Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review

Detalhes bibliográficos
Autor(a) principal: Rodrigues, Maria Cristina Soares
Data de Publicação: 2016
Outros Autores: Oliveira, Cesar de
Tipo de documento: Artigo
Idioma: eng
por
spa
Título da fonte: Revista Latino-Americana de Enfermagem (Online)
Texto Completo: https://www.revistas.usp.br/rlae/article/view/123951
Resumo: Objective: to identify and summarize studies examining both drug-drug interactions (DDI) and adverse drug reactions (ADR) in older adults polymedicated. Methods: an integrative review of studies published from January 2008 to December 2013, according to inclusion and exclusion criteria, in MEDLINE and EMBASE electronic databases were performed. Results: forty-seven full-text studies including 14,624,492 older adults (≥ 60 years) were analyzed: 24 (51.1%) concerning ADR, 14 (29.8%) DDI, and 9 studies (19.1%) investigating both DDI and ADR. We found a variety of methodological designs. The reviewed studies reinforced that polypharmacy is a multifactorial process, and predictors and inappropriate prescribing are associated with negative health outcomes, as increasing the frequency and types of ADRs and DDIs involving different drug classes, moreover, some studies show the most successful interventions to optimize prescribing. Conclusions: DDI and ADR among older adults continue to be a significant issue in the worldwide. The findings from the studies included in this integrative review, added to the previous reviews, can contribute to the improvement of advanced practices in geriatric nursing, to promote the safety of older patients in polypharmacy. However, more research is needed to elucidate gaps.
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spelling Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review Interações medicamentosas e reações adversas a medicamentos em polifarmácia em idosos: uma revisão integrativa Interacciones medicamentosas y reacciones adversas a los medicamentos en polifarmacia en adultos mayores: una revisión integradora Objective: to identify and summarize studies examining both drug-drug interactions (DDI) and adverse drug reactions (ADR) in older adults polymedicated. Methods: an integrative review of studies published from January 2008 to December 2013, according to inclusion and exclusion criteria, in MEDLINE and EMBASE electronic databases were performed. Results: forty-seven full-text studies including 14,624,492 older adults (≥ 60 years) were analyzed: 24 (51.1%) concerning ADR, 14 (29.8%) DDI, and 9 studies (19.1%) investigating both DDI and ADR. We found a variety of methodological designs. The reviewed studies reinforced that polypharmacy is a multifactorial process, and predictors and inappropriate prescribing are associated with negative health outcomes, as increasing the frequency and types of ADRs and DDIs involving different drug classes, moreover, some studies show the most successful interventions to optimize prescribing. Conclusions: DDI and ADR among older adults continue to be a significant issue in the worldwide. The findings from the studies included in this integrative review, added to the previous reviews, can contribute to the improvement of advanced practices in geriatric nursing, to promote the safety of older patients in polypharmacy. However, more research is needed to elucidate gaps. Objetivo: identificar e sintetizar estudos que examinam as interações medicamentosas (IM) e reações adversas a medicamentos (RAM) em idosos polimedicados. Métodos: revisão integrativa de estudos publicados de janeiro de 2008 a dezembro de 2013, de acordo com critérios de inclusão e exclusão, nas bases de dados eletrônicas MEDLINE e EMBASE. Resultados: foram analisados 47 estudos de texto completo, incluindo 14,624,492 idosos (≥ 60 anos): 24 (51,1%) sobre RAM, 14 (29,8%) sobre IM e 9 estudos (19,1%) que investigaram tanto IM como RAM. Encontramos uma variedade de desenhos metodológicos. Os estudos revisados reforçaram que a polifarmácia é um processo multifatorial, e os preditores e a prescrição inadequada estão associados a resultados negativos de saúde, como aumento da frequência e tipos de RAM e IM envolvendo diferentes classes de drogas, além disso, alguns estudos mostram as intervenções mais bem-sucedidas para otimizar a prescrição. Conclusões: IM e RAM entre idosos continuam a ser um problema significativo no mundo todo. Os resultados dos estudos incluídos nesta revisão integrativa, adicionado às revisões anteriores, podem contribuir para a melhoria das práticas avançadas de enfermagem geriátrica, para promover a segurança dos pacientes idosos em polifarmácia. No entanto, são necessárias mais pesquisas para elucidar lacunas. Objetivo: identificar y resumir los estudios que analizan tanto las interacciones medicamentosas (IM) como las reacciones adversas a medicamentos (RAM) en los adultos mayores polimedicados. Métodos: revisión integradora de estudios publicados entre enero de 2008 a diciembre de 2013, siguiendo criterios de inclusión y exclusión, en las