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Uso de medicamentos potencialmente inapropriados por idosos do município de São Paulo - Estudo SABE - Saúde, Bem Estar e Envelhecimento; Use of Potentially Inappropriate Medications by Elderly in São Paulo City: SABE Study - Health, Well-being and Aging

Cassoni, Teresa Cristina Jahn
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 03/10/2011 PT
Relevância na Pesquisa
46.32%
Introdução - Os efeitos prejudiciais envolvendo medicamentos pela cres- cente população idosa impulsionaram pesquisas para desenvolvimento e aplicação de diversos métodos e instrumentos para identificar padrões inadequados de prescrição/ uso e problemas farmacoterapêuticos envolvendo este grupo populacional. Objetivo - Verificar a prevalência do uso de medicamentos potencialmente inapropriados listados nos Critérios de Beers 2003 pelas pessoas idosas de 60 anos ou mais do município de São Paulo, entrevistadas pelo Estudo SABE no ano de 2006. Métodos - Trata-se de um estudo transversal de base populacional, com utilização de dados secundários obtidos do Estudo SABE. A amostra constituída de 1258 idosos de 60 anos ou mais. Os dados finais foram ponderados e expandidos de modo a representar a população idosa no ano de 2006. Os medicamentos foram classificados de acordo com a Anatomical Therapeutic Chemical Classification System. Para análise dos dados utilizou-se o pacote estatístico Stata com realização de regressão logística. Considerou-se nível de significância de p<0,05. Resultados Verificou-se a prevalência de 28 por cento de uso de MPI entre os idosos. Na análise pelo modelo de regressão logística multivariada as variáveis associadas ao consumo de MPI foram polifarmácia (p = 0...

Potentially inappropriate medication in nursing homes: application of the Beers criteria

Periquito, C.; Cavaco-Silva, P.; Oliveira, P.; Carneiro, C.; Fernandes, A. I.; Costa, F. A.
Fonte: Repositório Comum de Portugal Publicador: Repositório Comum de Portugal
Tipo: Conferência ou Objeto de Conferência
Publicado em 04/02/2015 ENG
Relevância na Pesquisa
46.29%
Poster presented at the 9th PCNE (Pharmaceutical Care Network Europe) Working Conference. Mechelen (Belgium), 2015

Abordagem farmacoepidemiológica da terapêutica no idoso: um ensaio em meio hospitalar

Catarino, Maria Helena Beirão
Fonte: Faculdade de Ciências Médicas. Universidade Nova de Lisboa Publicador: Faculdade de Ciências Médicas. Universidade Nova de Lisboa
Tipo: Dissertação de Mestrado
Publicado em //2006 POR
Relevância na Pesquisa
46.77%
Introdução: O envelhecimento demográfico e o aumento da esperança de vida, criam condições para uma maior incidência de doenças degenerativas. Vários aspectos críticos envolvem a medicação no idoso, tais como: polimedicação frequente, com risco acrescido de ocorrência de reacções adversas, relacionadas com interacções medicamentosas e eventual medicação desaconselhada, em que o risco pode ser superior ao benefício. Estes aspectos são particularmente críticos no idoso hospitalizado. Objectivo: Este estudo teve como objectivo estimar a prevalência da polimedicação em idosos hospitalizados e analisar a medicação considerada inadequada nesta população. Participantes e metodologia: Seguiu-se um modelo retrospectivo descritivo transversal, reportando-se os dados a um período de um ano e meio, incidindo sobre o último internamento. A natureza da medicação, foi analisada de acordo com o Formulário Terapêutico Nacional, Resumo das Caracteristicas do Medicamento e com critérios de Beers-2002.Englobou 100 idosos (>65 anos) utentes do Hospital Cuf Descobertas, em regime de internamento. Os dados pessoais e clínicos e respectivo mapa farmacoterapêutico, foram introduzidos em base de dados construída para este estudo...

