Abstract
ABSTRACT Objective: to identify the drug interactions among institutionalized elderly. Method: retrospective and documentary study with a quantitative approach developed in two Long Stay Institutions for Elderly, located in northeastern Brazil. Drug interactions were identified by using Drug-Reax® software from the Micromedex database, and they were classified by severity, start time, and documentation. Result: in the 286 analyzed prescriptions, 136 drug interactions were detected in both institutions, most of them classified as severe. The average number of drugs prescribed by the elderly was 4.5. In the analysis of Pearson's correlation, the number of drug interactions showed a statistically significant correlation with the time of institutionalization and with the amount of drugs administered on the day. Conclusion and implications for practice: the high consumption of drugs and serious drug interactions detected with significant clinical repercussions was evidenced in the study. Knowledge of these interactions is essential for the establishment of preventive safety measures in pharmacotherapy.
Highlights
The Brazilian demographic transition, resulting from the fecundity and mortality reduction rates, has implied the increase in the number of the elderly over the last years
It is estimated that 35 to 60% of elderly patients are exposed to potential drug interaction, of which, 5 to 10% evolve towards serious adverse reaction, that is, harmful and unpleasant reaction, resulting from intervention related to the use of drug.[4]
The number of drugs obtained is high when compared with a study carried out in the South region of Brazil, that had an average of 3.7 drugs/elderly and lower when compared with the results found in a Long Stay Institutions for Elderly (LSIE) of the Southeast region, which obtained an average of 7 drugs used by elderly.[19,20]
Summary
The Brazilian demographic transition, resulting from the fecundity and mortality reduction rates, has implied the increase in the number of the elderly over the last years. This ageing process is marked by chronic diseases, such as dyslipidemia, hypertension, diabetes and depression, by passing on the increase in the pharmaceuticals consumption, a condition known as polypharmacy.[1]. It is estimated that 35 to 60% of elderly patients are exposed to potential drug interaction, of which, 5 to 10% evolve towards serious adverse reaction, that is, harmful and unpleasant reaction, resulting from intervention related to the use of drug.[4] These adverse reactions may predispose elderly to the occurrence of adverse events, such as falls, fractures, post-surgery confusion, gastrointestinal bleedings, constipation, worsening of congestive heart failure condition, depression, cognitive deficit and renal dysfunction.[5]
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