Reação adversa a medicamentos como fator contribuinte para a internação hospitalar de idosos

Abstract

The increase in life expectancy and population aging are associated with a higher prevalence of chronic diseases and an increase in the number of drugs used. In this context, the occurrence of adverse drug reactions (ADR) in the elderly people is greater than the other individuals due to the vulnerability of their organism. Goals: To describe the occurrence of ADR related to home pharmacotherapy contributing to hospitalization for the elderly population. Methods: This is a Cross-sectional study involving patients older than 60 years old. The dependent variable was the occurrence of ADR related to drugs used at home. The ADRs were identified by analyzing the medical evolutions and laboratory examination results recorded in the medical record. Causality of ADR was verified employing the Naranjo algorithm. Results: The study included 183 elderly people, 22 of them (12%) had at least one ADR related to drugs used at home. There were 26 ADR identified, the most frequent were digitalis intoxication (n =4; 15.4%), raising the RNI (n = 2; 7.7%) and bradycardia (n = 2; 7.7%). The main drugs related to ADR were digoxin (n = 4), warfarin (n = 4) and amiodarone (n = 3). Regarding the causality, there were 21 (80.7%) of the ADR as probable and 5 (19.3%) as possible. Univariate analysis showed a statistically significant association with polypharmacy (OR: 3.05; IC95% 1.14-8.1; p= 0.021). Conclusions: The occurrence of ADR was positively associated with polypharmacy and it is an important issue for the health of the elderly population and should contribute to hospitalization.