Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward.

Detalhes bibliográficos
Autor(a) principal: Urzal, J
Data de Publicação: 2019
Outros Autores: Pedro, AB, Oliveira, I, Romero, I, Achega, M, Correia, I, Aldomiro, F, Augusto, J
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.10/2190
Resumo: INTRODUCTION: Polypharmacy is often observed in elderly patients and is associated with an increased risk of adverse drug reactions, side effects and interactions. Clinicians should be alert to inappropriate drug prescribing and reduce polypharmacy. MATERIAL AND METHODS: Observational, longitudinal, retrospective and descriptive study in an internal medicine ward in a Portuguese hospital. Polypharmacy was defined as the use of five or more different medicines. The purpose of this study was to describe the prevalence of polypharmacy and inappropriate prescribing at admission and discharge in an internal medicine ward, according to deprescribing.org guidelines/algorithms. A total of 838 consecutive patients were admitted between January and July 2017. All patients were aged under 65 years old, and those who died before discharge were excluded. Patients' medications were reviewed from a medical database at hospital admission and discharge. We examined whether patients were taking anticoagulants, proton pump inhibitors, benzodiazepines, antipsychotics and/or antihyperglycemic medication. RESULTS: A total of 483 patients were included, mean age was 79.2 ± 8.0 years, and 42% of patients were male. Median number of medications at admission and discharge was six. Polypharmacy was present in more than 70% of admitted patients. Proton pump inhibitors were the most common inappropriate prescription at discharge (17.2%). DISCUSSION: This study demonstrated a low use of inappropriate medicine (11.2% - 17.2%) in older people discharged from hospital, when compared to other studies. CONCLUSION: Our study shows that polypharmacy is present in more than 70% of elderly admitted patients. Nevertheless, the drug inappropriateness rate was not significantly affected by polypharmacy at both admission and discharge, being overall lower than published data.
id RCAP_19bee43ebe31b3cf4002501822b87baf
oai_identifier_str oai:repositorio.hff.min-saude.pt:10400.10/2190
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward.Prescrição Inapropriada em Idosos numa Enfermaria de Medicina InternaAgedInappropriate prescribingPolypharmacyPortugalINTRODUCTION: Polypharmacy is often observed in elderly patients and is associated with an increased risk of adverse drug reactions, side effects and interactions. Clinicians should be alert to inappropriate drug prescribing and reduce polypharmacy. MATERIAL AND METHODS: Observational, longitudinal, retrospective and descriptive study in an internal medicine ward in a Portuguese hospital. Polypharmacy was defined as the use of five or more different medicines. The purpose of this study was to describe the prevalence of polypharmacy and inappropriate prescribing at admission and discharge in an internal medicine ward, according to deprescribing.org guidelines/algorithms. A total of 838 consecutive patients were admitted between January and July 2017. All patients were aged under 65 years old, and those who died before discharge were excluded. Patients' medications were reviewed from a medical database at hospital admission and discharge. We examined whether patients were taking anticoagulants, proton pump inhibitors, benzodiazepines, antipsychotics and/or antihyperglycemic medication. RESULTS: A total of 483 patients were included, mean age was 79.2 ± 8.0 years, and 42% of patients were male. Median number of medications at admission and discharge was six. Polypharmacy was present in more than 70% of admitted patients. Proton pump inhibitors were the most common inappropriate prescription at discharge (17.2%). DISCUSSION: This study demonstrated a low use of inappropriate medicine (11.2% - 17.2%) in older people discharged from hospital, when compared to other studies. CONCLUSION: Our study shows that polypharmacy is present in more than 70% of elderly admitted patients. Nevertheless, the drug inappropriateness rate was not significantly affected by polypharmacy at both admission and discharge, being overall lower than published data.Introdução: A polimedicação é observada nos doentes idosos e está associada a um maior risco de reações adversas, efeitos secundários e interações. Os clínicos devem atentos à prescrição inapropriada e à redução da polimedicação. Material e Métodos: Estudo observacional, longitudinal, retrospetivo e descritivo, realizado numa enfermaria de medicina interna num hospital português. Definimos a polimedicação como o uso de cinco ou mais medicamentos. O objetivo foi descrever a prevalência da polimedicação e a prescrição inapropriada, na admissão e alta, de acordo com as guidelines/algoritmos definidos em deprescribing. org. Admitimos 838 doentes entre janeiro e julho de 2017. Excluímos todos aqueles com idade inferior a 65 anos