Fatores associados à utilização de medicamentos potencialmente inapropriados por idosos da atenção primária à saúde em Belo Horizonte - Minas Gerais

Abstract

As a consequence of the increasing rate of elderly population, there is the growing prevalence of individuals with multiple comorbidities that require one or more pharmacological interventions. The drugs assume the prime role in the elderly care. However, some of these drugs do not prove effectiveness or present more risks than benefits when used in Geriatrics and are considered Potentially Inappropriate Medications for the Elderly (PIM). The use PIM is linked to poor health outcomes and can be considered an important public health problem. Considering that the primary health care has the role to solve the major part of these health problems in the population, it is important to perform studies in this level of health care, identifying the magnitude of the use of PIM and the factors associated with their use. In this manner, this work aims to analyze the factors associated with the use of PIM by the elderly in two primary health care centers in Belo Horizonte, Minas Gerais, Brazil, and to investigate the agreement of PIM use frequency using the 2015 American Geriatric Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults - 2015 AGS Beers Criteria, the Brazilian consensus on potentially inappropriate medication for elderly (BCPIM) and the European union list of potentially inappropriate medications - EU(7)-PIM List. The study design is an analytical cross-sectional study with data collection by face-to-face interviews, search in prescriptions, medical records, and in the computer system of the pharmacy. The association between PIM use and independent variables was assessed by multiple logistic regression. The level of agreement of PIM use among the three criteria was measured with the Cohens kappa coefficient. A total of 227 patients 60 years of age were included in the study and the frequency of PIM use was high (53.7% for 2015 AGS Beers, 55.9% for BCPIM and 63.4% for the EU(7)-PIM List). The agreement between 2015 AGS Beers and BCPIM (Kappa=0,96 p=0.000) and between this and the EU(7)-PIM List (Kappa=0,75 p=0.000) was high, and moderate between the 2015 AGS Beers and the EU(7)-PIM List (kappa=0,73 p=0.000). Logistic regression showed association of PIM use with polypharmacy, self-reported neuropsychiatric and musculoskeletal diseases, age 70 years, preserved cognition and negative self-perception of health. The results point to the need to Strategies for improving the pharmacotherapy of the elderly in primary health Care.