Analysis of medication prescriptions for the elderly assisted at a geriatrics outpatient clinic

Authors

DOI:

https://doi.org/10.17267/2317-3378rec.2023e5162

Keywords:

Aging, Polypharmacy, Potentially Inappropriate Medications, Beers

Abstract

OBJECTIVE:  To evaluate the medication prescriptions of the elderly who are assisted in a geriatric outpatient clinic based on the Brazilian Consensus of Potentially Inappropriate Medications (PIM) for the Elderly.   METHODOLOGY:  This is a descriptive research with retrospective analysis of the electronic medical records of patients aged equal to or older than 60 years old, who attended the geriatric outpatient clinic of a hospital in Bahia from January to June 2018.  The research includes 291 medical records and documentation of the medications that the elderly people already used at home and the prescription in force after the consultation records were collected.  RESULTS: The median age was 73 years old. It was identified that before the consultation, 89 elderly people (30.6%) used inappropriate medications.  After the consultation with a geriatrician, 110 elderly people (37.6%) began to use them, with no statistical difference.  The median number of medications after the outpatient consultation was higher than before the consultation, with statistical significance (p<0.001).  It was found that of the elderly who did not use polypharmacy, 20.4% began to use it after the consultation. CONCLUSION:  Even after consultation with the geriatrician, there are still inadequacies in the prescriptions, with a relevant number of elderly people using five or more medications and using PIM.

 

Downloads

Download data is not yet available.

References

(1) Instituto Brasileiro de Geografia e Estatística. Evolução dos grupos etários 2010-2060 [Internet]. Rio de Janeiro: IBGE. Available from: https://www.ibge.gov.br/estatisticas/sociais/populacao/9109-projecao-da-populacao.html

(2) Albarqouni L, Palagama S, Chai J, Sivananthajothy P, Pathirana T, Bakhit M, Overuse of medications in low- and middle-income countries: a scoping review. Bull World Health Organ. 2023;101(1):36-61D. https://doi.org/10.2471/blt.22.288293

(3) Godoi DRS, Nascimento KBR, Nunes KJF, Silva TTA, Silva TKA. Polypharmacy and occurrence of drug interactions in elderly. Braz J Dev. 2021;7(3):30946-59. https://doi.org/10.34117/bjdv7n3-697

(4) Praxedes MFS, Pereira GCS, Lima CFM, Santos DB, Berhends JS. Prescribing potentially inappropriate medications for the elderly according to Beers Criteria: systematic review. Ciênc. Saúde Coletiva. 2021;26(8):3209-19. https://doi.org/10.1590/1413-81232021268.05672020

(5) Reis AMM, Alves CPB, Figueredo TP, Barroso SCC, Nascimento MMG. Adverse drug reaction as a contributing factor for hospitalization of the elderly. Rev. Bras. Farm. Hosp. Serv. Saúde. 2017;8(3):8-13. https://doi.org/10.30968/rbfhss.2017.083.002

(6) Rosa ASKC, Costa BP, Kapper CP, Dalmas GGS, Sbroglio LL, Andreis L, et al. Identification of inappropiate prescribing in a Geriatric outpatient clinic using the Criteria Stopp Start. Rev. Bras. Geriatr. Gerontol. 2016;19(5):871-9. https://doi.org/10.1590/1809-98232016019.150220

(7) Oliveira MG, Amorim WW, Borja-Oliveira CR, Coqueiro HL, Gusmão LC, Passos LC. Consenso brasileiro de medicamentos potencialmente inapropriados para idosos. Geriatr. Gerontol. Aging. 2016;10(4):1-14. https://doi.org/10.5327/Z2447-211520161600054

(8) Farias AD, Lima KC, Oliveira YMC, Leal AAF, Martins RR, Freitas CHSM. Prescription of potentially inappropriate medications for the elderly: a study in Primary Health Care. Ciênc. saúde coletiva. 2021;26(5):1781-92. https://doi.org/10.1590/1413-81232021265.04532021

(9) 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;67(4):674-694. https://doi.org/10.1111/jgs.15767

(10) Moreira FSM, Jerez-Roig J, Ferreira LMBM, Dantas APQM, Lima KC, Ferreira MAF. Use of potentially inappropriate medications in institutionalized elderly: prevalence and associated factors. Ciênc. Saúde Coletiva, 2020;25(6):273-82. https://doi.org/10.1590/1413-81232020256.26752018