Potentially inappropriate medication use in a city of Southeast Brazil

Pinto,Mauro Cunha Xavier; Ferré,Felipe; Pinheiro,Marcos Luciano Pimenta
Fonte: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas Publicador: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2012 EN
Relevância na Pesquisa
56.69%
Potentially inappropriate medication use by the Diamantina (Minas Gerais State) population was investigated by analyzing medicine consumption, self-medication, polypharmacy and drug interactions of medicines prescribed among those interviewed. Level of knowledge about rational drug use and its relationship to socio-economic variables was also evaluated using a semi-structured questionnaire. This survey was based on stratified sampling of 423 individuals selected randomly. The prevalence of prescription drug consumption was 42.32% (n=179) and cardiovascular drugs were the most prescribed. Drug interactions were found in 45.81% (n=82) of prescriptions and 92.68% (n=76) of these interactions were moderate, with co-administration of cardiovascular drugs occurring in more than half of the cases. The inappropriate use of medication, according to Beers criteria, occurred in 44.73% of prescriptions to the elderly. The prevalence of self-medication was 63.34% (n=268) while 21.99% (n=91) of individuals administered medications to their children without formal prescriptions, where this practice was associated to analgesic/antipyretic consumption. The population showed a high prevalence of inappropriate use of drugs across all strata of society...

Potentially inappropriate medication use among institutionalized elderly individuals in southeastern Brazil

Pinto,Mauro Cunha Xavier; Malaquias,Dalila Pinto; Ferré,Felipe; Pinheiro,Marcos Luciano Pimenta
Fonte: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas Publicador: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 EN
Relevância na Pesquisa
46.37%
In recent decades, the elderly population in Brazil has grown rapidly, as has concern for the health of this population. Institutionalization in nursing homes has appeared as an alternative form of health care for frail elderly that live alone. The present study evaluated the pharmacotherapy and inappropriate drug prescriptions for institutionalized elderly patients living in long-term institutions in southeastern Brazil. This research was conducted at five institutions with a total sample of 151 individuals aged at least 60 years. Databases were used to identify drug interactions, defined daily dose and inappropriate prescriptions. The prevalence of drug intake among the elderly was 95.36%, and there were an average of 3.31 ± 1.80 drug prescriptions per individual. Based on Beers criteria, the prevalence of inappropriate prescriptions was 25.83%. In addition, 70.2% of prescriptions were prescribed at a higher dosage than the defined daily dose (ATC/WHO). Potential drug interactions were identified for 54.11% of prescriptions; 81.42% of these were of moderate severity. The main inappropriate drugs were prescribed for cardiovascular and nervous system problems. Institutionalized elderly individuals presented a high consumption and misuse of medications...

Potentially inappropriate medication use in institutionalized older adults according to the Beers Criteria

Ganassin,Amanda Rodrigues; Matos,Vanessa Terezinha Gubert de; Toffoli-Kadri,Mônica Cristina
Fonte: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas Publicador: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2014 EN
Relevância na Pesquisa
56.6%
The need for specific care, coupled with new family arrangements, has contributed to the increasing institutionalization of elderly members. The purpose of this study was to evaluate drug use by institutionalized older adults according to Beers Criteria. This prospective, longitudinal study was conducted in the three non-profit long-stay geriatric care institutions of Campo Grande, in the Central-West region of Brazil. All subjects aged 60 years and above on November 2011 were included and followed until November 2012. Eighteen subjects were excluded and the final sample consisted of 133 individuals aged 60 to 113 years. Overall, 212 medications were used at geriatric care institution A, 532 at B, and 1329 at C. Thirty-four drugs were inappropriately prescribed 89 times at geriatric care institution A (41.98%), 49 prescribed 177 times at B (33.27%), and 91 prescribed 461 times at C (34.68%). Statistical differences in the inappropriate drug use were found between genders (p=0.007). The most commonly used potentially inappropriate medication were first-generation antihistamines (15.34%). There was a high frequency in the use of potentially inappropriate medications which can initiate marked side effects and may compromise the fragile health of institutionalized elderly. Thus...

