Prevalência de medicamentos potencialmente inapropriados nas prescrições de idosos hospitalizados

Abstract

Potentially inappropriate medicines (PIM) are those in which the risks may outweigh the therapeutic benefits, especially when there are more effective alternatives available. The use of inappropriate medications has a significant impact on the health and care of the elderly population. This study aimed to identify the prevalence of PIM in the prescriptions of elderly people hospitalized at the Hospital de Clínicas of the Universidade Federal do Triângulo Mineiro, MG, Brazil, determining the frequency of PIM in prescriptions, according to the sex and age of the patients and their relationship with polypharmacy and unfavorable outcomes, such as readmission and death; also checking potential drug interactions in prescriptions and whether there are reports of interactions and adverse reactions to medications in the medical records analyzed. A retrospective descriptive cross-sectional study was carried out, in which 350 medical records were analyzed. The sociodemographic profile of the patients was traced, relating the data found with PIM prescriptions, polypharmacy prior to hospitalization, potential drug interactions, and outcomes, in addition to checking the length of stay and whether there was a readmission. For data analysis, the chi-square and Fisher's exact tests were used, verifying the association between inappropriate prescriptions and polypharmacy, hospitalization outcomes and readmission. The same tests were used to verify the possible occurrence of drug interactions, in relation to inappropriate prescriptions and the analyzed outcomes. For the variables length of stay and time since last hospitalization, the Shapiro-Wilks normality test and the Mann-Whitney non-parametric tests were performed for independent samples. The results found demonstrated that there was a high prevalence of inappropriate medications for elderly people during hospitalizations (98%). In 100% of the medical records analyzed there was no information about interactions and adverse reactions to medications, with 92.9% of prescriptions presenting a risk of drug interactions. The high prevalence of PIMs in prescriptions for the elderly and the lack of records of adverse events indicates that it is essential to implement awareness-raising measures among the multidisciplinary team, making it necessary for institutions to invest in training health professionals, so that in the medium and long term long term, improving the health and quality of life of the elderly population is achieved.