e óbitos. A medicação dos doentes foi revista a partir da base de dados hospitalar, à admissão e à data de alta. Examinámos se os doentes estavam a tomar anticoagulantes, inibidores da bomba de protões, benzodiazepinas, antipsicóticos e/ou anti hiperglicémicos. Resultados: Incluímos 483 doentes, com média de idade de 79,2 ± 8,0 anos, e 42% dos quais eram homens. A mediana da medicação à admissão e à alta foi seis. A polimedicação estava presente em mais de 70% dos doentes admitidos. Os inibidores da bomba de protões foram a classe mais inapropriadamente prescrita à data de alta (17,2%). Discussão: Demonstrámos um uso reduzido de fármacos inapropriados (11,2% - 17,2%) nos idosos, à alta hospitalar, quando comparado com outros estudos. Conclusão: Demonstrámos que a polimedicação estava presente em mais de 70% dos idosos admitidos. Contudo, a taxa de prescrição inapropriada não afetou significativamente a polimedicação na admissão e na alta, sendo inferior aos dados publicados.Ordem dos MédicosRepositório do Hospital Prof. Doutor Fernando FonsecaUrzal, JPedro, ABOliveira, IRomero, IAchega, MCorreia, IAldomiro, FAugusto, J2019-04-02T08:50:50Z2019-01-01T00:00:00Z2019-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.10/2190engActa Med Port. 2019 Feb 28;32(2):141-1481646–075810.20344/amp.10683info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-20T15:52:53Zoai:repositorio.hff.min-saude.pt:10400.10/2190Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:53:09.862738Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward.
Prescrição Inapropriada em Idosos numa Enfermaria de Medicina Interna
title Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward.
spellingShingle Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward.
Urzal, J
Aged
Inappropriate prescribing
Polypharmacy
Portugal
title_short Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward.
title_full Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward.
title_fullStr Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward.
title_full_unstemmed Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward.
title_sort Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward.
author Urzal, J
author_facet Urzal, J
Pedro, AB
Oliveira, I
Romero, I
Achega, M
Correia, I
Aldomiro, F
Augusto, J
author_role author
author2 Pedro, AB
Oliveira, I
Romero, I
Achega, M
Correia, I
Aldomiro, F
Augusto, J
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório do Hospital Prof. Doutor Fernando Fonseca
dc.contributor.author.fl_str_mv Urzal, J
Pedro, AB
Oliveira, I
Romero, I
Achega, M
Correia, I
Aldomiro, F
Augusto, J
dc.subject.por.fl_str_mv Aged
Inappropriate prescribing
Polypharmacy
Portugal
topic Aged
Inappropriate prescribing
Polypharmacy
Portugal
description INTRODUCTION: Polypharmacy is often observed in elderly patients and is associated with an increased risk of adverse drug reactions, side effects and interactions. Clinicians should be alert to inappropriate drug prescribing and reduce polypharmacy. MATERIAL AND METHODS: Observational, longitudinal, retrospective and descriptive study in an internal medicine ward in a Portuguese hospital. Polypharmacy was defined as the use of five or more different medicines. The purpose of this study was to describe the prevalence of polypharmacy and inappropriate prescribing at admission and discharge in an internal medicine ward, according to deprescribing.org guidelines/algorithms. A total of 838 consecutive patients were admitted between January and July 2017. All patients were aged under 65 years old, and those who died before discharge were excluded. Patients' medications were reviewed from a medical database at hospital admission and discharge. We examined whether patients were taking anticoagulants, proton pump inhibitors, benzodiazepines, antipsychotics and/or antihyperglycemic medication. RESULTS: A total of 483 patients were included, mean age was 79.2 ± 8.0 years, and 42% of patients were male. Median number of medications at admission and discharge was six. Polypharmacy was present in more than 70% of admitted patients. Proton pump inhibitors were the most common inappropriate prescription at discharge (17.2%). DISCUSSION: This study demonstrated a low use of inappropriate medicine (11.2% - 17.2%) in older people discharged from hospital, when compared to other studies. CONCLUSION: Our study shows that polypharmacy is present in more than 70% of elderly admitted patients. Nevertheless, the drug inappropriateness rate was not significantly affected by polypharmacy at both admission and discharge, being overall lower than published data.
publishDate 2019
dc.date.none.fl_str_mv 2019-04-02T08:50:50Z
2019-01-01T00:00:00Z
2019-01-01T00:00:00Z
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://hdl.handle.net/10400.10/2190
url http://hdl.handle.net/10400.10/2190
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Acta Med Port. 2019 Feb 28;32(2):141-148
1646–0758
10.20344/amp.10683
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799130398542790656