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Polimedicação no idoso em contexto de cuidados de saúde primários : um estudo de caso
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O envelhecimento da população e o aumento da esperança de vida, implicam maior incidência e prevalência de patologias crónicas, fazendo com que os idosos sejam os principais consumidores de cuidados de saúde. A polimedicação pode ser definida quantitativamente, usualmente com o consumo de cinco ou mais fármacos simultaneamente, ou qualitativamente, através do uso de mais medicamentos do que os indicados.
O objetivo principal deste trabalho consiste na elaboração de um Estudo de Caso de um idoso, utente da Unidade Saúde Familiar (USF) Braga Norte, que se enquadra na definição de utente polimedicado. Desta forma, além do estudo de caso em si, será feita uma reflexão sobre a importância dos fármacos em questão na manutenção da saúde. Serão aplicados diversos critérios de decisão na escolha de fármacos, nomeadamente Critérios de Beers, STOP/START de forma a descrever a medicação potencialmente inadequada (MPI) e omissa (MPO), respetivamente, no idoso em estudo
O enquadramento teórico, onde é feita a reflexão do estudo de caso, consiste numa pesquisa sobre conceitos fundamentais, como definição de idoso, polimedicação, descrição dos diversos critérios.
Foi concluído que em contexto de Cuidados de Saúde Primários, a polifarmácia não é um procedimento fácil, pois o cálculo custo-benefício e o risco de reações adversas nem sempre são fáceis de gerir. A problemática da auto-medicação, são uma constante nos idosos, cuja informação é baseada em mitos de “o que é de venda livre, não causa prejuízo”. Cabe ao médico de família através da aquisição de novas informações, quer através da negociação com o utente, tentar inverter esta problemática. Todos estes propósitos foram focados no idoso. A pesquisa foi feita utilizando como palavras-chave polypharmacy; elderly; geriatric; adherence; hyperpharmacotherapy. As bases de dados usadas online foram a Pubmed e a Cochrane summaries ou, caso a situação o exigisse, livros e revistas da especialidade, tendo sido incluídos artigos em inglês ou em português, desde 2008 a 2017, inclusive.
The aging of the population and the increase in life expectancy imply a higher incidence and prevalence of chronic pathologies, making the elderly the main consumers of health care. Polymedication can be quantitatively defined, usually with consumption of five or more drugs simultaneously, or qualitatively, through the use of more drugs than indicated. The main objective of this study is the elaboration of a Case Study of an elderly person, patient in Family Health Unit (USF) Braga Norte, which falls within the definition of a polymedicated patient. Thus, in addition to the case study itself, a reflection will be made on the importance of the drugs in question in the maintenance of health. A number of decision criteria will be applied in drug selection, namely Beers Criteria, STOP / START to describe potentially inappropriate medication (MPI) and omission (MPO), respectively, in the elderly under study. The theoretical framework, where the reflection of the case study is made, consists of a research on fundamental concepts, such as definition of the elderly, polymedication, description of the various criteria. It was concluded that in the context of Primary Health Care, polypharmacy is not an easy procedure, since cost-benefit calculation and risk of adverse reactions are not always easy to manage. The problem of self-medication is a constant in the elderly, whose information is based on myths of "what is over-the-counter, does not cause harm". It is up to the family doctor to acquire new information, either through negotiation with the patient, to try to reverse this problem.All of these purposes were focused on the elderly. The research was done using as keywords polypharmacy; Elderly; Geriatric; Adherence; Hyperpharmacotherapy. The databases used online were Pubmed and Cochrane summaries or, if the situation required, books and journals of the specialty, having included articles in English or Portuguese, from 2008 to 2017 inclusive.
The aging of the population and the increase in life expectancy imply a higher incidence and prevalence of chronic pathologies, making the elderly the main consumers of health care. Polymedication can be quantitatively defined, usually with consumption of five or more drugs simultaneously, or qualitatively, through the use of more drugs than indicated. The main objective of this study is the elaboration of a Case Study of an elderly person, patient in Family Health Unit (USF) Braga Norte, which falls within the definition of a polymedicated patient. Thus, in addition to the case study itself, a reflection will be made on the importance of the drugs in question in the maintenance of health. A number of decision criteria will be applied in drug selection, namely Beers Criteria, STOP / START to describe potentially inappropriate medication (MPI) and omission (MPO), respectively, in the elderly under study. The theoretical framework, where the reflection of the case study is made, consists of a research on fundamental concepts, such as definition of the elderly, polymedication, description of the various criteria. It was concluded that in the context of Primary Health Care, polypharmacy is not an easy procedure, since cost-benefit calculation and risk of adverse reactions are not always easy to manage. The problem of self-medication is a constant in the elderly, whose information is based on myths of "what is over-the-counter, does not cause harm". It is up to the family doctor to acquire new information, either through negotiation with the patient, to try to reverse this problem.All of these purposes were focused on the elderly. The research was done using as keywords polypharmacy; Elderly; Geriatric; Adherence; Hyperpharmacotherapy. The databases used online were Pubmed and Cochrane summaries or, if the situation required, books and journals of the specialty, having included articles in English or Portuguese, from 2008 to 2017 inclusive.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
Polifarmácia Idosos Geriatria Hiperfarmacoterapia Medicina geral e familiar Adesão à terapêutica