Consumo de medicamentos en mayores de 65 años en Oporto (Portugal) y riesgo de prescripción de medicamentos potencialmente inapropiados

Abstract

Objetivo: Conocer el consumo de medicamentos entre los mayores de un área de Oporto, determinar la prevalencia de la prescripción de medicamentos potencialmente inapropiados y analizar su asociación con la polimedicación y otros factores. Dise˜no: Estudio observacional transversal de base poblacional. Emplazamiento: Unidade de Saúde Familiar Rainha D. Amélia, Centro histórico de Oporto (Por- tugal). Participantes: Muestra de 747 personas representativa de la población de 65 a˜nos y más del área de referencia. Mediciones principales: Identificación de todos los medicamentos prescritos utilizando los registros electrónicos disponibles. Se definió polimedicación como el tratamiento simultáneo con 5 o más medicamentos, y medicación potencialmente inapropiada (MPI) como el uso de medicamentos considerados inadecuados según los criterios de Beers 2012. Se recogieron datos sociodemográficos, de diagnóstico y de utilización de servicios. Se utilizó la regresión logística para analizar la asociación de las distintas covariables con el uso de MPI. Resultados: El 89,2% (IC 95%: 87,6-92,0) de la población de estudio tenían prescrito, al menos, un medicamento. El 59,2% (IC 95%: 55,7-62,7) estaban polimedicados. El 37,0% (IC 95%: 33,5- 40,5) consumían MPI. La prescripción de MPI se asocia a mayor edad (OR = 1,02 [IC 95%: 1,00- 1,05]), polimedicación (OR = 4,45 [IC 95%: 3,12-6,36]), depresión/ansiedad (OR = 2,18 [IC 95%: 1,36-3,51]) y artrosis (OR = 1,64 [IC 95%: 1,11-2,42])

Objective: To determine medication consumption in the older people from a central area ofOporto; determine the prevalence of prescription of Potentially Inappropriate Medication andto analyse the polypharmacy and other important connected factors.Design, setting and patients: Cross-sectional study with a sample of 747 patients older than64 years, who were attended in a Primary care health centre: USF Rainha D. Amélia, Oporto,Portugal.Main outcome measures: identification of all medication prescribed from electronic registers.Polypharmacy was considered more than 5 medication prescribed and Potential InappropriateMedication was identified by Beers criteria 2012. The socio-demographic factors, diagnosis andhealth care services use were registered too. Logistic regression analysis was used to determinethe association between co-variables.Results: There were 89.2% (95% CI: 87.6-92.0) of the studied population with at least one pres-cription. The polypharmacy was present at 59.2% (95% CI: 55.7-62.7) of people. The PotentialInappropriate Medication was present in 37.0% (95% CI: 33.5-40.5) of the cases. The PotentialInappropriate Medication was related with increasing age [OR = 1.02 (95% CI: 1.00-1.05)], polyp-harmacy [OR = 4.45 (95% CI: 3.12-6.36)], and be diagnosed with depression/anxiety [OR = 2.18(95% CI: 1.36-3.51)] and/or arthrosis [OR = 1.64 (95% CI: 1.11-2.42)].Conclusion: The rate of medication prescription, polypharmacy and the prescription ofPotentially Inappropriate Medication are very high in Portuguese population studied. The polyp-harmacy is the most important factor related with this potential inappropriate medication. Thephysician need to have carefully with prescription of the anxiolytic and anti-inflammatory paindrugs.