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Polypharmacy in the elderly: therapy adherence

Pinto, Isabel C.; Ribeiro, Maria Isabel; Geraldo, I.; Novo, S.; Reis, M.; Rocha, D.
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Conferência ou Objeto de Conferência
ENG
Relevância na Pesquisa
37.15%
The elderly population has been growing significantly, leading to an increased prevalence of chronic diseases and consequent taking medication. Polypharmacy is the chronic and simultaneous use of different drugs by the same individual, and the elderly are the more susceptible. The complex therapies of elderly can lead to therapy non-adherence, increasing several health risks. This study aimed to estimate the prevalence of polymedicated elderly, evaluate therapy adherence and associated factors, and check the differences among non-institutionalized elderly and users of day centers. This cross-sectional study was based on a questionnaire, validated for the Portuguese population based on the Morisky scale, applied to 200 non-institutionalized elderly and 68 under day centers, of interior and coastal counties of northern Portugal. It was considered as polymedicated seniors taking ≥4 drugs. To assess therapy adherence, those whose average adherence levels were ≥3.5, were called adherent. The sample was predominantly polymedicated (59%) and shows high therapy adherence (95%), the average number of different drugs daily ingested was about seven. Elderly of coastal, show superiors levels of therapy adherence than those of interior county (p=0.007). Only the economic difficulties are related to non-adherence (p=0.022). No statistically significant differences were found between non-institutionalized elderly and users of day centers. This study shows that a large proportion of elderly were polymedicated...

Polypharmacy, chronic diseases and nutritional markers in community-dwelling older

Silveira,Erika Aparecida; Dalastra,Luana; Pagotto,Valéria
Fonte: Associação Brasileira de Saúde Coletiva Publicador: Associação Brasileira de Saúde Coletiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2014 EN
Relevância na Pesquisa
37.57%
Polypharmacy is a common practice among the elderly, but few studies have evaluated its association with nutritional markers. The aim of this study was to estimate the prevalence of polypharmacy and its association with nutritional markers, chronic diseases, sociodemographic and health variables. This research is part of the Study Elderly/Goiânia, which evaluated 418 elderly community in a cross-sectional design. Polypharmacy was defined as the use of five or more concomitant medications. The following nutritional markers were investigated: BMI, waist circumference, percentage body fat, weight gain and loss, use of diet, daily consumption of fruits, vegetables, skimmed and whole milk. Multivariate analysis was performed using hierarchical Poisson regression, with significance level set at 5%. The prevalence of polypharmacy was 28% (95%CI 23.1 - 32.5), with a significant association with feminine gender, age range 75 - 79 years, eutrophic nutritional status and obesity, use of diet, poor self-rated health and presence of two, three or more chronic diseases. The high prevalence of polypharmacy and its association with nutritional markers and chronic diseases call the attention for the need of nutritional surveillance and monitoring in the elderly.

Pharmacoepidemiological profile and polypharmacy indicators in elderly outpatients

Baldoni,André de Oliveira; Ayres,Lorena Rocha; Martinez,Edson Zangiacomi; Dewulf,Nathalie de Lourdes Sousa; Santos,Vânia dos; Obreli-Neto,Paulo Roque; Pereira,Leonardo Régis Leira
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 01/09/2013 EN
Relevância na Pesquisa
37.5%
This cross-sectional study was carried out with 1000 elderly outpatients assisted by a Basic Health District Unit (UBDS) from the Brazilian Public Health System (SUS) in the municipality of Ribeirão Preto. We analyzed the clinical, socioeconomic and pharmacoepidemiological profile of the elderly patients in order to identify factors associated with polypharmacy amongst this population. We used a truncated negative binomial model to examine the association of polypharmacy with the independent variables of the study. The software SAS was used for the statistical analysis and the significance level adopted was 0.05. The most prevalent drugs were those for the cardiovascular system (83.4%). There was a mean use of seven drugs per patient and 47.9% of the interviewees used >7 drugs. The variables that showed association with polypharmacy (P value < 0.01) were female gender, age >75 years, self-medication, number of health problems, number of medical appointments, presence of adverse drug events, use of over-the-counter drugs, use of psychotropic drugs, lack of physical exercise and use of sweeteners. The exposition to all these factors justified the high prevalence of polypharmacy amongst the interviewees. These results showed the need to adopt clinical intervention and educational and managerial measures to analyze and promote rationality in the use of drugs amongst the elderly users of SUS.

