Avaliação de prescrição de medicamentos potencialmente inapropriados, segundo critério de Beers de 2019, em idosos

Abstract

Advanced age is considered the most important risk factor for the development of chronic diseases. In clinical practice, the Beers Criteria are used as a tool that lists potentially inappropriate medications for the elderly (MPI). The general objective was to evaluate the percentage and types of potentially inappropriate medications prescribed to elderly hospitalized in a hospital in Brasília-DF and, specifically, stratify by gender, age, and use of polypharmacy; establish percentage of MPIs for the elderly by classes of prescribed medications; to investigate the use of drug interactions to be avoided in the elderly and generate safety information in the hospital management system to expand patient care. The method is a retrospective observational study of descriptive and quantitative type. Data were collected in a private hospital in the Federal District, in the medical records of patients hospitalized in wards between 2019 and 2021. The sample consisted of N=376 patients, divided into four groups, of 47 men and 47 women in each group, and ages 65-69 years, 70-74 years, 75-79 years and 80 years or more. The normality of the distribution of quantitative variables was tested by the Shapiro-Wilk test and the One-Way Variance Analysis (ANOVA) was used to identify which means would differ from each other. The Tukey test with a significance level of 5% was used to verify if there was a difference in the mean of the groups. In the results, the relative frequency of the number of drugs per prescription averaged 10.25 (SD=4.11) and the MPIs frequency had an average of 1.14 (SD=0.93), resulting in 10.79% prescriptions for each patient. The group with the most prescription, generating polypharmacy, was in the group of women aged 65-69 years, with 100%. However, there was no significance for the variables gender and age. In the MPIs, the Food Tract System and Metabolism (72.60%) prevailed and the most prescribed drugs were for peptic ulcer and gastroesophageal reflux disease (GERD) - Proton pump inhibitor with 73.18%. In drug interactions, the class of Opioids x Benzodiazepines (47.55%) of the total N=204 drugs prevailed and there was a significant difference in the P-value results of 0.004. The Tukey test was applied with a significance factor of 0.05 in the MPIs group. The results between the groups and the treatments were not significant between age and gender. In relation to treatment in the drug class, the overall mean was 5.10 (SD=4.38) and the opioid x Benzodiazepine group, with 12.13%. The null hypothesis was rejected due to the evidence that, in one of the means, it was different from the others, when there was drug interaction in the groups. It was concluded that the iatrogenic triad, composed of polypharmacy, drug interactions and prescriptions containing MPI, was present in the results presented. This scenario is unfavorable for elderly patients dependent on medications because polypharmacy negatively influences the quality of patient care and health outcomes due to the high risk of adverse reaction in the use of MPI and polypharmacy.