Reis Cristiane Moreira, Dos Santos Andrezza Gouvêa, de Jesus Souza Paula, Reis Adriano Max Moreira
Hospital das Clínicas, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 110, Belo Horizonte, Minas Gerais, Brazil; Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627 Pampulha Belo Horizonte, Minas Gerais, Brazil.
Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627 Pampulha Belo Horizonte, Minas Gerais, Brazil.
J Geriatr Oncol. 2017 Jul;8(4):303-307. doi: 10.1016/j.jgo.2017.05.003. Epub 2017 Jun 24.
To determine the frequency and the factors associated with the use of potentially inappropriate medications (PIMs) by older adults with cancer at an onco-haematology ambulatory clinic of a teaching hospital in Brazil.
Patients aged 60years or older (n=160) subjected to parenteral antineoplastic chemotherapy from May to December 2015 and treated with one or more medications in the ambulatory clinic were interviewed. Data on medications, comorbidities, oncological diagnosis, and functional status were recorded. Functionality was determined using the Vulnerable Elders Survey (VES-13). PIMs were determined using the 2015 Beers Criteria. Logistic regression was used to determine the factors associated with the use of PIMs.
A total of 78 (48.1%) older adults used at least one PIM. The PIMs to be avoided by older adults were proton pump inhibitors (33.3%), antiemetics (10.5%), long-acting benzodiazepines (10.5%), and antidepressants (7.6%). Multivariate analysis indicated that PIMs were associated with the use of five or more medications (odds ratio, 3.14; 95% confidence interval, 1.4-6.6), after adjusting for the number of medications, number of comorbidities, depression, and arthritis/arthrosis.
The frequency of use of PIMs by older adults at the investigated ambulatory clinic was high. Polypharmacy was positively associated with the use of PIMs.
确定巴西一家教学医院肿瘤血液科门诊中癌症老年患者使用潜在不适当药物（PIM）的频率及相关因素。
对2015年5月至12月接受胃肠外抗肿瘤化疗且在门诊接受一种或多种药物治疗的60岁及以上患者（n = 160）进行访谈。记录用药、合并症、肿瘤诊断和功能状态的数据。使用脆弱老年人调查（VES - 13）确定功能状态。使用2015年《Beers标准》确定PIM。采用逻辑回归确定与使用PIM相关的因素。
共有78名（48.1%）老年人使用了至少一种PIM。老年人应避免使用的PIM包括质子泵抑制剂（33.3%）、止吐药（10.5%）、长效苯二氮䓬类药物（10.5%）和抗抑郁药（7.6%）。多变量分析表明，在调整用药数量、合并症数量、抑郁症和关节炎/关节病后，PIM与使用五种或更多药物相关（比值比，3.14；95%置信区间，1.4 - 6.6）。
在所调查的门诊中，老年患者使用PIM的频率较高。多种药物联合使用与PIM的使用呈正相关。