Polypharmacy in general practice: differences between practitioners.

Bjerrum, L; Søgaard, J; Hallas, J; Kragstrup, J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /03/1999 EN
Relevância na Pesquisa
27.68%
BACKGROUND: Polypharmacy, the simultaneous use of multiple drugs, is associated with adverse drug reactions, medication errors, and increased risk of hospitalization. When the number of concurrently used drugs totals five or more (major polypharmacy), a significant risk may be present. AIM: To analyse the interpractice variation in the prevalence of major polypharmacy among listed patients, and to identify possible predictors of major polypharmacy related to the practice. METHOD: Prescription data were retrieved from the Odense Pharmacoepidemiological Database, and individuals subject to major polypharmacy were identified. The age- and sex-standardized prevalence rate of major polypharmacy was calculated for each practice in the County of Funen in Denmark (n = 173), using the distribution of age and sex of the background population as a reference. The practice characteristics were retrieved from the Regional Health Insurance System. Possible predictors of major polypharmacy related to the general practitioners (GPs) were analysed using backward stepwise linear multiple regression. RESULTS: A six-fold variation between the practices in the prevalence of major polypharmacy was found (16 to 96 per 1000 listed patients; median = 42). Predictors related to the practice structure...

Polypharmacy: Misleading, but manageable

Bushardt, Reamer L; Massey, Emily B; Simpson, Temple W; Ariail, Jane C; Simpson, Kit N
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
27.42%
The percentage of the population described as elderly is growing, and a higher prevalence of multiple, chronic disease states must be managed concurrently. Healthcare practitioners must appropriately use medication for multiple diseases and avoid risks often associated with multiple medication use such as adverse effects, drug/drug interactions, drug/disease interactions, and inappropriate dosing. The purpose of this study is to identify a consensus definition for polypharmacy and evaluate its prevalence among elderly outpatients. The authors also sought to identify or develop a clinical tool which would assist healthcare practitioners guard against inappropriate drug therapy in elderly patients. The most commonly cited definition was a medication not matching a diagnosis. Inappropriate was part of definitions used frequently. Some definitions placed a numeric value on concurrent medications. Two common definitions (ie, 6 or more medications or a potentially inappropriate medication) were used to evaluate polypharmacy in elderly South Carolinians (n = 1027). Data analysis demonstrates that a significant percentage of this population is prescribed six or more concomitant drugs and/or uses a potentially inappropriate medication. The findings are 29.4% are prescribed 6 or more concurrent drugs...

Polypharmacy or medication washout: an old tool revisited

Hoffman, Daniel A; Schiller, Mark; Greenblatt, James M; Iosifescu, Dan V
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
27.5%
There has been a rapid increase in the use of polypharmacy in psychiatry possibly due to the introduction of newer drugs, greater availability of these newer drugs, excessive confidence in clinical trial results, widespread prescribing of psychotropic medications by primary care, and pressure to augment with additional medications for unresolved side effects or greater efficacy. Even the new generation of medications may not hold significant advantages over older drugs. In fact, there may be additional safety risks with polypharmacy being so widespread. Washout, as a clinical tool, is rarely done in medication management today. Studies have shown that augmenting therapy with additional medications resulted in 9.1%–34.1% dropouts due to intolerance of the augmentation, whereas studies of medication washout demonstrated only 5.9%–7.8% intolerance to the washout procedure. These perils justify reconsideration of medication washout before deciding on augmentation. There are unwarranted fears and resistance in the medical community toward medication washout, especially at the moment a physician is trying to decide whether to washout or add more medications to the treatment regimen. However, medication washout provides unique benefits to the physician: it establishes a new baseline of the disorder...

