Risk factors associated with drug therapy among elderly people with alzheimer’s disease: A cross-sectional study

Detalhes bibliográficos
Autor(a) principal: Forgerini, Marcela [UNESP]
Data de Publicação: 2020
Outros Autores: Herdeiro, Maria Teresa, Galduróz, José Carlos Fernandes, Mastroianni, Patrícia de Carvalho [UNESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://dx.doi.org/10.1590/1516-3180.2019.0461.r2.19022020
http://hdl.handle.net/11449/200810
Resumo: BACKGROUND: Improving knowledge and establishing strategies and policies for better patient safety are worldwide priorities. OBJECTIVE: To evaluate drug safety among elderly people with Alzheimer’s disease (AD). DESIGN AND SETTING: Cross-sectional study among elderly people within the National AD Assistance Protocol (PCDTDA/MS) who were living in the municipality of Araraquara, Brazil, in 2017. METHODS: Through interviews conducted with relatives/caregivers of elderly people with diagnoses of AD, the following variables were evaluated: comorbidities, drug therapy used, use of potentially inappropriate medications for the elderly (PIMs), presence of potentially inappropriate interactions (PIIs) and medication regimen complexity index. Factors associated with AD severity were also evaluated. Multivariate and simple logistic regressions were applied. RESULTS: 143 elderly people enrolled in PCDTDA/MS were analyzed. The majority were women (67.1%); assisted only through the public healthcare system (75.5%); polymedicated (57.4%); using at least one PIM (63.6%); presenting at least one PII (63.6%); and under drug therapy of low to medium complexity (92.2%). No semi-annual monitoring of the effectiveness of PCDTDA/MS drugs was identified. The proportion using AD drug therapy at daily doses differing from those recommended by the World Health Organization was 75.6%. However, these doses were not associated with drug risk. CONCLUSION: The data from this study raise the hypothesis that use of polypharmacy might show a correlation with severity of AD. The drug safety risk may be associated with comorbidities of the metabolic syndrome, anxiety and off-label use of PIMs, such as risperidone and quetiapine, and benzodiazepines (i.e. clonazepam and flunitrazepam).
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spelling Risk factors associated with drug therapy among elderly people with alzheimer’s disease: A cross-sectional studyDementiaPatient safetyPolypharmacyBACKGROUND: Improving knowledge and establishing strategies and policies for better patient safety are worldwide priorities. OBJECTIVE: To evaluate drug safety among elderly people with Alzheimer’s disease (AD). DESIGN AND SETTING: Cross-sectional study among elderly people within the National AD Assistance Protocol (PCDTDA/MS) who were living in the municipality of Araraquara, Brazil, in 2017. METHODS: Through interviews conducted with relatives/caregivers of elderly people with diagnoses of AD, the following variables were evaluated: comorbidities, drug therapy used, use of potentially inappropriate medications for the elderly (PIMs), presence of potentially inappropriate interactions (PIIs) and medication regimen complexity index. Factors associated with AD severity were also evaluated. Multivariate and simple logistic regressions were applied. RESULTS: 143 elderly people enrolled in PCDTDA/MS were analyzed. The majority were women (67.1%); assisted only through the public healthcare system (75.5%); polymedicated (57.4%); using at least one PIM (63.6%); presenting at least one PII (63.6%); and under drug therapy of low to medium complexity (92.2%). No semi-annual monitoring of the effectiveness of PCDTDA/MS drugs was identified. The proportion using AD drug therapy at daily doses differing from those recommended by the World Health Organization was 75.6%. However, these doses were not associated with drug risk. CONCLUSION: The data from this study raise the hypothesis that use of polypharmacy might show a correlation with severity of AD. The drug safety risk may be associated with comorbidities of the metabolic syndrome, anxiety and off-label use of PIMs, such as risperidone and quetiapine, and benzodiazepines (i.e. clonazepam and flunitrazepam).Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Department of Drugs and Medicines School of Pharmaceutical Sciences Universidade Estadual Paulista (UNESP)Department of Medical Sciences Universidade de Aveiro Institute of Biomedicine (iBiMED)Department of Psychobiology Universidade Federal de São Paulo (UNIFESP)Department of Drugs and Medicines Universidade Estadual Paulista (UNESP)Department of Drugs and Medicines School of Pharmaceutical Sciences Universidade Estadual Paulista (UNESP)Department of Drugs and Medicines Universidade Estadual Paulista (UNESP)CAPES: 001CNPq: 131206/2017-6FAPESP: 2013/12681-2FAPESP: 2018/07501-9CNPq: 459461/2014-1Universidade Estadual Paulista (Unesp)Institute of Biomedicine (iBiMED)Universidade Federal de São Paulo (UNIFESP)Forgerini, Marcela [UNESP]Herdeiro, Maria TeresaGalduróz, José Carlos FernandesMastroianni, Patrícia de Carvalho [UNESP]2020-12-12T02:16:41Z2020-12-12T02:16:41Z2020-05-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article216-228application/pdfhttp://dx.doi.org/10.1590/1516-3180.2019.0461.r2.19022020Sao Paulo Medical Journal, v. 138, n. 3, p. 216-228, 2020.1516-3180http://hdl.handle.net/11449/20081010.1590/1516-3180.2019.0461.r2.19022020S1516-318020200003002162-s2.0-85088490771S1516-31802020000300216.pdfScopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengSao Paulo Medical Journalinfo:eu-repo/semantics/openAccess2024-01-23T07:08:03Zoai:repositorio.unesp.br:11449/200810Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-01-23T07:08:03Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Risk factors associated with drug therapy among elderly people with alzheimer’s disease: A cross-sectional study
