评估在特殊制度机构中对老年人群的药物治疗使用老年人潜在不适当处方(停止)标准筛选工具

E. AnaMaríaHerrera, G. JoséJuliánLópez
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引用次数: 2

摘要

背景:老年患者是适当处方的主要挑战,因为他们的重要部位发生了重大变化,多种合并症等因素助长了他们的脆弱性。根据目前的证据,处方错误的数量随着年龄和使用药物的数量而增加,表明65岁以上的人在使用8种以上药物时发生医疗错误的风险更大。目的:根据老年人潜在不适当处方筛查工具(STOPP)评估方法的应用结果,识别和描述老年人不适当药物,以提出机构处方指南。方法:采用横断面观察性研究,回顾性收集资料,对300例65岁以上、使用5种以上药物并应用STOPP标准的老年患者进行处方不当频次调查。这项研究是在一个特殊制度医疗机构进行的,审查了医疗记录,并考虑了诸如药物数量、适应症、剂量、治疗重复、相互作用和禁忌症等变量。结果:主要诊断为高血压(47%),其次为糖尿病(10%)和其他甲状腺功能减退(4%)。将STOPP标准应用于每个病历后,发现50.7%(152)的研究人群至少有1个不适当处方,分布如下:2个STOPP标准,7个STOPP标准,28个STOPP标准,115个STOPP标准。结论:半数处方存在至少一项处方标准不足的情况,其中最主要的是无指征或无指征用药不当。最后,提出了老年人合理用药的指导方针,并对该制度的每一个细节进行了阐述。
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EVALUATION OF PHARMACOTHERAPY USED ON GERIATRIC POPULATION IN AN INSTITUTION OF SPECIAL REGIME WITH THE SCREENING TOOL OF OLDER PERSONS’ POTENTIALLY INAPPROPRIATE PRESCRIPTIONS (STOPP) CRITERIA
Background: Geriatric patients represent a major challenge for appropriate prescription because they have significant changes in vital areas, multiple comorbidities among other things that encourage their fragility. In light of current evidence, the number of prescription errors increases with age and with the number of drugs USED, showing that people over 65 is at greater risk of medical error when more than 8 drugs are consumed. Objectives: To identify and describe the inappropriate medicines in elderly people in order to propose an institutional prescription guide based on the results of the application of the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) assessment methodology. Methods: A cross-section observational study with a retrospective collection of information was carried out in order to identify the frequency of inappropriate prescriptions in 300 elderly patients that were over 65 years, with a consumption of more than 5 medications and applying the STOPP criteria. The study was made in a special regime medical institution, reviewing medical records and considering variables such as number of medications, indications, dosage, therapeutic duplication, interactions and contraindications, among others. Results: The principal diagnosis was hipertension (47%) followed by diabetes mellitus (10%) and other hypothyroidisms (4%).After applying the STOPP criteria to each of the medical records, it was found that 50.7% (152) of the studied population had at least one inappropriate prescription distributed as follows: 2 prescriptions had 4 STOPP criteria, 7 prescriptions had 3 STOPP criteria, 28 had 2 STOPP criteria and 115 had 1 STOPP criteria. Conclusions: It was found that half of the prescriptions have at least one inadequate prescribed criteria, being the most important the inappropriate use of not indicated drugs or without an indication. Finally, guidelines for the rational use of drugs in the elderly with every detail of this institution are proposed.
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