A Survey on Polypharmacy and Use of Inappropriate Medications

Rambhade, Sujit; Chakarborty, Anup; Shrivastava, Anand; Patil, Umesh K.; Rambhade, Ashish
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
27.57%
In the past, polypharmacy was referred to the mixing of many drugs in one prescription. Today polypharmacy implies to the prescription of too many medications for an individual patient, with an associated higher risk of adverse drug reactions (ADRs) and interactions. Situations certainly exist where the combination therapy or polytherapy is the used for single disease condition. Polypharmacy is a problem of substantial importance, in terms of both direct medication costs and indirect medication costs resulting from drug-related morbidity. Polypharmacy increases the risk of side effects and interactions. Moreover it is a preventable problem. A retrospective study was carried out at Bhopal district (Capital of Madhya Pradesh, India) in the year of September-November 2009 by collecting prescriptions of consultants at various levels of health care. The tendency of polypharmacy was studied and analyzed under the various heads in the survey. Available data suggests that polypharmacy is a widespread problem, and physician, clinical pharmacists and patients are all responsible. These risks can be minimized through identifying the prevalence of this potential problem in a high-risk population and by increasing awareness among patients and healthcare professionals. Physicians and clinical pharmacists have the potential to combating this problem through a variety of interventions such as reducing the number of medications taken...

Chronic Condition Clusters and Polypharmacy among Adults

Vyas, Ami; Pan, Xiaoyun; Sambamoorthi, Usha
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
27.65%
Objective. The primary objective of the study was to estimate the rates of polypharmacy among individuals with multimorbidity defined as chronic condition clusters and examine their associations with polypharmacy. Methods. Cross-sectional analysis of 10,528 individuals of age above 21, with at least one physical condition in cardiometabolic (diabetes or heart disease or hypertension), musculoskeletal (arthritis or osteoporosis), and respiratory (chronic obstructive pulmonary disease (COPD) or asthma) clusters from the 2009 Medical Expenditure Panel Survey. Chi-square tests and logistic regressions were performed to analyze the association between polypharmacy and multimorbidity. Results. Polypharmacy rates varied from a low of 7.2% among those with respiratory cluster to a high of 64.1% among those with all three disease clusters. Among those with two or more disease clusters, the rates varied from 28.3% for musculoskeletal and respiratory clusters to 41.8% for those with cardiometabolic and respiratory clusters. Individual with cardiometabolic conditions alone or in combination with other disease clusters were more likely to have polypharmacy. Compared to those with musculoskeletal and respiratory conditions, those with cardiometabolic and respiratory conditions had 1.68 times higher likelihood of polypharmacy. Conclusions. Rates of polypharmacy differed by specific disease clusters. Individuals with cardiometabolic condition were particularly at high risk of polypharmacy...

Polypharmacy In Psychiatry: A Review

Kukreja, Sanjay; Kalra, Gurvinder; Shah, Nilesh; Shrivastava, Amresh
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
27.5%
Psychiatric polypharmacy refers to the prescription of two or more psychiatric medications concurrently to a patient. It can be categorised as same-class, multi-class, adjunctive, augmentation and total polypharmacy. Despite advances in psychopharmacology and a better understanding of the principles of therapeutics, its practice is increasing rapidly. The prevalence of polypharmacy in psychiatry varies between 13%-90%. There are various clinical and pharmaco-economic factors associated with it. Dealing with polypharmacy requires an understanding of its associated factors. Education, guidelines and algorithms for the appropriate management of various conditions are effective ways to avoid irrational polypharmacy.

