The iatrogenic triad in a group of elderly women contracted to a health plan

• Autor(a) principal: Oliveira,Henrique Souza Barros de
• Data de Publicação: 2019
• Outros Autores: Manso,Maria Elisa Gonzalez
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista Brasileira de Geriatria e Gerontologia
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1809-98232019000100211
• topic: Old Age Assistance; Prescription Drug Overuse; Potentially Inappropriate Medication List; Drug Interactions; Prepaid Health Plans; Public Health

Abstract Objective: to study the main elements of the iatrogenic triad in a group of elderly women with a Chronic Non-Communicable Disease (CNCD) contracted to a health plan. Method: A cross-sectional and descriptive epidemiological study was carried out by analyzing 3,501 medical prescriptions of 725 elderly women aged ≥65 years. The medications were determined to be Potentially Inappropriate Medications (PIM) based on four instruments (AGS Beers 2015, PRISCUS List, EU(7)-PIM, Brazilian Consensus of PIM - CBPIM). In addition, the most prescribed drugs were assessed for possible Drug Interactions (DI) and classified according to degree of severity. Results: the present study revealed that 89.3% of the studied group used at least one element of the iatrogenic triad, and 44.9% of the sample were associated with the use of polypharmacy and PIM. A total of 48.0% were taking at least five continuous use medications. The main DI were omeprazole, simvastatin and levothyroxine, all of which are of significant severity and have potential drug-food interactions. A total of 35.1% of PIM were identified through the four criteria used, 26.6% were identified by the CBPIM, 25.8% by the EU(7)-PIM, and 24.6% and 6.6% by AGS Beers and PRISCUS, respectively. Conclusion: a high index of continuous use medications, PIM and potential DI were identified, mainly enzymatic inhibitors in a group of elderly women at risk due to their clinical characteristics. Old age was associated with the presence of all the elements of the iatrogenic triad. It was also noted that there were no significant differences between the criteria applied, except for the PRISCUS list.