Banca de DEFESA: FRANCISCA SUELI MONTE MOREIRA

Use of drugs for elderly people in the elderly in long-term care institutions

aged, nursing homes, Cross-Sectional Studies, inappropriate prescribing, Potentially Inappropriate Medication List

The rapid growth of the Brazilian elderly population has been accompanied by a greater burden of diseases, an increase in the use of health services and an increase in the demand for Nursing Home (NH). The elderly are more susceptible to the occurrence of adverse events due to physiological changes related to aging that may influence the pharmacokinetics and pharmacodynamics of the drugs. The present study has as main objectives to verify the prevalence of potentially inappropriate drug use (PIM) for the elderly and the associated factors, as well as to evaluate the changes in the occurrence of PIM over time. The first stage of the study (study 1) follows a cross-sectional design and used baseline data from the study "Human Aging and Health: the reality of the institutionalized elderly in the city of Natal / RN", which aims to assess health / institutionalized elderly in the city of Natal / RN. The collection was performed based on the data collected in 10 Institutions of NH. Inappropriate medications were classified according to the 2015 American Geriatric Scoiety (AGS) Beers Criteria. Sociodemographic variables, related to NH and health conditions, were analyzed. Univariate and multivariate analyzes were performed between the main variable (PIM use) and the other variables. The study population consisted of 321 elderly people, and the prevalence of 54.6% of PIP was identified. Multivariate analysis revealed that PIM use was associated with polypharmacy and dementia. The second part of the study (Study 2) followed a 24-month longitudinal with 6-month follow-up intervals. The variables and 2015 AGS Beers Criteria adopted in study 1 were maintained. The prevalence of PIM use was high in the 4 waves, with 63.4% in wave 1, 62.9% in wave 2, 69.2% % in wave 3 and 65.9% in wave 4. The classes of drugs most frequently used as PIM in all waves were antipsychotics, bezodiazepines and proton pump inhibitors. The study revealed that the use of PIP is high among NH residents, remaining high over time. The prevalence of MPI in this magnitude reveals the need to improve the quality of the pharmacotherapy of the elderly and requires actions of professionals and managers.