The Next Therapeutic Challenge in HIV: Polypharmacy

Edelman, E. Jennifer; Gordon, Kirsha S.; Glover, Janis; McNicholl, Ian R.; Fiellin, David A.; Justice, Amy C.
Fonte: Springer International Publishing Publicador: Springer International Publishing
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
27.61%
With the adoption of combination antiretroviral therapy (ART), most HIV-infected individuals in care are on five or more medications and at risk of harm from polypharmacy, a risk that likely increases with number of medications, age, and physiologic frailty. Established harms of polypharmacy include decreased medication adherence and increased serious adverse drug events, including organ system injury, hospitalization, geriatric syndromes (falls, fractures, and cognitive decline) and mortality. The literature on polypharmacy among those with HIV infection is limited, and the literature on polypharmacy among non-HIV patients requires adaptation to the special issues facing those on chronic ART. First, those aging with HIV infection often initiate ART in their 3rd or 4th decade of life and are expected to remain on ART for the rest of their lives. Second, those with HIV may be at higher risk for age-associated comorbid disease, further increasing their risk of polypharmacy. Third, those with HIV may have an enhanced susceptibility to harm from polypharmacy due to decreased organ system reserve, chronic inflammation, and ongoing immune dysfunction. Finally, because ART is life-extending, nonadherence to ART is particularly concerning. After reviewing the relevant literature...

Polypharmacy in the management of patients with schizophrenia on risperidone in a tertiary-care hospital in Malaysia

Jacob, SA; Ibrahim, MI Mohamed; Mohammed, F
Fonte: Radcliffe Publishing Ltd. Publicador: Radcliffe Publishing Ltd.
Tipo: Artigo de Revista Científica
Publicado em /01/2013 EN
Relevância na Pesquisa
27.42%
The present study was conducted primarily to determine the occurrence of polypharmacy in patients with schizophrenia on risperidone. The secondary aim was to ascertain the incidence of inappropriate prescribing with anticholinergics. A retrospective review of the medical records of all patients who were being followed up at the out-patient clinic of a tertiary-care hospital in Malaysia was conducted. Only patients who were being prescribed risperidone between 1 June 2008 and 31 December 2008 were included in the study. Demographic data such as patient’s age, gender and race were obtained from the patient’s medical records. In total, 113 patients met the selection criteria. Polypharmacy was found to occur in 34 patients (30.09%), with the majority (76.47%) being on two antipsychotics. In total, 27 patients (34.18%) on monotherapy with risperidone were prescribed an anticholinergic on scheduled dosing, while 19 patients (24.05%) were prescribed it on an as-needed basis. Of the patients on polypharmacy, 26 (76.47%) were on scheduled dosing of anticholinergics, while three (8.82%) were taking the medication on an as-needed basis. Polypharmacy should be avoided, and the use of anticholinergics should be closely reviewed. By adopting more efficient prescribing practices...

A method for calculating adherence to polypharmacy from dispensing data records

Arnet, Isabelle; Abraham, Ivo; Messerli, Markus; Hersberger, Kurt E.
Fonte: Springer Netherlands Publicador: Springer Netherlands
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
27.68%
Background Several measures for calculating adherence to one medication from dispensing data records have been proposed, but the nomenclature is inconsistent and computations vary. The same measures, like the medication possession ratio (MPR), have been used for multiple medication regimens, and have tended to over- or under-estimate adherence rates. Objective To demonstrate the impact of varying elements in MPR to a single medication regimen; to define standards for the estimation of adherence to polypharmacy; to propose a new method for calculating adherence to polypharmacy; to face validate it. Setting Face validity of the proposed method. Method Variations in the MPR formula were simulated. Standards for the estimation of adherence to polypharmacy were defined. A new method to calculate adherence to polypharmacy was established. Its face validity with three illustrative cases obtained from a pharmacy refill database was assessed. Main outcome measure Adherence rate to polypharmacy from refill data records. Results MPR to a single medication is operationalized in the numerator and denominator and is influenced by the parameters like observation period, medication gaps, overlap. For polypharmacy, an average MPR is commonly used, which is not accounting for the specificity of multiple medications...

Provide optimized antidepressant monotherapy with multiple drugs before considering antidepressant polypharmacy

SAAH, Tammy; GARLOW, Steven J.; RAPAPORT, Mark H.
Fonte: Shanghai Municipal Bureau of Publishing Publicador: Shanghai Municipal Bureau of Publishing
Tipo: Artigo de Revista Científica
Publicado em /12/2014 EN
Relevância na Pesquisa
37.15%
Many patients with chronic or recurring major depressive disorder have suboptimal responses to the wide range of antidepressant medications available. When confronted with these patients, clinicians may augment the original antidepressant with other medications, including adjunctive treatment with a second or third antidepressant. Although it is a widely-used practice among psychiatrists and primary care physicians in high-income countries, evidence for the benefits of this type of antidepressant polypharmacy is limited. Care should be taken to utilize this approach only after failure of optimized monotherapy with different classes of antidepressants.

