Polimedicação e medicação potencialmente inapropriada no idoso : estudo descritivo de base populacional em cuidados de saúde primários

Abstract

Introduction: The polymedication and use of inappropriate medications by elderly outpatients is a public health concern with potentially serious health consequences. Explicit criteria for determining potentially inappropriate medication consumption in elderly population were created by Beers et al and have been used worldwide in the past two decades. Objective: To evaluate the prevalence and associated factors of polymedication and potentially inappropriate medication in elderly outpatient population. Methods: Observational cross-sectional study, in a sample of 148 elderly outpatients in attending primary health care. Potentially inappropriate medications were identified on the basis of 2003 Beers criteria. Results: Approximately 91% (n=134) of the sample had used at least two or more medications, 58.1% (n=82) five or more medications, and 27.7% (n=41) one of the potentially inappropriate drug disease independent from which 87% were categorized as potentially “high risk” defined by Beers. The patients under study were taking a total of 833 medications, with an average of 5.6 per patient, distributed mainly for the Cardiovascular, Nervous and Muscle-Skeletal System. Amiodarone, ticlopidine and diazepam were the most frequently prescribed potentially inappropriate drugs, accounting for 48% of all potentially inappropriate medications taking by the sample. The use of benzodiazepines and poor patient self-reported health status were significantly associated with polymedication, instead the higher number of drugs and lower education degree were the most important determinant of risk of receiving a potentially inappropriate medication.Conclusion: Polymedication and potentially inappropriate medication use were common among older adults in this study. Nevertheless more studies are needed to confirm the high prevalence and the pattern of potentially inappropriate use and their adverse health outcomes in elderly Portuguese population.