Health Outcomes Associated With Potentially Inappropriate Medication Use in Older Adults

Fick, Donna M.; Mion, Lorraine C.; Beers, Mark H.; Waller, Jennifer L.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /02/2008 EN
Relevância na Pesquisa
46.38%
The purpose of this study was to examine the prevalence of potentially inappropriate medication use (PIMs) among community-dwelling older adults and the association between PIMs and health care outcomes. Participants were 17,971 individuals age 65 years and older. PIM use was defined by the Beers criteria. Drug-related problems (DRPs) were defined using ICD-9 codes. Forty percent of the 17,971 individuals filled at least 1 PIM prescription, and 13% filled 2 or more PIM prescriptions. Overall DRP prevalence among those with at least 1 PIM prescription was 14.3% compared to 4.7% in the non-PIM group (p < .001). In conclusion, preventing PIM use may be important for decreasing medication-related problems, which are increasingly being recognized as requiring an integrated interdisciplinary approach.

Medication Use Patterns among Urban Youth Participating in School-Based Asthma Education

Patel Shrimali, Bina; Hasenbush, Amira; Davis, Adam; Tager, Ira; Magzamen, Sheryl
Fonte: Springer US Publicador: Springer US
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.56%
Although pharmaceutical management is an integral part of asthma control, few community-based analyses have focused on this aspect of disease management. The primary goal of this analysis was to assess whether participation in the school-based Kickin’ Asthma program improved appropriate asthma medication use among middle school students. A secondary goal was to determine whether improvements in medication use were associated with subsequent improvements in asthma-related symptoms among participating students. Students completed an in-class case-identification questionnaire to determine asthma status. Eligible students were invited to enroll in a school-based asthma curriculum delivered over four sessions by an asthma health educator. Students completed a pre-survey and a 3-month follow-up post-survey that compared symptom frequency and medication use. From 2004 to 2007, 579 participating students completed pre- and post-surveys. Program participation resulted in improvements in appropriate use across all three medication use categories: 20.0% of students initiated appropriate reliever use when “feeling symptoms” (p < 0.001), 41.6% of students reporting inappropriate medication use “before exercise” initiated reliever use (p < 0.001)...

Preventive medication use among persons with limited life expectancy

Maddison, André R; Fisher, Judith; Johnston, Grace
Fonte: Maney Publishing Publicador: Maney Publishing
Tipo: Artigo de Revista Científica
Publicado em /01/2011 EN
Relevância na Pesquisa
36.67%
Persons with limited life expectancy (LLE) – less than 1 year – are significant consumers of health care, are at increased risk of polypharmacy and adverse drug events, and have dynamic health statuses. Therefore, medication use among this population must be appropriate and regularly evaluated. The objective of this review is to assess the current state of knowledge and clinical practice presented in the literature regarding preventive medication use among persons with LLE. We searched Medline, Embase, and CINAHL using Medical Subject Headings. Broad searches were first conducted using the terms ‘terminal care or therapy’ or ‘advanced disease’ and ‘polypharmacy’ or ‘inappropriate medication’ or ‘preventive medicine’, followed by more specific searches using the terms ‘statins’ or ‘anti-hypertensives’ or ‘bisphosphonates’ or ‘laxatives’ and ‘terminal care’. Frameworks to assess appropriate versus inappropriate medications for persons with LLE, and the prevalence of potentially inappropriate medication use among this population, are presented. A considerable proportion of individuals with a known terminal condition continue to take chronic disease preventive medications until death despite questionable benefit. The addition of palliative preventive medications is advised. There is an indication that as death approaches the shift from a curative to palliative goal of care translates into a shift in medication use. This literature review is a first step towards improving medication use and decreasing polypharmacy in persons at the end of life. There is a need to develop consensus criteria to assess appropriate versus inappropriate medication use...

