Prevalence of potentially inappropriate medications in older adults in Argentina using Beers criteria and the IFAsPIAM List

Chiapella, Luciana; Menna, Jorgelina Montemarani; Marzi, Marta Mónica; Mamprin, María Eugenia

doi:10.1007/s11096-019-00858-8

Cited by 20 publications

(19 citation statements)

References 32 publications

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“…Females are probably more prone for inappropriate drug prescription due to longer life of female population worldwide, which many national-wide socio-epidemiological studies noted, and consequently the higher number of medical conditions that can develop due to physiological and pathophysiological processes due to age. In line with our results, there are many studies with the same conclusion in terms of gender as a risk factor for PIM [27][28][29] .…”

Section: Discussionsupporting

confidence: 92%

“…Paroxetine as the antidepressant drug showed as inappropriate in our research according to Beers criteria, even in 51 patients. This antidepressive agent should be avoided among elderly people because of the higher risk of mortality outcome, which is the conclusion of different epidemiological studies 28,29,33 . Our result for typical and atypical antipsychotics indicate a relatively high incidence of their use which is not an adequate approach according to Beers criteria, where quetiapine has the highest rate, even in 109 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Multivariable logistic regression showed strong influence of this factor and present significant risk factor through adjusted OR value of 3.99. This can be explained by large number of medical specialist examination at patients with comorbidity and consequently and consequently the simultaneous prescribing of drugs that enter into potential interactions according to Beers criteria [24][25][26][27][28][29] .…”

Section: Discussionmentioning

confidence: 99%

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Potentially inappropriate medication prescribing among elderly patients with cardiovascular diseases

Stojanović¹,

Djurić

Jakovljevic³

et al. 2022

VOJNOSANIT PREGL

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Background/Aim: The purpose of the conducted study was to show the frequencies of PIM in the elderly population with cardiovascular diseases and to describe factors with significant impact on PIM present in the elderly population. Methods: The study was performed as a retrospective, cross-sectional study. The research was performed during 2018 , the relevant data collected during the period from January 2016 to December 2017. Study sample included 1500 patients over 65 years with cardiovasculares disease who had medical records at the Institute for Gerontology and Palliative Care, Belgrade. Assessment of PIM was done by standard international criteria American Geriatrics Society 2015 updated Beers Criteria for potentially inappropriate medication use in older adults. Results: PIM frequency in elderly population was 70, 3%. In relation to gender, it was more frequent in female elders. Mean number of prescribed drugs was similar for 2016 and 2017, respectively 7, 2 and 7, 3. The most common were: medium acting benzodiazepines (70, 9%), central ? blockers (23, 98%), and antipsychotics (typical and atypical) (20,94%). The most common comorbidity was noted in a group labelled with the international disease classification I00-I99 which inlcudes heart and blood vessel diseases (n=2658; 36.9%). The most common diagnoses belonged to the subgroup I10-I15 hypertensive diseases (n=1298; 18%), I20-I25 ischemic heart diseases (n= 542; 7.5%), I30-I52, other forms of heart disease (n=705; 9.8%), I60-I69 cerebrovascular diseases (n =94; 1.3%), and I80- I89 diseases of veins, lymph vessels and lymph nodes (n=12; 0.17%). Predictor for PIM were numerous: polypharmacy, gender, nicotine use, cognitive status, nutrition state and number of diseases registered at study sample. Conclusion: Cardiovascular diseases in the elderly population are associated with a high prevalence of potentially inappropriate drug prescribing. Creating health recommendations for prescribing drugs in the elderly that would emphasize these factors could reduce the prevalence of PIM in this population

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Potentially inappropriate medication prescribing among elderly patients with cardiovascular diseases

Stojanović¹,

Djurić

Jakovljevic³

et al. 2022

VOJNOSANIT PREGL

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“…Polypharmacy and the medication regimen complexity index (MRCI) are factors associated with PIMs found in other studies as well. Another factor associated with a higher prevalence of PIM in the STOPP and BCPIM criteria was the greater number of signs/symptoms, which may reflect more health problems that need to be treated 30,31 .…”

Section: Discussionmentioning

confidence: 99%

Medicamentos potencialmente inapropriados prescritos a pacientes de um Centro de Referência em Atenção à Saúde da Pessoa Idosa

Aires

Silva

Frota

et al. 2020

Rev. bras. geriatr. gerontol.

