Critérios de Avaliação da Prescrição de Medicamentos Potencialmente Inapropriados no Doente Geriátrico: Comparação de Resultados Práticos

Abstract

Background: There are several criteria to evaluate the prescription of potentially inappropriate medicines (MPI) for elderly patients. Beers criteria are the most frequently used tool but to the same group of patients, there are few comparative studies to evaluate MPI. Aims: To compare the frequency of potentially inappropriate prescribing using several explicit criteria: Zhan, McLeod, HEDIS 2006 and Beers. Methods: Cross sectional study, involving elderly patients from Lisbon region recruited in 15 pharmacies. Medicines were evaluated by 4 explicit criteria: Zhan, McLeod, 2006 HEDIS and 2003 Beers (2008 Portuguese operationalization). It was performed a descriptive analysis of frequencies with central dispersion. Results: 570 patients, with mean age of 74.1 years old (SD=6.4), were enrolled, with 71.7% of which being female. Studied patients were taking a total of 3,021 medicines that were analyzed. By Beers criteria, 37.0% of patients used, at least, one MPI being inappropriate, 9.5% of all of the medicines; by Zhan criteria, 12.8% of the patients were taking, at least, one MPI being inappropriate, 2.8% of the studied medicines; by McLeod criteria, 14.9% of the patients were taking, at least, one MPI, being inappropriate 3.1% of the medicines and by HEDIS 2006 criteria, 13.5% of the patients were taking, at least, one MPI, being inappropriate 2.8% of the medicines. Conclusions: 2003 Beers criteria (2008 Portuguese operationalization) were able to identify more patients taking potentially inappropriate medicines and more inappropriate medicines than the other studied criteria