Faculty of Nursing, Postgraduate Program in Nursing, Federal University of Goiás, Goiânia, Goiás, Brazil.
Faculty of Medicine, Postgraduate Program in Health Sciences, Federal University of Goiás, Goiânia, Goiás, Brazil.
PLoS One. 2020 Oct 28;15(10):e0240104. doi: 10.1371/journal.pone.0240104. eCollection 2020.
Pharmacological therapy plays an important role in disease control in the elderly; unfortunately, this comes with a high prevalence in the use of medications classified as potentially inappropriate.
To analyze the incidence, risk factors, and survival of elderly people using potentially inappropriate medications (PIM).
A ten-year follow-up assessment of elderly participants residing in a capital of Central Brazil was conducted. The initial assessment (baseline) included 418 elderly people. Data were collected through home interviews guided by a questionnaire covering socioeconomic, demographic, living conditions, and health variables. The medication information obtained comprised active ingredient, dosage, route, and regimen for the medications. The PIMs were classified according to 2019 Beers Criteria. The analyses were performed using STATA 15.0. For survival analysis, a Cox Regression was performed with the respective Kaplan Meier curve.
The incidence of PIM was 44.1 cases (95% CI: 35.2-54.7) per 1,000 people a year. The most used PIMs were nifedipine, glibenclamide, and sodium diclofenac. The risk factors were polypharmacy (aRR: 3.00; 95% CI: 1.31-6.88) and diabetes mellitus (aRR: 1.57; 95% CI: 1.03-2.39). We identified no statistically significant association between survival and the use of PIM.
The study highlights the high consumption of PIM among the elderly causing polypharmacy risks. Health professionals working in drug treatment need to be alert to polypharmacy risks to ensure the rational use of medications to prevent adverse reactions and other health problems.
药物治疗在老年人疾病控制中起着重要作用；遗憾的是，这伴随着使用被归类为潜在不适当药物的高流行率。
分析使用潜在不适当药物（PIM）的老年人的发生率、风险因素和生存率。
对巴西中部首府的老年居民进行了为期十年的随访评估。初始评估（基线）包括 418 名老年人。通过家庭访谈收集数据，由一份问卷指导，涵盖社会经济、人口统计学、生活条件和健康变量。获得的药物信息包括活性成分、剂量、途径和药物方案。根据 2019 年 Beers 标准对 PIM 进行分类。使用 STATA 15.0 进行分析。对于生存分析，使用 Cox 回归进行分析，并绘制相应的 Kaplan-Meier 曲线。
PIM 的发生率为每年每 1000 人 44.1 例（95%CI：35.2-54.7）。使用最多的 PIM 是硝苯地平、格列本脲和双氯芬酸钠。风险因素是多种药物治疗（aRR：3.00；95%CI：1.31-6.88）和糖尿病（aRR：1.57；95%CI：1.03-2.39）。我们没有发现生存率与使用 PIM 之间存在统计学显著关联。
该研究强调了老年人中 PIM 的高消耗导致了多种药物治疗的风险。从事药物治疗的卫生专业人员需要警惕多种药物治疗的风险，以确保药物的合理使用，预防不良反应和其他健康问题。