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Resumo Objetivo Analisar o perfil farmacoterapêutico dos idosos atendidos em um Centro de Referência em Atenção à Saúde da Pessoa Idosa quanto ao uso de medicamentos potencialmente inapropriados (MPI) por meio de três critérios de rastreamento e determinar fatores associados à prescrição de MPI. Método Estudo transversal com dados obtidos por revisão retrospectiva dos prontuários de idosos, atendidos entre 2017 e 2018 por médico geriatra. Para identificar os MPI, utilizaram-se os Critérios de Beers, o Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) e o Consenso Brasileiro de Medicamentos Potencialmente Inapropriados para Idosos. Características relacionadas ao perfil sociodemográfico (idade e sexo), de hábitos de vida (tabagismo e consumo de álcool), clínico (doenças) e farmacoterapêutico (medicamentos e Índice de Complexidade da Farmacoterapia - ICFT) foram avaliadas. Resultados Foram analisados 406 prontuários e identificados 3.059 medicamentos prescritos, dos quais 32,1% são MPI segundo Critérios STOPP, 14,4% pelo Consenso Brasileiro e 11,7% pelos Critérios de Beers. No total, 81,1% dos idosos apresentaram ao menos um MPI. Regressão de Poisson demonstrou associação entre a prescrição de MPI com polifarmácia, maior número de sinais e sintomas e maior valor de ICFT em ao menos um dos critérios. A força de concordância entre os critérios de MPI foi moderada. Conclusões A maioria dos prontuários analisados possuíam ao menos um MPI prescrito, sendo que os Critérios STOPP identificaram uma maior quantidade de MPI. Estratégias devem ser implementadas para melhorar a farmacoterapia dos idosos com atenção para os que apresentam fatores associados a MPI em seu perfil.

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“…13 Local studies have indicated that there is a significant percentage of patients over 75 years or more with polypharmacy, and who are prescribed inappropriate medications. 52 - 54 One of the challenges would be to negotiate with the INSSJP, building on the success of the vaccination program, the provision of other remunerated services, such as medication review, pharmacotherapy follow-up and health education.…”

Section: Challenges and Opportunitiesmentioning

confidence: 99%

Integration of Community pharmacy and pharmacists in primary health care policies in Argentina

Armando¹,

Uema²,

Vega³

2020

Pharm Pract (Granada)

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Argentina is a federal republic with approximately 44 million people, divided into 23 provinces and an autonomous city, Buenos Aires. The health system is segmented into public, social security and private subsystems. The social security and private sectors cover more than 60% of the population. Total health expenditure in 2017 was 9.4% of gross domestic product. Primary health care (PHC) was considered as the principal strategy for universal coverage policy for health system reform in Latin America at the end of 20th century. The most remarkable characteristics of the Argentinian health system are its fragmentation and disorganization. An increase of public sector demands, due to a socioeconomic crisis, led to the subsequent collapse of the system, caused primarily by a sustained lack of investment. First care level decentralization to the Integral Health Service Delivery Networks (IHSDN) becomes the cornerstone of a PHC-based system. Pharmacists and community pharmacies are not formally mentioned in PHC policies or IHSDN. However, pharmacies are recognized as healthcare establishments as part of the first care level. Community pharmacists are the only health care professional whose profit comes from the margin on product sales. Contracts with social security and private insurances provide small margins which reduce the viability of community pharmacies. There is a preference by community pharmacies to diversify product sales instead of providing professional services. This is driven by marketing and economic pressures rather than patient care and health policies. Dispensing is the main professional activity followed by management of minor illness and associated product recommendations. Currently, there are no national practice guidelines or standard operating procedures for the provision of pharmaceutical services and there is no nationally agreed portfolio of services. National pharmacy organizations appear to have no official strategic statements or plans which would guide community pharmacies. There are some isolated experiences in community pharmacies and in public first care level pharmacies that demonstrate the possibilities and opportunities for implementing pharmaceutical services under the PHC approach. There is a real lack of integration of community pharmacies and pharmacists in the healthcare system.

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Prevalence of potentially inappropriate medications in older adults in Argentina using Beers criteria and the IFAsPIAM List

Cited by 20 publications

References 32 publications

Potentially inappropriate medication prescribing among elderly patients with cardiovascular diseases

Potentially inappropriate medication prescribing among elderly patients with cardiovascular diseases

Medicamentos potencialmente inapropriados prescritos a pacientes de um Centro de Referência em Atenção à Saúde da Pessoa Idosa

Integration of Community pharmacy and pharmacists in primary health care policies in Argentina

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