Consumption of potentially inappropriate drugs and medication reconciliation in the elderly
DOI:
https://doi.org/10.48492/servir025-6.23472Keywords:
Aged, Inappropriate prescription, Medication reconciliationAbstract
In the elderly, the consumption of inappropriate drugs leads to the development of adverse events.
Objectives: To know the magnitude of the problem and to understand whether drug reconciliation is a clinically and economically viable solution.
Methodology: Systematic review, using the PICO method. The descriptors “Polypharmacy”, “Inappropriate Prescription”, “Drug Reconciliation”, “Drug utilization review“ and “Deprescribing“ were used.
Results: The existence of inappropriate prescriptions is very prevalent. Drug reconciliation is effective in reducing it, but it is not proven to reduce adverse events. Lack of professional involvement, patient noncompliance and cost of implementation are barriers to consider.
Conclusions: Drug reconciliation programs need to be improved to be clinically and economically sustainable.
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References
Franchi C; Tettamanti M; Pasina L; Djignefa C; Forti- no I; Bortolotti A; ... Nobili, A. (2014). Changes in drug prescribing to Italian community-dwelling elderly peo- ple: the EPIFARM-Elderly Project 2000-2010. Eur J Clin Pharmacol., 70(4): 437-443
O’Connor M; Gallagher P. & O’Mahony D. (2012). Inappropriate Prescribing: Criteria, Detection and Pre- vention. Drugs Aging, 29(6): 437-452.
Boparai M. & Korc-Grodzicki B. (2011). Prescribing for older adults. Mt Sinai J Med, 78(4): 613-626.
Obreli Neto P; Nobili A; de Lyra Jr; Pilger D; Gui- doni C; de Oliveira Baldoni A; ... Nakamura R. (2012). Incidence and predictors of adverse drug reactions caused by drug-drug interactions in elderly outpatients: a prospective cohort study. J Pharm Pharm Sci., 15(2): 332-343.
Wu C; Bell C. & Wodchis W. (2012). Incidence and Economic Burden of Adverse Drug Reactions among Elderly Patients in Ontario Emergency Departments: A Retrospective Study. Drug Saf., 35(9):769-781.
Scott, I., Gray L., Martin J., Pillans P. & Mitchell C. (2013). Deciding when to stop: towards evidence-based deprescribing of drugs in older populations. Evid Based Med., 18(4):121-124.
Portugal. (2015). Despacho n.º 1400-A/2015 de 10 de fevereiro do Ministério da Saúde. Diário da República, 2.ª série — N.º 28 — 10 de fevereiro de 2015.
Henriques, M. (2011). Adesão ao regime medicamentoso em idosos na comunidade: eficácia das intervenções de enfermagem (Tese de doutoramento). Disponível em: http://hdl.handle.net/10451/3801.
Matias, M. (2011). Reconciliação da Medicação no Pós-operatório da Cirurgia Ortopédica (Dissertação de Mestrado). Disponível em: http://hdl.handle.net/10400.6/959
Parente, J. (2011). Avaliação do uso de medicamentos inapropriados em idosos: aplicação dos Critérios de Beers. (Dissertação de Mestrado). Disponível em: http://hdl.handle.net/10400.6/1007.
Santos, M., & Almeida, A. (2010). Polimedicação no idoso. Revista de Enfermagem Referência, serIII(2): 149-162.
Shi, S. & Klotz, U. (2011). Age-related changes in pharmacokinetics. Curr Drug Metab., 12(7):601-610.
World Health Organization. (2014). The High 5s Project Implementation Guide. Assuring Medication Accuracy at Transitions in Care: Medication Reconciliation. Disponível em: http://www.who.int/patientsafety/implementation/solutions/high5s/h5s-guide.pdf
University of Oxford. (2015). P I C O: Formulate an Answerable Question. Disponível em: http://learntech.physiol.ox.ac.uk/cochrane_tutorial/cochlibd0e84.php
Barnett, K., McCowan, C., Evans, J., Gillespie, N., Davey, P. & Fahey T. (2011). Prevalence and outcomes of use of potentially inappropriate medicines in older people: cohort study stratified by residence in nursing home or in the community. BMJ Qual Saf, 20(3):275-281.
Bongue, B., Laroche, M., Gutton, S., Colvez, A., Guéguen, R., Moulin, J., Merle, L. (2011, Dec) Potentially inappropriate drug prescription in the elderly in France: a population-based study from the French National Insurance Healthcare system. Eur J Clin Pharmacol, 67(12): 1291-1299.
