doctoralThesis
Uso de medicamentos potencialmente inapropriados entre idosos institucionalizados: um estudo longitudinal
Fecha
2018-12-17Registro en:
MOREIRA, Francisca Sueli Monte. Uso de medicamentos potencialmente inapropriados entre idosos institucionalizados: um estudo longitudinal. 2018. 133f. Tese (Doutorado em Saúde Coletiva) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2018.
Autor
Moreira, Francisca Sueli Monte
Resumen
The main obectives of this work were to verify the prevalence of Potentially
Inappropriate Medication (PIM) use amog older people living in long term instituition and
associated factors, as well as to evaluate the changes in the occurrence of PIM use over time.
The first stage of the study (Study 1) follows a cross-sectional design and used baseline data
from the study "Human Aging and Health: the reality of the institutionalized elderly in the
city of Natal/RN", which aims to assess health/institutionalized elderly in the city of
Natal/RN. The collection was performed based on the data collected in 10 Long Term Care
(LTC) in the city of Natal, RN. Inappropriate medications were classified according to the
2015 American Geriatric Society (AGS) Beers Criteria for Potentially Inappropriate
Medication Use in Older Adults - 2015. Sociodemographic variables, related to LTC and
health conditions, were analyzed. For the univariate and multivariate analyzes between the
main variable (use of one or more PIM according to the 2015 AGS/Beers criteria ) and the
other variables, the Poisson regression was used with a robust estimator. The study population
consisted of 321 elderly people, of whom 304 used medications, and the prevalence of PIM was
54.6% (95% CI: 48.9-60.2). Multivariate analysis revealed that PIM was associated with
polypharmacy and dementia, and the most frequent PIM groups were antipsychotic,
benzodiazepine and sulfonylureas. The second part of the study (Study 2) followed a 24-
month longitudinal follow-up with 6-month follow-up intervals (waves). The variables and
the AGS/Beers criteria adopted in Study 1 were maintained. The prevalence of PIM use was
high in the 4 waves, and 63.4% (95% CI: 57,6-69,1) in the wave 1, 62.9% (95% CI: 56.8-
68.9) in wave 2, 69.2% (95% CI: 63.1-75.3) in wave 3 and 65.9% (95% CI: 59.4-72.4) in
wave 4. Among the PIM classes analyzed, antipsychotics (39,1%), benzodiazepines (30,7%)
and proton pump inhibitors (7,6%) were the most frequently identified in all waves. The study
revealed the maintenance of the high prevalence of PIM among the elderly of the LTC, setting
the need to adopt indicators on the use of these medicines and the implementation of
strategies that make pharmacotherapy safer and more adequate for older adults.