Open AccessPotentially inappropriate medications for the elderly: Incidence and impact on mortality in a cohort ten-year follow-up
Author(s) -
Natacha Christina de Araújo,
Érika Aparecida Silveira,
Brenda Godoi Mota,
João Paulo Neves Mota,
Ana Elisa Bauer de Camargo Silva,
Rafael Alves Guimarães,
Valéria Pagotto
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0240104
Subject(s) - medicine , polypharmacy , beers criteria , incidence (geometry) , proportional hazards model , cohort , emergency medicine , physics , optics
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. Objective To analyze the incidence, risk factors, and survival of elderly people using potentially inappropriate medications (PIM). Method 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. Results 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. Conclusion 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.