Medicamentos potencialmente inapropriados para idosos atendidos na atenção primária

Abstract

To describe the prevalence of prescribing Potentially Inappropriate Medications (PIMs) and associated factors among older adults attending Primary Health Care. Methods: A cross-sectional study was conducted in Marau, Rio Grande do Sul, with older adults receiving care in Primary Health Care in the year 2019. Data were collected from electronic medical records and included sociodemographic, health, and behavioral characteristics. The collected variables were gender, age, education, alcohol consumption, tobacco use, physical activity, ethnicity, nutritional status, employment status, and associated comorbidities. The prevalence of prescribing PIMs (dependent variable) with a 95% confidence interval (CI95) was quantitatively calculated from these variables. Additionally, the distribution of PIM prescribing prevalence according to exposure variables (independent) was assessed using the chi-square test, considering a type I error of 5%. The Beers Criteria list was used to categorize PIMs, classifying those either currently using any PIMs or receiving prescriptions during the consultation documented in the questionnaire as being on PIMs. Results: In the sample analyzed (n=1,727), a prevalence of PIM prescribing of 45.3% (CI 43-48) was found, with statistically significant relations observed concerning gender (51.9%; p<0.001), skin color (42.6%; p<0.014), and presence of comorbidities (p<0.001) such as hypertension (49.4%), diabetes mellitus (53.3%), and mental health conditions (40.6%). Other analyzed variables did not exhibit significantly relevant associations. Conclusion: The prevalence of prescribing PIMs is high among older adults, particularly among women, individuals of white ethnicity, and those with associated comorbidities. Hence, it is essential for healthcare professionals to be knowledgeable about these medications and assess their necessity or potential substitution with less harmful alternatives. Studies on this subject can enhance Primary Health Care, thereby improving treatment and the quality of life of older adults.