Application of the 2015 Beers Criteria Operationalized for Portugal in Institutionalized Elderly People: A Cross-Sectional Study

被引:5
作者
Peixoto, Sofia [1 ]
Almeida, Armando [2 ]
Caramelo, Ana [2 ]
Mendes, Ligia [3 ]
机构
[1] Univ Catolica Portuguese, Inst Ciencias Saude, Dept Gerontol & Cuidado Geriatr, Porto, Portugal
[2] Univ Catolica Portuguese, Ctr Invest Interdisciplinar Saude, Porto, Portugal
[3] Assistencia Social Adventista, Dept Med Geral & Familiar, Lisbon, Portugal
关键词
Aged; Inappropriate Prescribing; Institutionalization; Portugal; Potentially Inappropriate Medication List; POTENTIALLY INAPPROPRIATE MEDICATIONS; NURSING-HOME RESIDENTS; ADVERSE DRUG-REACTIONS; TERM-CARE FACILITIES; NONPHARMACOLOGICAL INTERVENTIONS; OLDER-PEOPLE; POLYPHARMACY; COMMUNITY; PRESCRIPTIONS; IMPACT;
D O I
10.20344/amp.13030
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: The consumption of potentially inappropriate medicines is high among institutionalized elderly, predisposing to potential drug interactions, adverse drug events, risk of iatrogenic cascade, increased morbidity and mortality and health costs. Medication review is a promising strategy for therapeutic optimization, although scarcely documented in Portugal. The aim of this study was to characterize, using explicit criteria, the existence of potentially inappropriate medicines, among institutionalized elderly, and to calculate the eventual cost savings, with their discontinuation. Material and Methods: Descriptive and cross-sectional study conducted in three residential homes for the elderly, from different geographic regions, based on a random sample of 33 health records. In order to characterize the existence of potentially inappropriate medicines, we used the 2015 Beers criteria, revised by the American Geriatrics Society and in the Portuguese version. Results: On average, 11 drugs are prescribed to elderly residents of three residential structures for the elderly. All health records contain potentially inappropriate medicines (mean 4.8 +/- 2.0 per resident), with anxiolytics (17.7%), antidepressants (17.7%) and antipsychotics (15.8%) being the most prevalent. Its reduction would result in an average monthly savings of (SIC)9.6 per resident. Discussion: The consumption of potentially inappropriate medicines is higher than the literature describes, and the cost of medicines is high. The involvement of nurses in the process of drug management and reconciliation, in coordination with the physician, could be an effective strategy. This is the first study using the latest Portuguese version of the Beers criteria, which makes the comparability of the results difficult. Conclusion: The consumption of potentially inappropriate medicines is high, which suggest the need for adoption of improvement measures.
引用
收藏
页码:741 / 748
页数:8
相关论文
共 67 条
[1]   Prevalence of potentially inappropriate medications use among older adults and risk factors using the 2015 American Geriatrics Society Beers criteria [J].
Alhawassi, Tariq M. ;
Alatawi, Wafa ;
Alwhaibi, Monira .
BMC GERIATRICS, 2019, 19 (1)
[2]   Interventions to optimise prescribing for older people in care homes [J].
Alldred, David P. ;
Kennedy, Mary-Claire ;
Hughes, Carmel ;
Chen, Timothy F. ;
Miller, Paul .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2016, (02)
[3]  
Almeida A., 2016, SERVIR, V59, P93
[4]  
Alonso A, 2017, POLYPHARMACY MANAGEM, V2nd
[5]  
Alzner R, 2016, WIEN MED WOCHENSCHR, V166, P161, DOI 10.1007/s10354-015-0428-8
[6]  
[Anonymous], Infomed. base de dados de medicamentos do Infarmed. Pesquisa de medicamentos com DCI "estetrol"
[7]   Potentially Inappropriate Prescribing in Belgian Nursing Homes: Prevalence and Associated Factors [J].
Anrys, Pauline M. S. ;
Strauven, Goedele C. ;
Foulon, Veerle ;
Degryse, Jean-Marie ;
Henrard, Severine ;
Spinewine, Anne .
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 2018, 19 (10) :884-890
[8]   The effectiveness of non-pharmacological interventions in older adults with depressive disorders: A systematic review [J].
Apostolo, Joao ;
Bobrowicz-Campos, Elzbieta ;
Rodrigues, Manuel ;
Castro, Ines ;
Cardoso, Daniela .
INTERNATIONAL JOURNAL OF NURSING STUDIES, 2016, 58 :59-70
[9]  
BEERS MH, 1991, ARCH INTERN MED, V151, P1825
[10]   The Use of Antidepressants in Belgian Nursing Homes Focus on Indications and Dosages in the PHEBE Study [J].
Bourgeois, Jolyce ;
Elseviers, Monique M. ;
Van Bortel, Luc ;
Petrovic, Mirko ;
Vander Stichele, Robert H. .
DRUGS & AGING, 2012, 29 (09) :759-769