Avaliação do uso de medicamentos potencialmente inapropriados e da adesão à farmacoterapia em idosos atendidos por um plano de saúde suplementar
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Data
2020-08-26
Autores
Tranhago, Camilla da Penha
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Universidade Federal do Espírito Santo
Resumo
The association between polypharmacy, the presence of multiple comorbidities and physiological changes related to aging increases the complexity of pharmacotherapy in the elderly. In this context, some medications may be considered inappropriate for these individuals. Older health insurance users were related to the use of more drugs, which may make them even more vulnerable to the use of potentially inappropriate medications (PIM). The aim of this study was to identify the prevalence of use and the factors associated with the use of PIM by elderly people affiliated with supplementary health insurance, according to the Beers 2019 criteria. This is a cross-sectional study conducted with elderly residents in the city of Vitória-ES, from a supplementary health plan. Socioeconomic, demographic and clinical data were collected through interviews during home visits, from October 2018 to June 2019. The association between the use of PIM and independent variables was verified by univariate logistic regression with their respective confidence intervals. (CI) 95%. We interviewed 332 elderly, 237 female and 95 male, the average age was 81.5 years. A 65% prevalence of PIM use was identified. In the multiple logistic regression model, the variables associated with the use of PIM were self-medication (p = 0.004), high risk clinical profile (p = 0.022), use of psychotropic medication (p = 0.000001) and use of medicines for the musculoskeletal system (p = 0.04) and alimentary tract (p = 0.03). Practicing physical activity was associated with the use of MPI as a protection factor (p = 0.02). The prevalence of polypharmacy was 79.5%. Self-medication was identified in 44.6% of patients. The adherence assessment revealed low adherence prevalence rates ranging from 6.4 to 74.7%, depending on the assessment instrument used. The factors associated with low adherence to each instrument were: age greater than or equal to 86 years (p = 0.009) and physical activity (p = 0.011) in the BMQ; having cognitive deficit (p = 0.028) in the Morisky-Green Test; and polypharmacy (p <0.0001) in MedTake. The results of this study indicate the need for changes in the care of the elderly in supplementary health, in order to increase adherence and the safety of drug therapy, thus guaranteeing a higher quality of life for this population segment.
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Saúde suplementar , Lista de medicamentos potencialmente inapropriados , Adesão à medicação