Potentially inappropriate medication on communitydwelling older adults: Longitudinal analysis using the International Mobility in Aging Study.

Edison Pineda, Alejandra Fernández, Carmen Lucía Curcio, Juliana Fernandes de Souza, Afshin Vafaei, José Fernando Gómez
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Abstract

Introduction: Medications are a fundamental part of the treatment of multiple pathologies. However, despite their benefits, some are considered potentially inappropriate medications for older people given their safety profile. Epidemiological data differences related to potentially inappropriate medications make it difficult to determine their effects on elderly people.

Objective: To estimate the prevalence and types of potentially inappropriate medications using the 2019 Beers Criteria® in a cohort of adults older than 65 years.

Materials and methods: We performed an observational, multicenter, retrospective, longitudinal study of a four-year follow-up of potentially inappropriate medications in community-dwelling older adults.

Results: We followed 820 participants from five cities for four years (2012-2016) and evaluated them in three different moments (m1 = 2012, m2 = 2014, and m3 = 2016). The average age was 69.07 years, and 50.9% were women. The potentially inappropriate medication prevalence in the participants was 40.24%. The potentially inappropriate medications' mean among the studied subjects in the first moment was 1.65 (SD = 0.963), in the second was 1.73 (SD = 1.032), and in the third was 1.62 (SD = 0.915). There were no statistical differences between measurements (Friedman test, value = 0.204). The most frequent potentially inappropriate medications categories were gastrointestinal (39.4%), analgesics (18.8%), delirium-related drugs (15.4%), benzodiazepines (15.2%), and cardiovascular (14.2%).

Conclusions: About half of the population of the community-dwelling older adults had prescriptions of potentially inappropriate medications in a sustained manner and without significant variability over time. Mainly potentially inappropriate medications were gastrointestinal and cardiovascular drugs, analgesics, delirium-related drugs, and benzodiazepines.

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对居住在社区的老年人的潜在不当用药:利用国际老龄流动性研究进行纵向分析。
引言药物是治疗多种疾病的基本要素。然而,尽管药物有其益处,但鉴于其安全性,有些药物被认为可能不适合老年人使用。由于潜在不适当药物的流行病学数据存在差异,因此很难确定其对老年人的影响:使用 2019 Beers Criteria® 估计 65 岁以上成年人队列中潜在不适当药物的流行率和类型:我们对居住在社区的老年人的潜在用药不当情况进行了为期四年的观察性、多中心、回顾性、纵向研究:我们对来自五个城市的 820 名参与者进行了为期四年(2012-2016 年)的随访,并在三个不同的时间段(m1 = 2012 年、m2 = 2014 年和 m3 = 2016 年)对他们进行了评估。参与者的平均年龄为 69.07 岁,50.9% 为女性。参与者的潜在用药不当率为 40.24%。研究对象的潜在不当用药平均值在第一时刻为 1.65(SD = 0.963),第二时刻为 1.73(SD = 1.032),第三时刻为 1.62(SD = 0.915)。不同测量之间没有统计学差异(Friedman 检验,值 = 0.204)。最常见的潜在不当药物类别是胃肠道药物(39.4%)、镇痛药(18.8%)、谵妄相关药物(15.4%)、苯二氮卓类药物(15.2%)和心血管药物(14.2%):在社区居住的老年人中,约有一半的人持续开具潜在的不适当药物处方,且随着时间的推移变化不大。可能不适当的药物主要是胃肠道和心血管药物、镇痛药、谵妄相关药物和苯二氮卓类药物。
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