Análise do padrão do uso de medicamentos em idosos no município de Goiânia, Goiás; Analysis of the pattern of drugs use in the elderly in Goiânia, Goiás

SANTOS, Thalyta Renata Araújo
Fonte: Universidade Federal de Goiás; BR; UFG; Mestrado em Ciências da Saúde; Ciências da Saúde - Medicina Publicador: Universidade Federal de Goiás; BR; UFG; Mestrado em Ciências da Saúde; Ciências da Saúde - Medicina
Tipo: Dissertação Formato: application/pdf
POR
Relevância na Pesquisa
36.77%
Introduction: The fact of elderly people live in a greater amount with chronic diseases, make the elderly a great consumer of health services and, probably, the most medicated group in the society. In this context serious problems arise, such as the use of multiple medications simultaneously (polypharmacy) that can lead to serious consequences to the elderly health. Another problem is the self-medication, which may exacerbate the associated risks with prescript drugs, delaying a diagnosis and masking a disease. There is, still, the use of drugs considered inappropriate for elderly, either by reducing the therapeutic efficacy or an increased risk of adverse effects that increase the advantages in elderly usage. Objective: Analyzing the pattern of use of medications in aged people in the city of Goiânia-GO, and associate it with socioeconomic aspects and with the self-rated health. Methods: A population-based study and cross-section, that evaluated the health of elderly in the city of Goiânia-GO. The data collection was carried out in December/2009 to April/2010 from 934 elderly. The questionnaire had questions about medications, in addition to information about self-rated health and socioeconomic profile. The drugs groups were classified according to the Anatomical Therapeutic Chemical and Classification-ATC. The inappropriate drugs for elderly were identified according to Beers Criteria. Used Mann Whitney (U) and Chi-square test...

Post-discharge medication reviews for patients with heart failure: a pilot study

Ponniah, A.; Shakib, S.; Doecke, C.; Boyce, M.; Angley, M.
Fonte: Kluwer Academic Publ Publicador: Kluwer Academic Publ
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
46.35%
Background Medication misadventure is greatest at times of change such as the transition from hospital to community. Patients with heart failure are prone to medication misadventure due to polypharmacy, inappropriate medication use and frequent readmissions. Objective To identify the barriers encountered when implementing a Liaison Pharmacist facilitated post-discharge medication management service for patients with heart failure. Method A Liaison Pharmacist contacted the patient’s General Practitioner (GP), sent them a medication discharge summary and organised an appointment for the patient with the GP approximately 2 days post-discharge to make a Home Medicines Review (HMR) referral. The patient’s community pharmacist was also contacted, sent a medication discharge summary and requested to engage an accredited pharmacist to undertake the HMR. The Liaison Pharmacist arranged for the HMR report to be sent to the outpatient department clinic to enable assessment of outcomes at the outpatient department follow-up 12 weeks post-discharge. Main outcome measure: GP HMR referral rates. Results 90 patients were offered the service. Fifty-nine patients (66%) agreed to have their GP contacted with 56 GPs agreeing to order a HMR and 41 patients having an HMR post-discharge. Barriers to the implementation of a HMR post-discharge included: patient withdrawal...

Consumo de benzodiazepinas por idosos institucionalizados: inapropriação, qualidade de sono e contributo para a segurança na medicação; Benzodiazepines consumption by institutionalized elderly: inappropriate medication, sleep quality and contributes for medication safety

Graça, Anabela; Coelho, André
Fonte: Escola Nacional de Saúde Pública Publicador: Escola Nacional de Saúde Pública
Tipo: Artigo de Revista Científica
Publicado em /05/2014 POR
Relevância na Pesquisa
36.54%
A racionalização do uso de medicamentos constitui-se como um fator contribuinte para a melhoria da segurança do doente, particularmente no que respeita à segurança na medicação, tendo-se tornado prioritária para as organizações e instituições de saúde. A avaliação do uso de medicamentos inapropriados no idoso constitui-se como uma medida que concorre para evitar, prevenir ou corrigir eventos adversos associados ao seu uso. As benzodiazepinas são uma das classes de medicamentos mais prescritas em idosos. No entanto, e apesar de sua utilidade clínica, algumas benzodiazepinas são consideradas inapropriadas nesta faixa etária por potenciarem o efeito sedativo e aumentar a incidência de quedas e fraturas. A longo prazo, na promoção da qualidade do sono, a sua efetividade é discutível já que a toma de uma benzodiazepina para a resolução de um problema como o sono, muitas vezes pontual, passa a ser um problema crónico de exigência de toma contínua, sem que a qualidade deste seja restabelecida, pondo em risco a segurança do doente. Este estudo tem como objetivo caracterizar o consumo de benzodiazepinas por idosos institucionalizados, numa instituição de longa permanência do concelho de Sesimbra, sua inapropriação e a relação com a qualidade de sono. Foi desenvolvido um estudo descritivo e transversal...

