Profile of Prescription Medication in an Internal Medicine Ward

Abstract

Aging-related loss of resilience associated with the lack of evidence regarding the therapeutic efficacy of medicines can prompt a lack of efficacy of treatments and multiple prescriptions. This work aims to characterize the medication profile of Portuguese older adult inpatients and explore the relationship between hospitalization days and the consumption of medicines. A retrospective data analysis study in older patients who were admitted to a medical internal medicine ward during 2019. The median age of the 616 patients included was 85 years. During the hospitalized period, patients took on average 18.08 medicines. The most prescribed drugs belong to the subgroup of (a) anti-thrombotic agents (6.7%), with enoxaparin being the most prescribed, (b) other analgesics and antipyretics (6.6%), paracetamol being the most frequent, and (c) the Angiotensin Conversion Enzyme Inhibitor (ACE) (6.5%), captopril being the most frequent. The high number of prescriptions in older adults during their hospitalization suggests the need of changing therapeutics to achieve a better efficacy of treatment, which corroborates the hypothesis that the lack of scientific evidence concerning the risk/benefits of many medical therapies in older adults can make it difficult to achieve good clinical outcomes and promote the wastage of health resources.

Potentially Inappropriate Medication at Admission and at Discharge: A Geriatric Study in an Internal Medicine Service in Portugal

“…A total of 3873 diagnoses were registered, 21.4% belonging to the group of diseases related to the circulatory system, 6.4% to endocrine, nutritional, and metabolic diseases, and 10.7% to respiratory system diseases. A detailed characterization of the included population can be found in a previous study [ 13 ].…”

“…Considering the need for deprescribing to reduce polypharmacy [ 33 ], it becomes important to reduce the number of prescribed medicines, especially if PIM prescriptions occur [ 19 , 34 ]. However, as previously described, the multiple comorbidities of internal medicine inpatients associated with the lack of evidence for the use of some medicines in older adults and the need to treat/stabilize the cause of the hospitalization favors the prescription of multiple drugs, including PIMs [ 13 ].…”

“…A total of 616 patients were included in the study, for which detailed characterization was previously published [ 13 ]. Prescription data were collected on the first day (admission data) and the last day of hospitalization in the internal medicine ward (discharge data).…”

The Different Patterns of Over-the-Counter Nonsteroidal Anti-Inflammatory Drugs or Analgesics Use in Patients with Chronic Kidney Disease and the General Population

“…We previously reported that 64% of liver [ 4 ] and 63% of kidney transplant recipients use NSAIDs and/or analgesics [ 4 , 5 ]. In contrast, analgesics and antipyretics were recorded only in 6.6% of patients hospitalized in the internal medicine wards [ 21 ]. Such cohort-related discrepancies may be explained by the differences in the indications, population-specific comorbidities, pain burden and medical advice, age, drug education, patients’ beliefs and study methodologies.…”

“…People with intellectual disabilities were more likely than those in the general population cohort to be prescribed paracetamol for all investigated types of pain, and were less likely to have a prescription for NSAIDs [ 20 ]. Paracetamol was also the most frequent among analgesics and antipyretics recorded in patients hospitalized in the internal medicine ward [ 21 ]. We hypothesize, that CKD patients pay more attention to their kidney function and are better educated about NSAIDs nephrotoxicity.…”