Cahir, C., Fahey, T., Teeling, M., Teljeur, C., Feely, J. & Bennett, K. (2010). Potentially inappropriate prescribing and cost outcomes for older people: a national population study. Br J Clin Pharmacol., 69(5):543-552.
Bell, J., Ahonen, J., Lavikainen, P., Hartikainen, S. (2013). Potentially inappropriate drug use among older persons in Finland: application of a new national categorization. Eur J Clin Pharmacol., 69(3):657-664.
Baldoni, A., Ayres, L., Martinez, E., Dewulf, N., Dos Santos, V., Pereira, L. (2014). Factors associated with potentially inappropriate medications use by the elderly according to Beers criteria 2003 and 2012. Int J Clin Pharm., 36(2):316-324.
Holguín, E. & Orozco, J. (2011). Medicación potencialmente inapropiada en ancianos en un hospital de cuarto nivel en Bogotá. Universitas Médica. 52(2):149-168.
Galvin, R., Moriarty, F., Cousins, G., Cahir, C., Motterlini, N., ... Kenny, R. (2014). Prevalence of potentially inappropriate prescribing and prescribing omissions in older Irish adults: findings from The Irish Longitu Dinal Study on Ageing study (TILDA). Eur J Clin Pharmacol., 70(5):599-606.
Bradley, M., Fahey, T., Cahir, C., Bennett, K., O’Reilly, D., Parsons, C., Hughes, C. (2012) Potentially inappropriate prescribing and cost outcomes for older people: a cross-sectional study using the Northern Ireland Enhanced Prescribing Database. Eur J Clin Pharmacol., 68(10):1425-1433.
Nyborg, G., Straand, J. & Brekke, M.(2012). Inappropriate prescribing for the elderlya modern epidemic? Eur J Clin Pharmacol., 68(7):1085-1094.
Bradley, M., Motterlini, N., Padmanabhan, S., Cahir, C., Williams, T., Fahey, T. & Hughes, C. (2014). Potentially inappropriate prescribing among older people in the United Kingdom. BMC Geriatr, 12;14:72.
Chang, C., Lai, H., Yang, S., Wu, R., Liu, H., ... Chan, D. (2014). Patientand clinic visit-related factors associated with potentially inappropriate medication use among older home healthcare service recipients. PLoS One., 9(4):e94350.
Stafford, A., Alswayan, M. & Tenni, P. (2011). Inappropriate prescribing in older residents of Australian care homes. J Clin Pharm Ther., 36(1):33-44.
Elseviers, M., Vander Stichele, R. & Van Bortel, L. (2014). Quality of prescribing in Belgian nursing homes: an electronic assessment of the medication chart. Int J Qual Health Care, 26(1):93-9.
Bao, Y., Shao, H., Bishop, T., Schackman B. & Bruce M. (2012). Inappropriate medication in a national sample of US elderly patients receiving home health care. J Gen Intern Med., 27(3):304-10.
Heidari, S., Aliabadi, A., Naebi, A. & Khoramirad, A. (2014). Frequency of Use of Potentially Inappropriate Medications and Its Associated Factors in Elderly People in Qom City, 2012, Iran. Qom Univ Med Sci J., 8(4):44-52.
Ruggiero, C., Dell’Aquila, G., Gasperini, B., Onder, G., Lattanzio, F ULISSE Study Group. (2010). Potentially inappropriate drug prescriptions and risk of hospitalization among older, Italian, nursing home residents: the ULISSE project. Drugs Aging, 1;27(9):747-58.
Gallagher, P., Lang, P., Cherubini, A., Topinková, E., Cruz-Jentoft, A. O’Mahony, D. (2011). Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals. Eur J Clin Pharmacol, 67(11):1175-88.
Faustino, C., Passarelli, M. & Jacob-Filho, W. (2013). Potentially inappropriate medications among elderly Brazilian outpatients. Sao Paulo Med J. 131(1):19-26.
San-José, A., Agustí, A., Vidal, X., Formiga, F., Gómez-Hernández, M. Barbé, J. (2015). Inappropriate prescribing to the oldest old patients admitted to hospital: prevalence, most frequently used medicines, and associated factors. BMC Geriatr. 9;15:42.