Review of deprescribing processes and development of an evidence-based, patient-centred deprescribing process

Reeve, E.; Shakib, S.; Hendrix, I.; Roberts, M.S.; Wiese, M.D.
Fonte: Wiley Publicador: Wiley
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
46.7%
Inappropriate use of medication is widespread, especially in older people, and is associated with risks, including adverse drug reactions, hospitalization and increased mortality. Optimization of appropriate medication use to minimize these harms is an ongoing challenge in healthcare. The term ‘deprescribing’ has been used to describe the complex process that is required for safe and effective cessation of medication. Patients play an important role in their own health and, while they may complain about the number of medications they have to take, they may also be reluctant to cease a medication when given the opportunity to do so. A review of previously proposed deprescribing processes and relevant literature was used to develop the patient-centred deprescribing process, which is a five-step cycle that encompasses gaining a comprehensive medication history, identifying potentially inappropriate medications, determining whether the potentially inappropriate medication can be ceased, planning the withdrawal regimen (e.g. tapering where necessary) and provision of monitoring, support and documentation. This is the first deprescribing process developed using knowledge of the patients’ views of medication cessation; it focuses on engaging patients throughout the process...

Medication prescription among elderly patients admitted through an acute assessment unit

Yong, T.; Lau, S.; Li, J.; Hakendorf, P.; Thompson, C.
Fonte: Blackwell Publishing Publicador: Blackwell Publishing
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
46.28%
Aim: This study assessed medication use patterns and polypharmacy in patients who were admitted through an acute assessment unit (AAU) and stratified results according to patient age. This study also examined risk factors associated with polypharmacy and consequences of polypharmacy, namely prescription writing errors, drug–drug interaction and geriatric syndrome. Methods: The medication charts and admission notes of 200 consecutive patients admitted through the AAU over a period of 1 month were retrospectively reviewed. Data were collected on patients' demographics, comorbidities, types and number of medications, hospital length of stay and reason(s) for presentation. Potentially harmful prescription errors or errors necessitating intervention were also recorded, as were any potential adverse drug–drug interactions. Results: Medications for the treatment of disorders of the cardiovascular (46% of total patients) and nervous systems (30%) predominated. Of the 200 patients reviewed, 158 were aged ≥65 years and their mean serum creatinine was higher than those aged <65 years (100.9 ± 54.0 vs. 79.9 ± 45.9 µmol/L, P = 0.01), 81% were taking five or more concurrent regular medications at the time of admission. Of all 200 patients...

Polypharmacy and Potentially Inappropriate Medication Use among Community-Dwelling Elders with Dementia

Lau, Denys T.; Mercaldo, Nathaniel D.; Harris, Andrew T.; Trittschuh, Emily; Shega, Joseph; Weintraub, Sandra
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
Relevância na Pesquisa
46.43%
This cross-sectional study examines the association between total prescription medication use and potentially inappropriate medication use (PIRx) among community-dwelling elderly patients with and without dementia. Data (9/2005-9/2007) were from the NIA-funded National Alzheimer's Coordinating Center Uniform Data Set (UDS). The study analyzed the UDS initial visits of 4,518 community-dwelling subjects aged 65+ with and without dementia (2,665 and 1,853, respectively). PIRx was defined using a partial list of the 2003 Beers criteria. Generalized linear mixed models were applied to estimate the association between PIRx and polypharmacy. In both groups (with and without dementia), subjects who received PIRx on average took more medications than those taking no PIRx. As the total number of medications used increased, the odds of having PIRx also increased, controlling for dementia diagnosis and other subject characteristics. Our key findings were consistent after considering two definitions of PIRx (with or without oral estrogens) and accounting for missing data. In summary, the total number of medications used is associated with PIRx among ADC's community-dwelling elderly patients with and without dementia, with polypharmacy increasing the risk of PIRx. Ensuring appropriate medication use in this population is clinically important because of the significant risks for institutionalization.

