Abstract
The need for specific care, coupled with new family arrangements, has contributed to the increasing institutionalization of elderly members. The purpose of this study was to evaluate drug use by institutionalized older adults according to Beers Criteria. This prospective, longitudinal study was conducted in the three non-profit long-stay geriatric care institutions of Campo Grande, in the Central-West region of Brazil. All subjects aged 60 years and above on November 2011 were included and followed until November 2012. Eighteen subjects were excluded and the final sample consisted of 133 individuals aged 60 to 113 years. Overall, 212 medications were used at geriatric care institution A, 532 at B, and 1329 at C. Thirty-four drugs were inappropriately prescribed 89 times at geriatric care institution A (41.98%), 49 prescribed 177 times at B (33.27%), and 91 prescribed 461 times at C (34.68%). Statistical differences in the inappropriate drug use were found between genders (p=0.007). The most commonly used potentially inappropriate medication were first-generation antihistamines (15.34%). There was a high frequency in the use of potentially inappropriate medications which can initiate marked side effects and may compromise the fragile health of institutionalized elderly. Thus, adopting the Beers Criteria in prescribing medication contributes to minimize adverse reactions and drug interactions.
Highlights
Older adults have unique medication requirements as organ functions are reduced by age-related physiological changes
Non-profit long-stay geriatric care institutions are residential nursing homes for individuals of 60 years and over who have some degree of difficulty in performing daily activities and for those whose families lack the financial, physical, or emotional resources to provide them with the necessary care (ANVISA, 2005)
Data was collected weekly from the subjects’ medical records; the variables investigated were gender, age, number of prescribed drugs and identification of their active principles, and PIM occurrence according to the Beers Criteria (Fick et al, 2012), (a) potentially inappropriate medications for use in older adults independent of diagnoses or conditions, (b) potentially inappropriate medications for use in older adults considering diagnoses and conditions, and (c) medications that, potentially inappropriate to older adults, can be used with caution
Summary
Older adults have unique medication requirements as organ functions are reduced by age-related physiological changes. These changes affect the pharmacokinetics and pharmacodynamics of drugs, making it difficult to draw a clear-cut line between risks and benefits of their use in this population (Mangoni, Jackson, 2003; Baldoni et al, 2010). Biotransformation can be affected by hepatic blood flow, which can be reduced by as much as half in the elderly This results in reduced first pass metabolism and increased bioavailability of drugs (Mangoni, Jackson, 2003). One example is diazepam, which has a half-life of 24 hours in younger patients and 90 hours in elderly patients (Mangoni, Jackson, 2003)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
