Polimedicación y prescripción de fármacos inadecuados en pacientes ancianos inmovilizados que viven en la comunidad

Abstract

Objectives. To ascertain and analyse the drug consumption of the immobile elderly, as well as the number of potentially inappropriate medcations (PIM). Design. Cross-sectional study. Setting. Fourteen rural primary care centres. Participants. Non-institutionalised immobile patients, older than 64 years were selected by systematic sampling. Principal measurements. Review of patients' medicine cabinets and noting the daily doses and current number of drugs, as well as the origin of the prescription. Identification of PIM (Beers criteria). Results. One-hundred forty-three homes visits were made. The mean age was 81.3±7.9 years, of whom 74.8% were women. The most common drugs were: analgesics (9.2%), antacids (7.1%), nitrites-calcium antagonists (6.5%), non-steroidal anti-inflammatories (5.0%), and angiotensm converting enzyme inhibitors (4.7%). The percentage of patients who took more than 4 drugs was 76.1%. A PIM was taken by 35% of the elderly. The most common were: long-acting tranquilisers (41.5%), hypnotics (13.8%), digoxin (13.8%), indomethacin (7.7%), and antispasmodics (6.1%). In the majority of cases, the prescribing of the PIM was made by the family doctor (77.7%). Women took significantly more inappropriate drugs than men (0.50±0.72 vs to 0.25±0.50; P=.001) and those on multiple medication more than those not on multiple medication (0.50±0.73 vs 0.31±0.52; P=.008). Conclusions. The prevalence of inappropriate therapy m the immobile elderly is high, therefore an effort must be made to reduce it. Procedures directed towards increasing the quality of prescribing could improve the state of health and quality of life of these patients.