Polypharmacy and the use of potentially inappropriate medications among aged inpatients

• Autor(a) principal: Oliveira,Marcus Vinicius Palmeira
• Data de Publicação: 2018
• Outros Autores: Buarque,David Costa
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Geriatrics, Gerontology and Aging (Online)
• Texto Completo: https://ggaging.com/details/456
• topic: health of the elderly; inappropriate prescribing; polypharmacy

<p><b>OBJECTIVE:</b> In Brazil, 70% of older adults have at least one chronic disease and, of these, 60% use more than four medications regularly, characterizing polypharmacy. Potentially inappropriate medications (PIMs) are used by 40% of this population. Both polypharmacy and PIM use are associated with negative outcomes, such as increased frequency of drug interactions, falls, frailty, malnutrition, and in some cases, death.<br> <b>METHOD:</b> This was a cross-sectional study with retrospective data collection of all older patients admitted for clinical reasons to a tertiary care hospital in Brazil from March 2015 to February 2016. We evaluated patients for the presence of polypharmacy and PIM use, correlating these findings with other variables of interest.<br> <b>RESULTS:</b> The medical records of 456 patients were analyzed. Mean patient age was 83 years, and 71.3% were women. The mean Charlson comorbidity index (CCI) was 2.38, and dementia was the most prevalent comorbidity (36.6%). Polypharmacy was present in 56.5% of patients, and 46.4% of them used at least one PIM. Antipsychotics were the most frequently used PIM (46.2%), followed by benzodiazepines (33.0%). Drug interactions were detected in 53.5% of patients. The presence of polypharmacy was associated with the use of PIMs (p &lt; 0.001). Additionally, both polypharmacy and PIM use were associated with drug interactions (p &lt; 0.01), poorer functional status (p &lt; 0.01), and higher CCI (p = 0.015).<br> <b>CONCLUSION:</b> In this study population, the prevalence of polypharmacy was 56.5%, and 46.5% of cases included the use of PIMs. Both conditions were associated with drug interactions, poorer functional status, and higher CCl.</p>