Profile of Prescription Medication in an Internal Medicine Ward

Carla Perpétuo,Jorge Aperta,Fátima Roque,Ana I Plácido,Maria Teresa Herdeiro

doi:10.3390/healthcare9060704

Carla Perpétuo, Jorge Aperta + Show 3 more

Open Access

https://doi.org/10.3390/healthcare9060704

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Abstract

Aging-related loss of resilience associated with the lack of evidence regarding the therapeutic efficacy of medicines can prompt a lack of efficacy of treatments and multiple prescriptions. This work aims to characterize the medication profile of Portuguese older adult inpatients and explore the relationship between hospitalization days and the consumption of medicines. A retrospective data analysis study in older patients who were admitted to a medical internal medicine ward during 2019. The median age of the 616 patients included was 85 years. During the hospitalized period, patients took on average 18.08 medicines. The most prescribed drugs belong to the subgroup of (a) anti-thrombotic agents (6.7%), with enoxaparin being the most prescribed, (b) other analgesics and antipyretics (6.6%), paracetamol being the most frequent, and (c) the Angiotensin Conversion Enzyme Inhibitor (ACE) (6.5%), captopril being the most frequent. The high number of prescriptions in older adults during their hospitalization suggests the need of changing therapeutics to achieve a better efficacy of treatment, which corroborates the hypothesis that the lack of scientific evidence concerning the risk/benefits of many medical therapies in older adults can make it difficult to achieve good clinical outcomes and promote the wastage of health resources.

Highlights

This study analyzed the medication profile of Portuguese inpatients at an internal medicine service and concluded that during hospitalization, the inpatients consumed a high number of medicines, suggesting that the high frailly of older adults associated with the lack of prescription guidelines for older adults made it difficult to achieve clinical outcomes and increased the time of hospitalization
The high average age of the participants included in this study is not surprising, since according to Eurostat, Portuguese have an average life expectancy of 81.5, which is higher than the mean of 27 European Union countries (81.0)
The increase in life expectancy is not accompanied by health quality; only 9% of Portuguese older adults are considered healthy, which is a lower number when compared with Austria

Summary

Introduction

Aging is characterized by progressive alterations in psychological, biological (with drug pharmacodynamics and pharmacokinetics alterations), and even social functions and greater susceptibility to disease [3]. Such alterations can cause a decrease in the ability to recover from unhealthy conditions and can increase the consumption of health resources, which includes medicines [4,5]. Pharmacotherapy can improve quality of life, cure, prevent, or relieve symptoms, but in the older population, special care must be taken with the occurrence of adverse drug reactions (ADR) [7]. Sometimes, prescription can occur without adequate clinical data, which can compromise clinical outcomes and the well-being of the patients [8,9]

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