Potentially inappropriate medication use in the elderly

Abstract

Neprikladno propisivanje lijekova starijim osobama je često povezano s povećanim rizikom za nastanak neželjenih djelovanja lijekova, povećanim morbiditetom i mortalitetom, te troškovima zdravstvene zaštite. Cilj ove studije bio je odrediti učestalost propisivanja potencijalno neprikladnih lijekova (PNL) osobama starije životne dobi koristeći originalni protokol razvijen od autora Mimica Matanović and Vlahović-Palčevski. Istraživanje je uključilo 102 hospitalizirana bolesnika starosti 2: 65 godina. Glavni izvor podataka bila je medicinska dokumentacija bolesnika. Prosječna dob bila je 74 godine (raspon 65 - 92), a prosječan broj lijekova po ispitaniku bio je 6 (raspon 1 - 15). Ukupno je 40,2 % bolesnika uzimalo barem jedan PNL. Najčešći PNL bili su dugodjelujući benzodiazepini, centralni antihipertenziv moksonidin i nesteroidni anti-inflamatomi lijekovi (NSAIL). Barem jedna kombinacija lijekova koji mogu stupiti u klinički značajnu inetrakciju bila je propisana 38,2 % bolesnika. Najčešće kombinacije s uključivale su primjenu NSAIL i antihipertenziva ili diuretika, istovremenu primjenu više lijekova s učinkom na SŽS i kombinacije lijekova koje mogu rezultirati hiperkalijemijom. Ovim istraživanjem otkrivena je velika prevalencija neodgovarajućeg propisivanja lijekova osobama starije životne dobi.Inappropriate prescribing to the elderly is often associated with an increased risk od adverse drug events, morbidity, mortality and health care costs. The purpose of this study was to determine the prevalence of potentially inappropriate medication use in the elderly using the new comprehensive protocol developed by authors Mimica Matanović and Vlahović-Palčevski. The study included 102 hospitalized patients aged ~ 65 years. Information on prescribed drugs was retrieved mainly from the patients' medical records. The average age of the patient was found to be 74 years (range 65 - 92), and each patient was on an average of 6 medicines (range 1 - 15). A total of 40,2 % of patients received at least one potentially inappropriate medication. Drugs of most concem were long-acting benzodiazepines, centrally active antihypertensive moxonidine and nonsteroidal antiinflammatory drugs (NSAIDs). A total of 38,2 % of patients were prescribed at least one drug combination that is potentially harmful. The most common combinations included NSAID and an antihypertensive or diuretic, simultaneous use of CNS agents and combination of drugs which can lead to severe hyperkalemia. This study has shown that inappropriate prescribing to older people is highly prevalent