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
27.5%
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...

Prevalence and factors associated with polypharmacy in older people with cancer

Turner, J.; Shakib, S.; Singhal, N.; Hogan-Doran, J.; Prowse, R.; Johns, S.; Bell, J.
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
37.65%
Purpose Polypharmacy has been associated with drug–drug interactions, adverse drug events, hospitalisation and increased mortality. The purpose of this study was to investigate the prevalence and factors associated with polypharmacy in older people with cancer. Patients and methods Patients aged ≥70 years (n=385) presenting to the medical oncology outpatient clinic at Royal Adelaide Hospital between January 2009 and July 2010 completed a structured data collection instrument. The instrument included domains related to medications, diagnoses, instrumental activities of daily living (IADLs), Karnofsky Performance Scale (KPS), physical function (SF-36), pain (ten-point visual analogue scale, VAS), weight loss (patient self-reported over previous 6 months), exhaustion (CES-D) and distress (ten-point VAS). Frailty was computed using Fried’s frailty phenotype. Logistic regression was used to compute unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association between polypharmacy (defined as five or more self-reported daily medications) and clinical parameters. Results Polypharmacy was present in 57 % (n=221) of patients. When adjusting for age, gender and Charlson Comorbidity Index (CCI), polypharmacy was associated with being pre-frail (OR=2.35...

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
27.65%
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...

Pharmacoepidemiological profile and polypharmacy indicators in elderly outpatients

Baldoni, André de Oliveira; Ayres, Lorena Rocha; Martinez, Edson Zangiacomi; Dewulf, Nathalie de Lourdes Sousa; Santos, Vânia dos; Obreli-Neto, Paulo Roque; Pereira, Leonardo Régis Leira
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 01/09/2013 ENG
Relevância na Pesquisa
37.5%
Este estudo transversal foi realizado por meio de entrevistas com 1000 idosos atendidos em uma Unidade Básica Distrital de Saúde (UBDS) do Sistema Único de Saúde (SUS) no município de Ribeirão Preto. Analisou-se o perfil clínico, socioeconômico e farmacoepidemiológico a fim de identificar os fatores associados à polifarmácia nessa população. Utilizou-se um modelo binomial negativo truncado para análise da associação da polifarmácia com as variáveis independentes do estudo. O software SAS foi utilizado para a análise estatística. O nível de significância adotado foi de 0,05. Os fármacos com maior prevalência de uso foram do sistema cardiovascular (83,4%). Observou-se média de, aproximadamente, sete fármacos por paciente e 47,9% dos entrevistados usavam >7 fármacos. As variáveis que apresentaram associação com a polifarmácia (p< 0,01) foram: mulheres, idade (>75 anos), automedicação, quantidade de problemas de saúde, número de consultas médicas, uso de medicamentos isentos de prescrição médica, uso de psicotrópicos, não realização de exercícios físicos e uso de adoçante. A exposição a todos esses fatores justifica a alta prevalência de polifarmácia entre os entrevistados. Os resultados mostraram a necessidade de adotar medidas de intervenção clínica e educacional e gerencial para analisar e promover a racionalização do uso de fármacos entre os idosos usuários do SUS.; This cross-sectional study was carried out with 1000 elderly outpatients assisted by a Basic Health District Unit (UBDS) from the Brazilian Public Health System (SUS) in the municipality of Ribeirão Preto. We analyzed the clinical...

