Polypharmacy and inappropriate prescription affect the quality of life of the elderly
Abstract
Introduction: Older adults are a heterogeneous population, in some cases with multiple comorbidities they must coexist and in others with normal physiological aging. The demographic change in Latin America, there was a gradual increase in the rate of the population, estimated in 2010 approximately 59 million older adults, by 2050 are estimated almost 200 million people over 65 years, According to the WHO, states that cases of polypharmacy in the elderly are between 5 and 78%, being likely to have an inappropriate prescription which increases the risk of drug interactions leading to several adverse effects that deteriorate their quality of life.
Objective: analyze the inappropriate prescription of medications with the use of the STOPP-START criteria and the risk factors associated at quality of life in adults over 65 years of age or older with polypharmacy from the Las Casas and Conocoto Health Center in September To November in the year 2016.
Methodology: A cut-off study was performed between inappropriate prescribing (STOPP-START criteria) in patients with polypharmacy and quality of life (SF-12 Health questionnaire), being compared between two Health Centers.
Results: it was found that there is a greater number of prescribers, increasing the risk of poor quality of life in older adults with polypharmacy. C.S. Las Casas RR = 1.66, chi 2 =6.59 with p <0.05 and C.S. RR = 1.7, chi 2 = 5.56 p <0.05.
Conclusions: Inappropriate prescribing has evident association with pluripathology and comorbidities presented by older adults in addition to a higher number of prescribers, a risk of poor quality of life. In the Health care center that provides to the elderly with specialization in Family Medicine and who have the postgraduate course in Family and Community Medicine, patients with polypharmacy were evidenced with a lower risk of inappropriate prescribing and therefore less probability of adverse effects and poor quality of life.
Downloads
References
2. Cano-Gutierrez C, Samper-Ternent R, Cabrera J, Rosselli D. Uso de Medicamentos en Adultos mayores de Bogotá, Colombia. 2016;33(3):1–6.
3. Koronkowski M, Eisenhower C, Marcum Z. An Update on Geriatric Medication Safety and Challenges Specific to the Care of Older Adults HHS Public Access Anticholinergics: Cognitive Impairment and Incident Dementia Background. Ann Longterm Care. 2016;24(3):37–40.
4. INEC. Instituto Nacional de Estadisticas y [Internet]. CENSO del 2010. 2010. p. 1112. Available from: http://www.ecuadorencifras.gob.ec/censo-de-poblacion-y-vivienda/.
5. Organización Panamericana de la Salud. La salud de los adultos mayores: una visión compartida. Bibl Sede OPS [Internet]. 2010;293. Available from: http://www.paho.org/blogs/paltex/wp-content/uploads/2013/06/SaludDeLosAdultosMayores_preliminares.pdf
6. Löffler C, Drewelow E, Paschka SD, Frankenstein M, Eger J, Jatsch L, et al. Optimizing polypharmacy among elderly hospital patients with chronic diseases--study protocol of the cluster randomized controlled POLITE-RCT trial. Implement Sci [Internet]. 2014;9:151. Available
7. Langeard A, Pothier K, Morello R, Lelong-Boulouard V, Lescure P, Bocca M-L, et al. Polypharmacy Cut-Off for Gait and Cognitive Impairments. Front Pharmacol [Internet]. 2016;7(August):1–6. Available from: http://journal.frontiersin.org/Article/10.3389/fphar.2016.00296/abstract
8. Vald XW. Polifarmacia. PSCV. 2015;1(6):15–35.
9. Espinoza I, Osorio P, Torrejón MJ, Lucas-Carrasco R, Bunout D. Validación del cuestionario de calidad de vida (WHOQOL-BREF) en adultos mayores chilenos. Rev Med Chile [Internet]. 2011;579–86. Available from: http://www.scielo.cl/pdf/rmc/v139n5/art03.pdf
10. Nordin Olsson I, Runnamo R, Engfeldt P. Medication quality and quality of life in the elderly, a cohort study. Health Qual Life Outcomes [Internet]. 2011;9(1):95. Available from: http://www.hqlo.com/content/9/1/95
11. Diz-Lois F, Fernández O. El paciente polimedicado. Galicia Clin. 2012;73(S1):S37–41.
12. Sabzwari SR, Qidwai W, Bhanji S. Polypharmacy in elderly: A cautious trail to tread. J Pak Med Assoc. 2013;63(5):624–7.
13. Rebollo AG, Gómez D. Mejora de la Adhesión Terapéutica en el paciente Polimedicado. 2015;
14. Ecuador M de S publica del. Registro Diario de Atenciones y Consultas Ambulatorias, Vacunaciones y Odontológicas, definiciones, e indicadores de salud. Quito: REDACA; 2015. p. 1000.
15. Kouladjian L, Chen TF, Gnjidic D, Hilmer SN. Education and assessment of pharmacists on the use of the drug burden index in older adults using a continuing professional development education method. Am J Pharm Educ. 2016;80(4).
16. Sánchez-Gutiérrez R, Flores-García A, Pedro Aguiar-García P, Ruiz-Bernés S, Sánchez-Beltran CA, Benítez-Guerrero V, et al. Efectos de la Polifarmacia sobre la calidad de vida en adultos mayores. Rev Fuente [Internet]. 2012;4(10):70–5. Available from: http://fuente.uan.edu.mx/publicaciones/04-10/4.pdf
17. Suay A, Ortega M, Mendo O, Simó MD. Anciano fragil. :43.
18. Soler PA. Detección y manejo de la fragilidad en Atención Primaria ; actualización . 2012;1–18.
19. Nicieza-García ML, Salgueiro-Vázquez ME, José F, Manso G. Optimización de la información sobre la medicación de personas polimedicadas en atención primaria. Gac Sanit. 2016;30(1):69–72.
20. Urzúa A. Calidad de vida: Una revisión teórica del concepto Quality of life: A theoretical review. Ter PSICOLÓgICA. 2012;30(1):718–4808.
21. CEPAL. Las personas mayores en América Latina y el Caribe. Nac Unidas CEPAL. 2003.
22. Chan DD, Tsou H, Chang C, Yang R, Tsauo J, Chen C, et al. Integrated care for geriatric frailty and sarcopenia : a randomized control trial. 2016;(October 2015).
23. Dr. Felipe Salech M., Dr. Rafael Jara L. PLM a. CAMBIOS FISIOLÓGICOS Physiological changes associated with normal aging. Rev Med Clin Mondes [Internet]. 2012;23(1):19–29. Available from: http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90361755&pident_usuario=0&pcontactid=&pident_revista=202&ty=54&accion=L&origen=zonadelectura&web=www.elsevier.es&lan=es&fichero=202v23n01a90361755pdf001.pdf
24. Abizanda P. Medicina geriátrica: Una aproximación basada en problemas. Medicina. Barcelona: Elvieser; 2012. 423 p.
25. Walters W. Prioridades en materia de Politicas públicas para los adultos mayores en el Ecuador. Quito; 2014.
26. Graciela MAF, Ascar I, Cristina MAF, Hespe B, Mercedes FM. Relación entre polifarmacia y número de médicos consultados por pacientes ancianos Relationship between polypharmacy and number of specialists consulted by elderly patients. 2015;49(3):491–501.
Copyright (c) 2017 Rural Family Practice
This work is licensed under a Creative Commons Attribution 4.0 International License.