Identification of inappropriate prescribing in a Brazilian nursing home using STOPP/START screening tools and the Beers' Criteria

Nascimento,Mariana Martins Gonzaga; Ribeiro,Andréia Queiroz; Pereira,Mariana Linhares; Soares,Adriana Cristina; Loyola Filho,Antônio Ignácio de; Dias-Junior,Carlos Alan Candido
Fonte: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas Publicador: Universidade de São Paulo, Faculdade de Ciências Farmacêuticas
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2014 EN
Relevância na Pesquisa
46.32%
The objective of this study was to determine the prevalence of Potentially Inappropriate Medication (PIM) use and associated factors, as well as the prevalence of Prescribing Omissions (PO). A cross-sectional study was conducted in a philanthropic Brazilian nursing home involving 46 individuals aged 60 years or older. The following information was collected from medical records and drug prescriptions: gender, age, health conditions and drugs used in the past thirty days. PIM and PO were identified according to the Beers' Criteria and the STOPP/START screening tools. Over one third (37%) of the population used at least one PIM according to the Beers' Criteria (n=17) and 60.9% according to the STOPP tool. A significant association was found between polypharmacy (use of five or more drugs) and use of PIM according to the Beers' Criteria, but not according to the STOPP. Eight residents (17.4%) were exposed to eight PO. This study allowed the diagnosis of a concerning drug utilization profile with use of a high number of PIMs. Thus, there is an evident need to implement strategies for improving geriatric prescription.

Potentially inappropriate medication use in a city of Southeast Brazil

Pinto, Mauro Cunha Xavier; Ferré, Felipe; Pinheiro, Marcos Luciano Pimenta
Fonte: Universidade de São Paulo. Faculdade de Ciências Farmacêuticas Publicador: Universidade de São Paulo. Faculdade de Ciências Farmacêuticas
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/03/2012 ENG
Relevância na Pesquisa
56.65%
Potentially inappropriate medication use by the Diamantina (Minas Gerais State) population was investigated by analyzing medicine consumption, self-medication, polypharmacy and drug interactions of medicines prescribed among those interviewed. Level of knowledge about rational drug use and its relationship to socio-economic variables was also evaluated using a semi-structured questionnaire. This survey was based on stratified sampling of 423 individuals selected randomly. The prevalence of prescription drug consumption was 42.32% (n=179) and cardiovascular drugs were the most prescribed. Drug interactions were found in 45.81% (n=82) of prescriptions and 92.68% (n=76) of these interactions were moderate, with co-administration of cardiovascular drugs occurring in more than half of the cases. The inappropriate use of medication, according to Beers criteria, occurred in 44.73% of prescriptions to the elderly. The prevalence of self-medication was 63.34% (n=268) while 21.99% (n=91) of individuals administered medications to their children without formal prescriptions, where this practice was associated to analgesic/antipyretic consumption. The population showed a high prevalence of inappropriate use of drugs across all strata of society...

Potentially inappropriate medication use in institutionalized older adults according to the Beers Criteria