Hudhra, K. García-Caballos, M. Jucja, B. Casa- do-Fernández, E. Espigares-Rodriguez, E. & Bueno-Cavanillas, A. (2014). Frequency of potentially inappropriate prescriptions in older people at discharge according to Beers and STOPP criteria. Int J Clin Pharm., 36(3):596-603.
Wahab, M. Nyfort-Hansen, K. & Kowalski, S. (2012). Inappropriate prescribing in hospitalised Australian elderly as determined by the STOPP criteria. Int J Clin Pharm. 34(6):855-62.
Forsetlund, L. Eike, M. Gjerberg, E. & Vist, G. (2011). Effect of interventions to reduce potentially inappropriate use of drugs in nursing homes: a systematic review of randomised controlled trials. BMC Geriatr. 17; 11:16.
Mueller, S., Sponsler, K., Kripalani, S. & Schnipper, J. (2012). Hospital-based medication reconciliation practices: a systematic review. Arch Intern Med. 23;172(14):1057-69.
Alldred, D. Raynor D. Hughes, C. Barber, N. Chen, T. & Spoor, P. (2013). Interventions to optimise prescribing for older people in care homes. Cochrane Database Syst Rev. 28(2).
Patterson, S. Cadogan, C. Kerse, N. Cardwell, C. Bradley, M. Ryan, C. & Hughes, C. (2014). Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev, 7(10).
Loganathan., Singh, S., Franklin, B., Bottle, A., & Majeed, A. (2011, Mar). Interventions to optimise prescribing in care homes: systematic review. Age Ageing. 40(2):150-62.
Christensen, M. & Lundh A. (2014). Medication review in hospitalised patients to reduce morbidity and mortality. Cochrane Database Syst Rev. 28(2).
Kwan, J., Lo, L., Sampson, M., Shojania, K. (2013). Medication reconciliation during transitions of care as a patient safety strategy: a systematic review. Ann Intern Med. 5;158(5 Pt 2):397-403.
Thomas, R., Huntley, A., Mann, M., Huws, D., Elwyn, G., Paranjothy, S. & Purdy, S. (2014). Pharmacist-led interventions to reduce unplanned admissions for older people: a systematic review and meta-analysis of randomised controlled trials. Age Ageing. 43(2):174-87.
Faria, R., Barbieri, M., Light, K., Elliott, R. & Sculpher, M. (2014). The economics of medicines optimization: policy developments, remaining challenges and research priorities. Br Med Bull. 111(1):45-61.
Accreditation Canada.(2012). Medication Reconciliation in Canada: Raising The Bar Progress to date and the course ahead. Disponível em: https://www.ismp-canada.org/download/MedRec/20121101MedRecCanadaENG.pdf
Teixeira, J., Rodrigues, M. & Machado, V. (2012, Jun). Educação do paciente sobre regime terapêutico medicamentoso no processo de alta hospitalar: uma revisão integrativa. Rev Gaucha Enferm. 33(2):186-96.
Bondesson, A., Eriksson, T., Kragh, A., Holmdahl, L., Midlöv, P. & Höglund, P. (2013, Mar). In-hospital medication reviews reduce unidentified drug-related problems. Eur J Clin Pharmacol. 69(3):647-55.
Accreditation Canada. (2012). National Medication Reconciliation Strategy. Identifying Practice Leaders for Medication Reconciliation in Canada, 2012. Disponível em: https://www.ismp-canada.org/download/MedRec/Identifying_Practice_Leaders_for_Medication_Reconciliation_in_Canada.pdf
Anderson, K., Stowasser, D., Freeman, C. & Scott, I. (2014). Prescriber barriers and enablers to minimising potentially inappropriate medications in adults: a systematic review and thematic synthesis. BMJ Open. 8;4(12):e006544.
Ghibelli, S. Marengoni, A. Djade, C. Nobili, A. Tettamanti, M. Pasina, L. (2013). Prevention of Inappropriate Prescribing in Hospitalized Older Patients Using a Computerized Prescription Support System (INTER- check). Drugs Aging. 30(10):821-8.
Bulloch, M. & Olin, J. (2014). Instruments for evaluating medication use and prescribing in older adults. J Am Pharm Assoc. 54(5):530-7.
Elliott, R. & Stehlik, P. (2013). Identifying Inappropriate Prescribing for Older People. Journal of Pharmacy Practice & Research, 43(4):312-319.
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