Relevância clínica das potenciais interações medicamentosas em idosos institucionalizados

Abstract

The number of institutionalized people has grown in recent times due to several factors, whether personal, economic, social or the sum of both, however, advanced age, cognitive and functional decline and the condition of multimorbidity are factors that influence institutionalization, among these is the use of polypharmacy. The elderly are vulnerable to adverse drug-related events, including drug interactions. The general objective of this study was to classify the potential drug interactions in institutionalized elderly people using antihypertensive drugs according to the severity and type of interaction, in addition to the specific objectives, which are: I. To verify the prevalence of potential drug interactions according to severity and type of interaction. II. Describe the type and mechanism of potential clinically relevant drug interactions between the most prescribed drugs. Cross-sectional study carried out with individuals aged 60 years or over, of both sexes, residing in Long Stay Institutions for the Elderly (ILPI) in municipalities in southern Brazil. The total population residing in these institutions was 479 elderly people. Data collection was carried out through a structured questionnaire, covering sociodemographic variables, variables related to health in general and medications used. For this study, the database was consulted and individuals using antihypertensive drugs were selected. The severity of potential drug interactions, the level of documentation/scientific evidence and the mechanism of action involved were defined according to the Drug-Reax® System software, developed by Thomson MicromedexTM and accessed on the Capes journal portal. The study included 257 institutionalized elderly people who used antihypertensive drugs, most of whom were long-lived, female, widowed, educated and with multimorbidity. The most prevalent health problems were urinary and fecal incontinence and dementia. The study points out the distribution of potential drug interactions according to severity, being, Major 87.1%; Moderate 82.8%; Lower 21.1%. Contraindicated 3,4 Of the prescriptions analyzed for 257 institutionalized elderly people who use antihypertensive drugs, 232 (90.3%) of the elderly had at least one DI. It can also be observed that in relation to polypharmacy, it was identified that among the prescriptions evaluated, 83.7% of them had polypharmacy and 66.9% had excessive polypharmacy. Therefore, it is necessary for the health team to know the potential for seriousness of interactions, in the medications in use, so as not to compromise patient safety, and many of them can be monitored and avoided.