bases de datos electrónicas MEDLINE y EMBASE. Resultados: cuarenta y siete estudios de texto completo incluidos fueron analizados incluyendo 14,624,492 adultos mayores (≥ 60 años), de ellos 24 (51,1%) en relación con RAM, 14 (29,9%) con IM y 9 estudios (19,1%) que investigaron tanto IM como RAM. Encontramos una gran variedad de diseños metodológicos. Los estudios revisados reforzaron el concepto que la polifarmacia es un proceso multifactorial, y los predictores y la prescripción inadecuada se asocian con resultados negativos para la salud tales como el aumento de la frecuencia y tipos de RAM y IM implicando diferentes clases de fármacos, además que algunos estudios muestran cuales son las intervenciones más exitosas para optimizar la prescripción. Conclusiones: IM y RAM siguen siendo un problema importante en el mundo entero entre los adultos mayores. Los resultados de los estudios incluidos en esta revisión integradora, sumado a las revisiones previas, pueden contribuir a la mejora de las prácticas avanzadas de enfermería geriátrica, para promover la seguridad de los pacientes de mayor edad en la polifarmacia. Sin embargo, se necesita más investigación para esclarecer los vacíos de conocimiento. Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto2016-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rlae/article/view/12395110.1590/1518-8345.1316.2800Revista Latino-Americana de Enfermagem; v. 24 (2016); e2800-Revista Latino-Americana de Enfermagem; Vol. 24 (2016); e2800-Revista Latino-Americana de Enfermagem; Vol. 24 (2016); e2800-1518-83450104-1169reponame:Revista Latino-Americana de Enfermagem (Online)instname:Universidade de São Paulo (USP)instacron:USPengporspahttps://www.revistas.usp.br/rlae/article/view/123951/120133https://www.revistas.usp.br/rlae/article/view/123951/120134https://www.revistas.usp.br/rlae/article/view/123951/120135Copyright (c) 2016 Revista Latino-Americana de Enfermageminfo:eu-repo/semantics/openAccessRodrigues, Maria Cristina SoaresOliveira, Cesar de2016-12-23T10:05:43Zoai:revistas.usp.br:article/123951Revistahttp://www.scielo.br/rlaePUBhttps://old.scielo.br/oai/scielo-oai.phprlae@eerp.usp.br||shbcassi@eerp.usp.br1518-83450104-1169opendoar:2016-12-23T10:05:43Revista Latino-Americana de Enfermagem (Online) - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review
Interações medicamentosas e reações adversas a medicamentos em polifarmácia em idosos: uma revisão integrativa
Interacciones medicamentosas y reacciones adversas a los medicamentos en polifarmacia en adultos mayores: una revisión integradora
title Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review
spellingShingle Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review
Rodrigues, Maria Cristina Soares
title_short Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review
title_full Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review
title_fullStr Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review
title_full_unstemmed Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review
title_sort Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review
author Rodrigues, Maria Cristina Soares
author_facet Rodrigues, Maria Cristina Soares
Oliveira, Cesar de
author_role author
author2 Oliveira, Cesar de
author2_role author
dc.contributor.author.fl_str_mv Rodrigues, Maria Cristina Soares
Oliveira, Cesar de
description Objective: to identify and summarize studies examining both drug-drug interactions (DDI) and adverse drug reactions (ADR) in older adults polymedicated. Methods: an integrative review of studies published from January 2008 to December 2013, according to inclusion and exclusion criteria, in MEDLINE and EMBASE electronic databases were performed. Results: forty-seven full-text studies including 14,624,492 older adults (≥ 60 years) were analyzed: 24 (51.1%) concerning ADR, 14 (29.8%) DDI, and 9 studies (19.1%) investigating both DDI and ADR. We found a variety of methodological designs. The reviewed studies reinforced that polypharmacy is a multifactorial process, and predictors and inappropriate prescribing are associated with negative health outcomes, as increasing the frequency and types of ADRs and DDIs involving different drug classes, moreover, some studies show the most successful interventions to optimize prescribing. Conclusions: DDI and ADR among older adults continue to be a significant issue in the worldwide. The findings from the studies included in this integrative review, added to the previous reviews, can contribute to the improvement of advanced practices in geriatric nursing, to promote the safety of older patients in polypharmacy. However, more research is needed to elucidate gaps.
publishDate 2016
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dc.publisher.none.fl_str_mv Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto
publisher.none.fl_str_mv Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto
dc.source.none.fl_str_mv Revista Latino-Americana de Enfermagem; v. 24 (2016); e2800-
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