Ganassin, Amanda Rodrigues; Matos, Vanessa Terezinha Gubert de; Toffoli-Kadri, Mônica Cristina
Fonte: Universidade de São Paulo. Faculdade de Ciências Farmacêuticas Publicador: Universidade de São Paulo. Faculdade de Ciências Farmacêuticas
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/12/2014 ENG
Relevância na Pesquisa
46.53%
A exigência de cuidados específicos, aliada aos novos arranjos familiares, tem contribuído para a crescente institucionalização dos idosos. O objetivo do presente trabalho foi avaliar o uso de medicamentos por idosos institucionalizados utilizando os Critérios de Beers. Este estudo longitudinal prospectivo foi realizado nas três instituições de longa permanência para idosos de Campo Grande, Centro-Oeste do Brasil. Todos os sujeitos com 60 anos ou mais foram incluídos em Novembro de 2011 e acompanhados até Novembro de 2012. Dezoito idosos foram excluídos, sendo a amostra final composta por 133 sujeitos com idade entre 60 e 113 anos. O total de medicamentos utilizados foi 212 na instituição A, 532 na B e 1329 na C. Foram identificados 34 medicamentos inapropriados, prescritos 89 vezes na instituição A (41.98%), 49 prescritos 177 vezes na B (67.29%) e 90 prescritos 460 vezes na C (34.61%). Este estudo demonstrou diferença estatística na utilização de medicamentos inapropriados entre os gêneros (p=0.007). Os anti-histamínicos de 1ª geração foram os medicamentos potencialmente inapropriados para idosos mais utilizados (15.34%). Houve elevada frequência no uso de MPI, os quais podem desencadear efeitos colaterais acentuados e comprometer mais a saúde fragilizada do idoso institucionalizado. Ainda...

Potentially inappropriate prescribing in institutionalised older patients in Spain: the STOPP-START criteria compared with the Beers criteria

Ubeda,Amalia; Ferrándiz,M. Luisa; Maicas,Nuria; Gomez,Cristina; Bonet,Montserrat; Peris,Jose E.
Fonte: Pharmacy Practice (Internet) Publicador: Pharmacy Practice (Internet)
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/06/2012 ENG
Relevância na Pesquisa
46.64%
Objective: The aims of this study were to identify potentially inappropriate prescribing using the Beers and STOPP criteria. The START criteria were applied to detect prescription omission in the geriatric population. We compared the utility of these criteria in institutionalised older people. Methods: Descriptive study reviewing the medication and clinical records of 81 residents (aged 65 years and more) by pharmacists in a nursing home in the Lleida region (Spain). Results: The mean patients´ age was 84 (SD=8) years, with an average of 5 drugs per resident (total prescriptions: 416 medicines). The Beers criteria identified potentially inappropriate medication use in 25% of patients and 48% of patients used at least 1 inappropriate medication according to STOPP criteria. The most frequent potentially inappropriate medications for both criteria were long-acting benzodiazepines and NSAIDs. START detected 58 potential prescribing omissions in 44% of patients. Calcium-vitamin D supplementation in osteoporosis was the most frequent rule (15%), but omissions corresponding to the cardiovascular system implied 23% of patients. Conclusion: The STOPP-START criteria reveal that potentially inappropriate prescribing (PIP) is a highly prevalent problem among Spanish nursing home residents...

Clinical pharmacist evaluation of medication inappropriateness in the emergency department of a teaching hospital in Malta

West,Lorna Marie; Cordina,Maria; Cunningham,Scott
Fonte: Pharmacy Practice (Internet) Publicador: Pharmacy Practice (Internet)
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/12/2012 ENG
Relevância na Pesquisa
36.62%
Appropriate prescribing remains an important priority in all medical areas of practice. Objective: The objective of this study was to apply a Medication Appropriateness Index (MAI) to identify issues of inappropriate prescribing amongst patients admitted from the Emergency Department (ED). Method: This study was carried out at Malta's general hospital on 125 patients following a two-week pilot period on 10 patients. Patients aged 18 years and over and on medication therapy were included. Medication treatment for inappropriateness was assessed by using the MAI. Under-prescribing was also screened for Results: Treatment charts of 125 patients, including 697 medications, were assessed using a MAI. Overall, 115 (92%) patients had one or more medications with one or more MAI criteria rated as inappropriate, giving a total of 384 (55.1%) medications prescribed inappropriately. The mean SD MAI score per drug was 1.78 (SD=2.19). The most common medication classes with appropriateness problems were biguanides (100%), anti-arrhythmics (100%) and anti-platelets (96.8%). The most common problems involved incorrect directions (26%) and incorrect dosages (18.5%). There were 36 omitted medications with untreated indications. Conclusion: There is considerable inappropriate prescribing which could have significant negative effects regarding patient care.