title Risk factors associated with drug therapy among elderly people with alzheimer’s disease: A cross-sectional study
spellingShingle Risk factors associated with drug therapy among elderly people with alzheimer’s disease: A cross-sectional study
Forgerini, Marcela [UNESP]
Dementia
Patient safety
Polypharmacy
title_short Risk factors associated with drug therapy among elderly people with alzheimer’s disease: A cross-sectional study
title_full Risk factors associated with drug therapy among elderly people with alzheimer’s disease: A cross-sectional study
title_fullStr Risk factors associated with drug therapy among elderly people with alzheimer’s disease: A cross-sectional study
title_full_unstemmed Risk factors associated with drug therapy among elderly people with alzheimer’s disease: A cross-sectional study
title_sort Risk factors associated with drug therapy among elderly people with alzheimer’s disease: A cross-sectional study
author Forgerini, Marcela [UNESP]
author_facet Forgerini, Marcela [UNESP]
Herdeiro, Maria Teresa
Galduróz, José Carlos Fernandes
Mastroianni, Patrícia de Carvalho [UNESP]
author_role author
author2 Herdeiro, Maria Teresa
Galduróz, José Carlos Fernandes
Mastroianni, Patrícia de Carvalho [UNESP]
author2_role author
author
author
dc.contributor.none.fl_str_mv Universidade Estadual Paulista (Unesp)
Institute of Biomedicine (iBiMED)
Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Forgerini, Marcela [UNESP]
Herdeiro, Maria Teresa
Galduróz, José Carlos Fernandes
Mastroianni, Patrícia de Carvalho [UNESP]
dc.subject.por.fl_str_mv Dementia
Patient safety
Polypharmacy
topic Dementia
Patient safety
Polypharmacy
description BACKGROUND: Improving knowledge and establishing strategies and policies for better patient safety are worldwide priorities. OBJECTIVE: To evaluate drug safety among elderly people with Alzheimer’s disease (AD). DESIGN AND SETTING: Cross-sectional study among elderly people within the National AD Assistance Protocol (PCDTDA/MS) who were living in the municipality of Araraquara, Brazil, in 2017. METHODS: Through interviews conducted with relatives/caregivers of elderly people with diagnoses of AD, the following variables were evaluated: comorbidities, drug therapy used, use of potentially inappropriate medications for the elderly (PIMs), presence of potentially inappropriate interactions (PIIs) and medication regimen complexity index. Factors associated with AD severity were also evaluated. Multivariate and simple logistic regressions were applied. RESULTS: 143 elderly people enrolled in PCDTDA/MS were analyzed. The majority were women (67.1%); assisted only through the public healthcare system (75.5%); polymedicated (57.4%); using at least one PIM (63.6%); presenting at least one PII (63.6%); and under drug therapy of low to medium complexity (92.2%). No semi-annual monitoring of the effectiveness of PCDTDA/MS drugs was identified. The proportion using AD drug therapy at daily doses differing from those recommended by the World Health Organization was 75.6%. However, these doses were not associated with drug risk. CONCLUSION: The data from this study raise the hypothesis that use of polypharmacy might show a correlation with severity of AD. The drug safety risk may be associated with comorbidities of the metabolic syndrome, anxiety and off-label use of PIMs, such as risperidone and quetiapine, and benzodiazepines (i.e. clonazepam and flunitrazepam).
publishDate 2020
dc.date.none.fl_str_mv 2020-12-12T02:16:41Z
2020-12-12T02:16:41Z
2020-05-01
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/1516-3180.2019.0461.r2.19022020
Sao Paulo Medical Journal, v. 138, n. 3, p. 216-228, 2020.
1516-3180
http://hdl.handle.net/11449/200810
10.1590/1516-3180.2019.0461.r2.19022020
S1516-31802020000300216
2-s2.0-85088490771
S1516-31802020000300216.pdf
url http://dx.doi.org/10.1590/1516-3180.2019.0461.r2.19022020
http://hdl.handle.net/11449/200810
identifier_str_mv Sao Paulo Medical Journal, v. 138, n. 3, p. 216-228, 2020.
1516-3180
10.1590/1516-3180.2019.0461.r2.19022020
S1516-31802020000300216
2-s2.0-85088490771
S1516-31802020000300216.pdf
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Sao Paulo Medical Journal
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 216-228
application/pdf
dc.source.none.fl_str_mv Scopus
reponame:Repositório Institucional da UNESP
instname:Universidade Estadual Paulista (UNESP)
instacron:UNESP
instname_str Universidade Estadual Paulista (UNESP)
instacron_str UNESP
institution UNESP
reponame_str Repositório Institucional da UNESP
collection Repositório Institucional da UNESP
repository.name.fl_str_mv Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)
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