Prescrição inapropriada de medicamentos a idosos: análise dos critérios publicados de 2011 a 2016

Abstract

Background: The prescription to identify potentially inappropriate medications (PIM) for the elderly is a major problem in geriatric pharmacotherapy. Objective: To identify PIM prescribing criteria for older adults published in the last five years. Methods: The bibliographic research was performed in the Medline database. Inclusion criteria were articles published in the period from 2011 to 2016 that addressed the development and/or updating of PIM lists for the elderly. The selected publications were analyzed for the type of criterion, the method used in the development, origin and study scenario. Regarding the structure and content of the criteria, we verified the availability of information on inadequate dose, duration of pharmacotherapy, duplication, interactions, alternative pharmacotherapeutic and deprescription. Results: A total of 12 were identified PIM prescribing criteria, and three criteria refer to the update of previous versions. In Europe, 9 (75.0%) criteria were elaborated. It was evidenced that 10 (83.3%) were explicit criteria, developed by the Delphi method and intended for the elderly with age ≥ 65 years old. Among the parameters included in the PIM criteria, the inadequate dose approach was the most frequent, followed by information on the duration of pharmacotherapy, drug-drug interactions. The STOPP and Beers 2015 criteria responded in greater proportion to the parameters of quality of prescription analyzed. Conclusions: The number of explicit and implicit guiding criteria for the prescription of drugs in the elderly population, developed and updated were significant in the period studied. The prescribing parameters that compose the different criteria present heterogeneity