Polypharmacy and potentially inappropriate medication in elderly of Northern Portugal
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Introduction
The growing aging of population and increasing prevalence of chronic diseases require the simultaneous use of drugs, lead to the issue of polypharmacy and potentially interactions and inappropriate use.
Aim
To characterize polymedicated elderly and related factors, identify potentially interactions and inappropriate medication in elderly.
Material and Methods
This cross-sectional study was based on a questionnaire applied to 69 elderly (≥65 years) from northern Portugal. It was considered as polymedicated seniors taking ≥5 drugs. Beers list and the Delafuente classification were used to evaluate the therapeutic and possible interactions. It was used descriptive statistics and a model of binary regression, with a significance of 5%. The study was approved by Ethics Committee.
Results
The sample consisted mainly of males (53.6% vs. 46.4%), aged between 66 and 99 years (mean 82.01), while 65.2% have more than 80 years. However, most elderly are not polymedicated (58%), on average 4.61 different drugs are administered per day (maximum=19), antihypertensives (36.2%) and antacids (30.04%) are the most prescribed. Hypertension and depression increase the risk of polymedication eightfold (P = 0.004) and fivefold (P = 0.011) respectively. Female gender seems increase the risk of polypharmacy threefold, although not statistically significant (P = 0.102), and regarding age, the older age group (>85 years) seems reduces the risk of polypharmacy in 0.6 fold, but also not statistically significant. According with Delafuente classification, 1.4% of elderly has potentially drug interactions (Omeprazole and Iron salts). According to the list of Beers, 5.8% of seniors take drugs that classified as having some indications (hydroxyzine, amitriptyline).
Conclusions
Regarding polypharmacy, 42% of elderly are polymedicated with an average of about 5 different drugs per day, antihypertensives and antacids the most prescribed. Hypertension and depression are highly associated with polypharmacy. We identified one potentially drug interaction and about 6% of elderly taking drugs that classified as having some indications.
Introduction: The growing aging of population and increasing prevalence of chronic diseases require the simultaneous use of drugs, lead to the issue of polypharmacy and potentially interactions and inappropriate use. Aim: To characterize polymedicated elderly and related factors, identify potentially interactions and inappropriate medication in elderly.
Material and Methods: This cross-sectional study was based on a questionnaire applied to 69 elderly (≥65 years) from northern Portugal. It was considered as polymedicated seniors taking ≥5 drugs. Beers list and the Delafuente classification were used to evaluate the therapeutic and possible interactions. It was used descriptive statistics and a model of binary regression, with a significance of 5%. The study was approved by Ethics Committee.
Results: The sample consisted mainly of males (53.6% vs. 46.4%), aged between 66 and 99 years (mean 82.01), while 65.2% have more than 80 years. However, most elderly are not polymedicated (58%), on average 4.61 different drugs are administered per day (maximum=19), antihypertensives (36.2%) and antacids (30.04%) are the most prescribed. Hypertension and depression increase the risk of polymedication eightfold (p=0.004) and fivefold (p=0.011) respectively. Female gender seems increase the risk of polypharmacy threefold, although not statistically significant (p=0.102), and regarding age, the older age group (>85 years) seems reduces the risk of polypharmacy in 0.6 fold, but also not statistically significant. According with Delafuente classification, 1.4% of elderly has potentially drug interactions (Omeprazole and Iron salts). According to the list of Beers, 5.8% of seniors take drugs that classified as having some indications (hydroxyzine, amitriptyline).
Conclusions: Regarding polypharmacy, 42% of elderly are polymedicated with an average of about 5 different drugs per day, antihypertensives and antacids the most prescribed. Hypertension and depression are highly associated with polypharmacy. We identified one potentially drug interaction and about 6% of elderly taking drugs that classified as having some indications.
The elderly population has been growing significantly, leading to an increased prevalence of chronic diseases and consequent taking medication. The complex therapies of elderly can lead to therapy non-adherence, increasing several health risks.
Aim
This study aimed to estimate the prevalence of therapy adherence and associated factors.
Material and Methods
This cross-sectional study was based on a questionnaire, with MAT scale (measure of adherence to therapy) validated for the Portuguese population (Lima, 2001) based on the Morisky scale, applied to 52 elderly (≥65 years) from northern Portugal. To assess therapy adherence, those whose average adherence levels were ≥5, were called adherent. It was used descriptive statistics. The level of association between categories of variables was studied through the adjusted residuals (AdR) and the relationship between adherence to the therapeutic and the number of medications taken per day was studied using the Mann-Whitney U test, with a significance level of 5%. The study was approved by Ethics Committee.
Results
The sample consisted mainly of males elderly (61.5% vs. 38.5%), aged between 67 and 98 years (mean 82.71), and while 48.1% was between 75–84 years old. The participants shows high therapy adherence (96.2%). The non-adherent elderly are related to self-medication (AdR=4.3), with the high level of cholesterol (AdR=2.9) and chronic pain (AdR=2.9). The non-adherent elderly seem tend to take more drugs per day, although not statistically significant (P = 0.063).
Conclusions
This study shows that a large prevalence of elderly adhered to the therapy prescribed. Self-medication, having high cholesterol and chronic pain and higher number of different drugs per day seem related to non-adherence.
The elderly population has been growing significantly, leading to an increased prevalence of chronic diseases and consequent taking medication. The complex therapies of elderly can lead to therapy non-adherence, increasing several health risks. Aim: This study aimed to estimate the prevalence of therapy adherence and associated factors.
Material and Methods: This cross-sectional study was based on a questionnaire, with MAT scale (measure of adherence to therapy) validated for the Portuguese population (Delgado & Lima, 2001) adapted from other scales (Morisky, 1986; Ramalhinho, 1994; Shea, 1992), applied to 52 elderly (≥65 years) from northern Portugal. To assess therapy adherence, those whose average adherence levels were ≥5, were called adherent. It was used descriptive statistics. The level of association between categories of variables was studied through the adjusted residuals (AdR) and the relationship between adherence to the therapeutic and the number of medications taken per day was studied using the Mann-Whitney U test, with a significance level of 5%. The study was approved by Ethics Committee.
Results: The sample consisted mainly of males elderly (61.5% vs. 38.5%), aged between 67 and 98 years (mean 82.71), and while 48.1% was between 75-84 years old. The participants shows high therapy adherence (96.2%). The non-adherent elderly are related to self-medication (AdR=4.3), with the high level of cholesterol (AdR=2.9) and chronic pain (AdR=2.9). The non-adherent elderly seem tend to take more drugs per day, although not statistically significant (p=0.063).
Conclusions: This study shows that a large prevalence of elderly adhered to the therapy prescribed. Self-medication, having high cholesterol and chronic pain and higher number of different drugs per day seem related to non-adherence.
