Utilização dos critérios de Beers para avaliação das prescrições em idosos portadores de doenças crônicas vinculados a um plano de saúde

Oliveira, Henrique Souza Barros de; Sousa, Jamile Rafaela Poltronieri de; Donis, Ana Carolina Gariba; Manso, Maria Elisa Gonzalez

doi:10.5335/rbceh.v14i3.7376

Cited by 9 publications

(19 citation statements)

References 3 publications

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“…The elderly group surveyed was characterized by a slight predominance of male elderly persons, which differs from most groups presented in literature, where there are a majority of women in this type of program, especially in the southeast region of Brazil. Regarding the sociodemographic characteristics of the elderly linked to the Brazilian supplementary health sector, the largest coverage is concentrated in those who are married, retired and aged over 70 years, especially 80 and over, data which corroborated those found in this research 6,7,13,14 .…”

Section: Discussionsupporting

confidence: 89%

Analysis of quality of life and associated factors in a group of elderly persons with supplemental health plans in the city of São Paulo, Brazil

Manso

Maresti²,

Oliveira

2019

Rev. bras. geriatr. gerontol.

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Objective: To measure the Quality of Life (QoL) and associated factors in a group of elderly persons receiving care through a health plan operator in the city of São Paulo, Brazil. Method: A cross-sectional study was carried out with 169 elderly persons enrolled in a health plan and who were participants in a program to promote health and prevent risks and diseases. The Bref and Old versions of the World Health Organization Quality of Life (WHOQOL) instruments were adopted for the evaluation of the QoL of the elderly. After descriptive analysis, a comparative analysis was performed through the Student’s t-tests and ANOVA. The Brown-Forsythe test was applied for situations in which no homogeneity was found and the Tukey test for multiple comparisons was applied. Results: The highest mean QoL values were found in the Psychological [72.1 (±14.3)] and Environment [68 (±15.4)] and Intimacy [72.5 (±20.8)] domains, while the worst results were found in the Physical [64.3 (±18)] domain and in the Death and Dying facet [61.2 (±23.2)]. In this group, factors such as obesity, neoplasia and previous hospitalizations were negatively associated with QoL, whereas young elderly, female, widows, carriers of chronic non-communicable diseases and those limited to two morbidities, who practiced physical activity and had clinical care provided by a reference physician had a positive influence. Conclusion: The findings of this research showed high levels of satisfaction with health and QoL, in addition to raising relevant discussions about predictors that influence the QoL of the elderly receiving care from the supplementary sector. It also emphasizes the need for new strategies of action to ensure improvements in the health care of the elderly.

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Section: Discussionsupporting

confidence: 89%

Analysis of quality of life and associated factors in a group of elderly persons with supplemental health plans in the city of São Paulo, Brazil

Manso

Maresti²,

Oliveira

2019

Rev. bras. geriatr. gerontol.

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“…The prolonged use in the elderly with Helicobacter pylori infection or with successful eradication is associated with an increased risk of developing gastric neoplasia. In addition, the use of PPI concomitantly with other drugs represents a high risk for DI, and these drugs should be prescribed with caution 8,12,13,29,30 .…”

Section: Discussionmentioning

confidence: 99%

The iatrogenic triad in a group of elderly women contracted to a health plan

Oliveira

Manso

2019

Rev. bras. geriatr. gerontol.

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Objective: to study the main elements of the iatrogenic triad in a group of elderly women with a Chronic Non-Communicable Disease (CNCD) contracted to a health plan. Method: A cross-sectional and descriptive epidemiological study was carried out by analyzing 3,501 medical prescriptions of 725 elderly women aged ≥65 years. The medications were determined to be Potentially Inappropriate Medications (PIM) based on four instruments (AGS Beers 2015, PRISCUS List, EU(7)-PIM, Brazilian Consensus of PIM - CBPIM). In addition, the most prescribed drugs were assessed for possible Drug Interactions (DI) and classified according to degree of severity. Results: the present study revealed that 89.3% of the studied group used at least one element of the iatrogenic triad, and 44.9% of the sample were associated with the use of polypharmacy and PIM. A total of 48.0% were taking at least five continuous use medications. The main DI were omeprazole, simvastatin and levothyroxine, all of which are of significant severity and have potential drug-food interactions. A total of 35.1% of PIM were identified through the four criteria used, 26.6% were identified by the CBPIM, 25.8% by the EU(7)-PIM, and 24.6% and 6.6% by AGS Beers and PRISCUS, respectively. Conclusion: a high index of continuous use medications, PIM and potential DI were identified, mainly enzymatic inhibitors in a group of elderly women at risk due to their clinical characteristics. Old age was associated with the presence of all the elements of the iatrogenic triad. It was also noted that there were no significant differences between the criteria applied, except for the PRISCUS list.