(11) Resende ACGD, Costa FBC, Gomes IR, Araújo JG, Suguino MM, Vidal CEL. Evaluation of drug use in the elderly according to Beers criteria. Rev. Med. Minas Gerais [Internet]. 2017;27(Suppl 1):S30-S36. Available from: https://rmmg.org/exportar-pdf/2037/v27s1a06.pdf

(12) Bueno D, Almeida TT, Rocha BS. Prevalence of potentially inappropriate drug prescription for elderly of Family Health Unit in Porto Alegre/RS. Rev. APS [Internet]. 2016;19(3):370-75. Available from: https://periodicos.ufjf.br/index.php/aps/article/view/15579

(13) Oliveira HSB, Corradi MLG. Pharmacological aspects of elderly: an integrative literature review. Rev. Med. (São Paulo). 2018;97(2):165-76. https://doi.org/10.11606/issn.1679-9836.v97i2p165-176

(14) Zhang Y, Chen Z, Tian F. Potentially inappropriate medications in older Chinese outpatients based on the Beers criteria and Chinese criteria. Front Pharmacol. 2022;13:991087. https://doi.org/10.3389/fphar.2022.991087

(15) Wang F, Ma Z, Liu M, Wu X. Potentially inappropriate medications at admission and discharge in older adults: A comparison of the Beers 2019 and 2015 criteria. Int J Clin Pharmacol Ther. 2020;58(6):299-309. https://doi.org/10.5414/cp203638

(16) Bai Y, Wang J, Li G, Zhou Z, Zhang C. Evaluation of potentially inappropriate medications in older patients admitted to the cardiac intensive care unit according to the 2019 Beers criteria, STOPP criteria version 2 and Chinese criteria. J Clin Pharm Ther. 2022;47(12):1994-2007. https://doi.org/10.1111/jcpt.13736

(17) Oliveira RMAF, Gorzoni ML, Rosa RF. Potentially inappropriate medication use in hospitalized elderly patients. Rev. Assoc. Med. Bras. 2022;68(6):797-801. https://doi.org/10.1590/1806-9282.20220015

(18) Gomm W, Von Holt K, Thomé F, Broich K, Maier W, Fink A, et al. Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis. JAMA Neurol. 2016;73(4):410-16. https://doi.org/10.1001/jamaneurol.2015.4791

(19) Coluzzi F, Taylor Jr R, Pergolizzi Jr JV, Mattia C, Raffa RB. Good clinical practice guide for opioids in pain management: the three Ts - titration (trial), tweaking (tailoring), transition (tapering). Rev. Bras. Anestesiol. 2016;66(3):310-317. https://doi.org/10.1016/j.bjane.2014.09.005

(20) Primejdie DP, Bojita MT, Popa A. Potentially inappropriate medications in elderly ambulatory and institutionalized patients: an observational study. BMC Pharmacol Toxicol. 2016;17(1):38. https://doi.org/10.1186/s40360-016-0081-x

(21) Al Odhayani A, Tourkmani A, Alshehri M, Alqahtani H, Mishriky A. Potentially inappropriate medications prescribed for elderly patients through family physicians. Saudi J Biol Sci. 2017;24(1):200-07. https://doi.org/10.1016/j.sjbs.2016.05.006

(22) Wallace E, McDowell R, Bennett K, Fahey T, Smith SM. Impact of Potentially Inappropriate Prescribing on Adverse Drug Events, Health Related Quality of Life and Emergency Hospital Attendance in Older People Attending General Practice: A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci. 2017;72(2):271-77. https://doi.org/10.1093/gerona/glw140

(23) Ministério da Saúde (Brasil), Secretaria de Atenção à Saúde, Departamento de Ações Programáticas e Estratégicas. Orientações técnicas para a implementação de Linha de Cuidado para Atenção Integral à Saúde da Pessoa Idosa no Sistema Único de Saúde – SUS [Internet]. Brasília: Ministério da Saúde; 2018. 93 p. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/linha_cuidado_atencao_pessoa_idosa.pdf

Published

07/04/2023

Issue

Section

Original Articles

How to Cite

1.
Vaz LK de M, Ramos ASP, Goulart JL, Ramos TC, Ramos MESP. Analysis of medication prescriptions for the elderly assisted at a geriatrics outpatient clinic. Rev Enf Contemp [Internet]. 2023 Jul. 4 [cited 2024 Nov. 24];12:e5162. Available from: https://journals.bahiana.edu.br/index.php/enfermagem/article/view/5162

Most read articles by the same author(s)