Estudio sobre la utilización inapropiada de medicamentos en pacientes de edad avanzada hospitalizados en el servicio de medicina interna de un hospital privado

Abstract

INTRODUCTION The potentially inappropriate prescribing (PIP) contributes to the increased risk of adverse drug reactions (ADR) associated with increased risk of hospitalization, morbidity and increased resource use events. The increased life expectancy, an aging population and the frequent polymedication increase the risk of PPI. An active monitoring of prescriptions in elderly patients would reduce polymedicated in more than half of the prescribed drugs, with improvement of cognitive status and overall health of the patient. OBJECTIVES AND METHOD Our objective was to quantify the prevalence of these errors using the Beers and STOPP criteria for detection of PMI, START and ACOVE to detect POP and add the analysis of drug interactions according Stockley. We compare together the different tools and evaluate the factors associated with inappropriate prescribing and interactions appearance to then evaluate the applicability and usefulness of these tools. RESULTS The 78.33% of patients have a PIP. Of the total, 31.6% had only one PIM, 18.3% had only one POP and 28.33% had both PIM and POP. STOPP criteria with 65% of PIM and the Beers criteria 58.33% were detected. Using the criteria ACOVE detected 58.33% of POP and the START 66.67% criteria. 21.6% of patients had a serious drug interaction. The level of agreement in the prevalence of PPI found with the various criteria was low in all cases. Risk factors associated with PIP were polypharmacy, functional status and comorbidity. A significant relationship between the reason for admission and errors are also detected by the Beers criteria and interactions The variable most strongly associated with increased risk of interactions was polymedication. CONCLUSIONS The PIP in the elderly represent a current problem and high incidence in the population and underlines the importance of ensuring better health care for this group of patients. The 28.33% of the patients in our study presented simultaneously inappropriate prescribing any drug and any possible omission of limitations, and the variable most strongly associated with increased risk of interactions in our study was polymedication (p = 0.001) . However the power detection inadequacy varies depending on the criteria used. However there is currently no consensus in choosing the most appropriate tool. Although multiple studies that provide results in the use of all of them, none concludes selecting one of them as the most appropriate for use in our environment.