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“…A diminuição da produção do ácido clorídrico, induzida pelos IBPs, limita absorção do cálcio e causa uma perturbação na microbiota comensal, predispondo a um risco aumentado para perda de massa óssea, fraturas e de infeção por Clostridium difficile; são ainda descritas, a deficiência na absorção de alguns nutrientes, atrofia gástrica, risco aumentado para neoplasia gástrica, pneumonia e lesão renal. [64][65][66] É com base nestas evidências que os critérios de Beers de 2015 consideram inapropriada a prescrição regular dos IBPs, por mais de oito semanas, exceto em doentes com risco elevado 1,48 ; critérios que justificam o elevado número de MPIs identificados no estudo, bem como, na generalidade das instituições de longa permanência para idosos. 7,11,66 Face a estes resultados, considera-se importante a adoção de estratégias interdisciplinares 50 para assegurar a otimização do regime medicamentoso da pessoa idosa institucionalizada, tais como: intervenções educacionais, revisão da medicação, conferências de caso e utilização de programas informáticos que suportem a decisão clínica 67,68 ; no processo de revisão da medicação, devem ser envidados todos os esforços para minimizar o uso de fármacos, com particular atenção para aos grupos farmacológicos mais problemáticos, conforme explanado nos parágrafos anteriores.…”

Section: Discussionunclassified

Aplicação dos Critérios de Beers de 2015 Operacionalizados para Portugal em Pessoas Idosas Institucionalizadas: Um Estudo Transversal

Peixoto¹,

Almeida

Rego

et al. 2021

Acta Med Port

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Introduction: The consumption of potentially inappropriate medicines is high among institutionalized elderly, predisposing to potential drug interactions, adverse drug events, risk of iatrogenic cascade, increased morbidity and mortality and health costs. Medication review is a promising strategy for therapeutic optimization, although scarcely documented in Portugal. The aim of this study was to characterize, using explicit criteria, the existence of potentially inappropriate medicines, among institutionalized elderly, and to calculate the eventual cost savings, with their discontinuation.Material and Methods: Descriptive and cross-sectional study conducted in three residential homes for the elderly, from different geographic regions, based on a random sample of 33 health records. In order to characterize the existence of potentially inappropriate medicines, we used the 2015 Beers criteria, revised by the American Geriatrics Society and in the Portuguese version.Results: On average, 11 drugs are prescribed to elderly residents of three residential structures for the elderly. All health records contain potentially inappropriate medicines (mean 4.8 ± 2.0 per resident), with anxiolytics (17.7%), antidepressants (17.7%) and antipsychotics (15.8%) being the most prevalent. Its reduction would result in an average monthly savings of €9.6 per resident.Discussion: The consumption of potentially inappropriate medicines is higher than the literature describes, and the cost of medicines is high. The involvement of nurses in the process of drug management and reconciliation, in coordination with the physician, could be an effective strategy. This is the first study using the latest Portuguese version of the Beers criteria, which makes the comparability of the results difficult.Conclusion: The consumption of potentially inappropriate medicines is high, which suggest the need for adoption of improvement measures.

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Utilização dos critérios de Beers para avaliação das prescrições em idosos portadores de doenças crônicas vinculados a um plano de saúde

Cited by 9 publications

References 3 publications

Analysis of quality of life and associated factors in a group of elderly persons with supplemental health plans in the city of São Paulo, Brazil

Analysis of quality of life and associated factors in a group of elderly persons with supplemental health plans in the city of São Paulo, Brazil

The iatrogenic triad in a group of elderly women contracted to a health plan

Aplicação dos Critérios de Beers de 2015 Operacionalizados para Portugal em Pessoas Idosas Institucionalizadas: Um Estudo Transversal

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