Influência da renda na associação entre disfunção cognitiva e polifarmácia: Projeto Bambuí; Influence of income on the association between cognitive impairment and polypharmacy: Bambuí Project

Loyola Filho, Antônio I de; Uchoa, Elizabeth; Firmo, Josélia O A; Lima-Costa, Maria Fernanda
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf; application/pdf
Publicado em 01/02/2008 POR; ENG
Relevância na Pesquisa
37.42%
OBJETIVO: Avaliar a prevalência da polifarmácia e a influência da renda na associação entre uso de medicamentos e disfunção cognitiva, entre idosos. MÉTODOS: Dos 1.606 integrantes da linha base da coorte de idosos de Bambuí (Minas Gerais), iniciada em 1997, 1.554 participaram do estudo. Todos os participantes foram submetidos ao questionário mini-exame do estado mental. A associação entre disfunção cognitiva e polifarmácia foi testada por meio de regressões ordinais multivariadas, realizadas para a população total e para cada um dos estratos de renda. RESULTADOS: A prevalência de polifarmácia (consumo de dois ou mais medicamentos) foi de 70,4%, e o número de medicamentos consumidos mostrou-se negativa e independentemente associado à disfunção cognitiva (OR=0,72; IC 95%: 0,55;0,95). Quando estratificada pela renda pessoal (; 2), observou-se associação negativa entre uso de medicamentos e disfunção cognitiva entre idosos com renda mais baixa (OR=0,64; IC95%: 0,48;0,86), mas não entre aqueles de renda mais elevada (OR=1,74; IC 95%: 0,81;3,74). CONCLUSÕES: Com referência à associação entre disfunção cognitiva e número de medicamentos consumidos, os resultados indicam desigualdade social no uso de medicamentos. É possível que esses idosos não estejam consumindo os medicamentos necessários ao adequado tratamento de seus problemas de saúde.; OBJECTIVE: To evaluate the prevalence of polypharmacy and the influence of income on the association between medication use and cognitive impairment among elderly people. METHODS: Out of the 1...

Results of chart reviews conducted to evaluate primary care patients seen by second and third year family medicine residents for potential adverse polypharmacy

Chang,Linda F.; Lutfiyya,May N.; Cha,Isaac; El-Khabiry,Ehab
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 01/06/2007 ENG
Relevância na Pesquisa
37.15%
Objective: To determine the prescribing patterns of family medicine residents for patients aged more than 60 years with 2 or more chronic diseases and seen at least twice in a 12 month timeframe. Methods: This is a descriptive analysis which was based on chart reviews. The setting was the University of Illinois-Rockford Family Practice Residency. Patients aged 60 years with 2 or more chronic diseases who were seen at least twice by second and third year residents. Results: Findings from this chart review include: 28.8% of the prescribed medications were not effective for the documented condition, 26.3% of the prescribed doses were incorrect, and 44.5% of the drugs prescribed were not the least expensive alternative. Discussion: This preliminary study suggests a need for a focused intervention with family medicine residents regarding inappropriate polypharmacy issues with older patients.

Polypharmacy, chronic diseases and nutritional markers in community-dwelling older

Silveira,Erika Aparecida; Dalastra,Luana; Pagotto,Valéria
Fonte: Associação Brasileira de Pós -Graduação em Saúde Coletiva Publicador: Associação Brasileira de Pós -Graduação em Saúde Coletiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2014 EN
Relevância na Pesquisa
37.57%
Polypharmacy is a common practice among the elderly, but few studies have evaluated its association with nutritional markers. The aim of this study was to estimate the prevalence of polypharmacy and its association with nutritional markers, chronic diseases, sociodemographic and health variables. This research is part of the Study Elderly/Goiânia, which evaluated 418 elderly community in a cross-sectional design. Polypharmacy was defined as the use of five or more concomitant medications. The following nutritional markers were investigated: BMI, waist circumference, percentage body fat, weight gain and loss, use of diet, daily consumption of fruits, vegetables, skimmed and whole milk. Multivariate analysis was performed using hierarchical Poisson regression, with significance level set at 5%. The prevalence of polypharmacy was 28% (95%CI 23.1 - 32.5), with a significant association with feminine gender, age range 75 - 79 years, eutrophic nutritional status and obesity, use of diet, poor self-rated health and presence of two, three or more chronic diseases. The high prevalence of polypharmacy and its association with nutritional markers and chronic diseases call the attention for the need of nutritional surveillance and monitoring in the elderly.