Oliveira Márcio Galvão, Amorim Welma Wildes, de Jesus Sandra Rêgo, Heine Jacqueline Miranda, Coqueiro Hérica Lima, Passos Luiz Carlos Santana
Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil.
J Eval Clin Pract. 2015 Apr;21(2):320-5. doi: 10.1111/jep.12319. Epub 2015 Feb 9.
RATIONALE, AIMS AND OBJECTIVES: Explicit criteria for evaluating the appropriateness of medication use among the elderly have been extensively employed in several countries. The aim of the current study was to assess and characterize the prevalence of potentially inappropriate medications (PIMs) according to the Screening Tool of Older People's Prescriptions (STOPP) criteria and compare these data with the 2012 Beers criteria.
A prospective survey of the medications used by elderly patients was performed. A total of 142 participants were randomly selected via systematic sampling. The Beers and STOPP criteria were applied to evaluate the use of PIMs among the sample. All of the medications included in these criteria were assessed for their availability in Brazil. The prevalence of PIMs was chosen as an occurrence measure and compared among the exposure group using the prevalence ratio (PR) as a measure of association.
The prevalence of PIM use in the sample was 33.8% according to the STOPP criteria and 51.8% using the 2012 Beers criteria. The most prevalent PIMs according to the Beers criteria were short-acting nifedipine (17.4%) and glyburide (11.9%); according to the STOPP criteria, they were acetylsalicylic acid (32.9%), clonazepam (10.1%) and diclofenac (6.3%). The use of four or more drugs (polypharmacy) was associated with a higher prevalence of PIM use (PR = 3.11, 95% CIs = 1.65-5.85).
The 2012 Beers criteria identified more PIMs than the STOPP criteria. This difference highlights the need to develop national criteria.
原理、目的与目标：在多个国家，已广泛采用明确的标准来评估老年人用药的合理性。本研究的目的是根据老年人处方筛查工具（STOPP）标准评估并描述潜在不适当用药（PIM）的流行情况，并将这些数据与2012年Beers标准进行比较。
对老年患者使用的药物进行前瞻性调查。通过系统抽样随机选取了142名参与者。应用Beers标准和STOPP标准评估样本中PIM的使用情况。对这些标准中包含的所有药物在巴西的可获得性进行了评估。选择PIM的流行率作为发生指标，并使用流行率比（PR）作为关联指标在暴露组之间进行比较。
根据STOPP标准，样本中PIM的使用率为33.8%，而使用2012年Beers标准时为51.8%。根据Beers标准，最常见的PIM是短效硝苯地平（17.4%）和格列本脲（11.9%）；根据STOPP标准，它们是阿司匹林（32.9%）、氯硝西泮（10.1%）和双氯芬酸（6.3%）。使用四种或更多药物（多重用药）与PIM使用的较高流行率相关（PR = 3.11，95%置信区间 = 1.65 - 5.85）。
2012年Beers标准识别出的PIM比STOPP标准更多。这种差异凸显了制定国家标准的必要性。
