Postgraduate Program in Nursing, Faculty of Nursing, Federal University of Goiás, PPGENF/FEN/UFG, Rua 227 Qd. 68 s/n - Setor Universitário, Goiânia, Goiás, CEP 74605-080, Brazil.
Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, Goiás, Brazil.
Int J Clin Pharm. 2022 Oct;44(5):1132-1139. doi: 10.1007/s11096-022-01433-4. Epub 2022 Jul 27.
Much of the knowledge on the use of potentially inappropriate medications (PIM) in older adults is derived from cross-sectional studies, with little known about the risk factors over time.
Longitudinal analysis was applied to estimate the occurrence and risk factors of PIM use among older adults in a 10-year follow-up.
Longitudinal study with 418 older adult residents of a capital city of Central-West Brazil. The PIM were classified according to the Beers criteria 2019. The usage rate was calculated at baseline (2008) and at the 10-year follow-up moment (2018). Analysis of predictors (sociodemographic, self-rated health, hospitalization, number of comorbidities, polypharmacy, diabetes, hypertension, hypercholesterolemia and nutritional status) was performed using Generalized Estimating Equation (GEE) models.
Mean age at baseline was 70.6 years (SD 7.1) and 76% were women; 221 older adults took part in the follow up. The rate of PIM use was 50.4% at baseline and 57.5% at the 10-year follow-up. Multiple analysis showed that PIM use in the cohort was statistically higher in the older adults with a history of hospitalization (RR 1.20; 95% CI 1.01-1.40), with three or more diseases (RR 1.41; 95% CI 1.14-1.74), with polypharmacy (RR 1.81; 95% CI 1.47-2.24) and with diabetes mellitus (RR 1.24; 95% CI 1.05-1.47).
A high level of potentially inappropriate medication use was observed, reaching 50% of the older adults, with a 7% increase in the prevalence over the 10-year follow-up period. Hospitalization, multimorbidities, polypharmacy and diabetes mellitus were associated with the use of these medications. Interventions for surveillance of the deprescribing process need to be encouraged to avoid potential harm caused by the use of medications.
关于老年人中潜在不适当药物（PIM）使用的知识主要来自横断面研究，关于随时间推移的风险因素知之甚少。
本研究通过纵向分析来估计 10 年随访中老年人中 PIM 使用的发生情况和危险因素。
本研究是一项对巴西中西部首府城市的 418 名老年居民进行的纵向研究。根据 2019 年 Beers 标准对 PIM 进行分类。在基线（2008 年）和 10 年随访时（2018 年）计算使用率。使用广义估计方程（GEE）模型分析预测因素（社会人口统计学、自我评估健康状况、住院、合并症数量、多种药物治疗、糖尿病、高血压、高胆固醇血症和营养状况）。
基线时的平均年龄为 70.6 岁（SD 7.1），76%为女性；221 名老年人参加了随访。基线时 PIM 使用率为 50.4%，10 年随访时为 57.5%。多因素分析显示，在该队列中，有住院史（RR 1.20；95%CI 1.01-1.40）、有三种或更多疾病（RR 1.41；95%CI 1.14-1.74）、有多种药物治疗（RR 1.81；95%CI 1.47-2.24）和患有糖尿病（RR 1.24；95%CI 1.05-1.47）的老年人使用 PIM 的比例更高。
观察到老年人中潜在不适当药物的使用率很高，达到 50%，在 10 年随访期间，患病率增加了 7%。住院、多种合并症、多种药物治疗和糖尿病与这些药物的使用有关。需要鼓励对药物去留过程的监测进行干预，以避免药物使用带来的潜在危害。
