to have an ADE, present to the emergency department and be admitted to hospital. 39…”

Section: Stopp/start Criteriamentioning

confidence: 99%

Explicit criteria as clinical tools to minimize inappropriate medication use and its consequences

Curtin

Gallagher

O’Mahony

2019

Therapeutic Advances in Drug Safety

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Polypharmacy and prescribing of potentially inappropriate medications (PIMs) are the key elements of inappropriate medication use (IMU) in older multimorbid people. IMU is associated with a range of negative healthcare consequences including adverse drug events and unplanned hospitalizations. Furthermore, prescribing guidelines are commonly derived from randomized controlled clinical trials which have specifically excluded older adults with multimorbidity. Consequently, indiscriminate application of single disease pharmacotherapy guidelines to older multimorbid patients can lead to increased risk of drug–drug interactions, drug–disease interactions and poor drug adherence. Both polypharmacy and PIMs are highly prevalent in older people and strategies to improve the quality and safety of prescribing, largely through avoidance of IMU, are needed. In the last 30 years, numerous explicit PIM criteria-based tools have been developed to assist physicians with medication management in clinically complex multimorbid older people. Very few of these PIM criteria sets have been tested as an intervention compared with standard pharmaceutical care in well-designed clinical trials. In this review, we describe the most widely used sets of explicit PIM criteria to address inappropriate polypharmacy with particular focus on STOPP/START criteria and FORTA criteria which have been associated with positive patient-related outcomes when used as interventions in recent randomized controlled trials.

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Section: Stopp/start Criteriamentioning

confidence: 99%

Explicit criteria as clinical tools to minimize inappropriate medication use and its consequences

Curtin

Gallagher

O’Mahony

2019

Therapeutic Advances in Drug Safety

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show abstract

“…Los estudios revelan que esto se origina por aumento de enfermedades crónicas y deterioro propio del envejecimiento (31), sin contar fármacos consumidos de manera autónoma, que por desconocimiento de usuarios pudieran originar interacciones con tratamiento de base (32). El factor educacional es punto clave en cantidad de drogas farmacológicas que autoconsumen adultos mayores, se ha observado que mientras menor nivel educacional, mayor policonsumo de fármacos sin prescripción médica (33)(34)(35).…”

Section: Polifarmacia Y Calidad De Vidaunclassified

“…En Latinoamérica, la falta de coordinación entre niveles de atención de salud sumado a policonsulta con más de un profesional de salud (36), eleva el promedio de fármacos utilizados por adultos mayores de: 4,18 a 8,14 (37), evidenciando que la asistencia médica disociada y poco programada incrementa el promedio de medicamentos usados, además aquellos adultos mayores con más de 5 fármacos, van a presentar mayor riesgo sobre su condición de salud (34)(35)(36)(37)(38)39). En Chile, en Atención Primaria de Salud (ApS), esta realidad se contrarresta parcialmente, debido a existencia del SidrA (Sistema de Información de la Red Asistencial) "historia clínica digital", recogiendo morbilidades, tratamientos farmacológicos, intervenciones de salud y derivaciones del usuario.…”

Section: Prescripción Indiscriminada De Fármacosunclassified

“…Al correlacionarlo con la realidad chilena mediante el estudio "Using two tools to identify Potentially Inappropriate Medications (en adelante "piM" siglas en inglés) in elderly patients in Southern Chile", donde se realizó un estudio de observación de 250 pacientes de 65 años o más hospitalizados, utilizando criterios de Beers (2012) y StOpp (2008) para identificar medicamentos potencialmente inapropiados; se obtuvo que 41% de los pacientes se prescribió un piM, mientras que el 51% se prescribieron dos piM y al 8% más de dos piM, detectándose una asociación entre prescripción de piM y polifarmacia con ambos criterios. Lo que demuestra la realidad chilena en prescripción de piM, siendo frecuente en pacientes ancianos hospitalizados, por lo que pareciera beneficioso educar los equipos de atención médica sobre estos criterios para reducir la prescripción de piM (34).…”

Section: Prescripción Indiscriminada De Fármacosunclassified

“…La prescripción inadecuada de fármacos en adultos mayores está considerada como problemática de salud pública (9,46,47), relacionándose con mayor morbimortalidad y costes sanitarios (48). El gasto de fármacos mal indicados (49,50), supera costo de terapia realmente necesaria (34)(35)(36). Se prescriben en múltiples ocasiones medicamentos repetidos al adulto mayor, incrementando riesgos de eventos adversos (51)(52)(53).…”

Section: Prescripción Indiscriminada De Fármacosunclassified

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Polifarmacia en adulto mayor, impacto en su calidad de vida. Revision de literatura

et al. 2019

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RESUMENObjetivo Conocer mediante el análisis del estado del conocimiento, el impacto de polifarmacia en calidad de vida de adultos mayores y cuál ha sido el rol de enfermería frente a esta problemática de salud. Métodos Revisión descriptiva de 62 artículos originales de diversos diseños metodológicos, en bases de datos: EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS y Dialnet. Resultados La polifarmacia en adultos mayores se presenta con mayor frecuencia en el sexo femenino, en personas con bajo nivel de escolaridad, sumados a factores socioeconómico. Un gran porcentaje de adultos mayores presenta efecto cascada en consumo de fármacos, por cantidad de medicamentos consumidos y número de médicos consultados, produciendo interacciones farmacológicas, afectando funcionalidad y calidad de vida. Conclusiones Es necesario mayor control de medicamentos consumidos por adultos mayores, para evitar efectos nocivos. Los profesionales de enfermería deben tener un rol educativo en este grupo etario, para disminuir polifarmacia e impulsar estilos de vida que fomenten el envejecimiento saludable. Palabras Clave: Polifarmacia; anciano; calidad de vida; atención de enfermería (fuente: DeCS, BIREME). ABSTRACTObjective To know, by analyzing the state of knowledge, the impact of the polypharmacy on the quality of life of older adults and the role of nursing when dealing with this health problem. Materials and Methods Descriptive review of 62 original articles with multiple methodological designs, in the databases EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS and Dialnet. Results Polypharmacy in older adults is more frequent in the female sex and people with low level of education, and is associated with socioeconomic factors. A large percentage of older adults present with prescription cascade due to the amount of drugs consumed and the number of doctors consulted, leading to pharmacological interactions that affect functionality and quality of life. Conclusions More control of drugs consumed by older adults is needed to avoid harmful effects. Nursing professionals should have an educational role in this age group to reduce polypharmacy and promote lifestyles that foster healthy ageing.

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Potentially Inappropriate Prescribing among Elderly Patients at a Primary Care Clinic in Oman

Al-Busaidi

Al-Kharusi

Al-Hinai

et al. 2019

J Cross Cult Gerontol

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Using two tools to identify Potentially Inappropriate Medications (PIM) in elderly patients in Southern Chile

Cited by 16 publications

References 22 publications

Explicit criteria as clinical tools to minimize inappropriate medication use and its consequences

Explicit criteria as clinical tools to minimize inappropriate medication use and its consequences

Polifarmacia en adulto mayor, impacto en su calidad de vida. Revision de literatura

Potentially Inappropriate Prescribing among Elderly Patients at a Primary Care Clinic in Oman

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