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Publication
Potentially inappropriate prescription patterns in older adults: a cross-sectional study in Slovenia
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Authors
Abstract(s)
Introdução: O envelhecimento demográfico da população que se espera na europa deve se ao aumento da esperança de vida, com a diminuição da taxa de fertilidade. Em 2018,
19,41% da população eslovena tinha mais que 65 anos, mas espera-se que esta
percentagem atinja os 30,6% em 2050. Uma forma de travar o aumento das despesas
públicas é otimizar a utilização de recursos e aumentar a saúde dos cidadãos de maneira
que tenham menos morbilidade e assim dependam menos do sistema de saúde. Os padrões
de prescrição em idosos tornam-se críticos para a determinação de uma terapêutica eficaz
e otimizada, com diminuição da complexidade da terapêutica para o utente idoso,
melhores resultados de saúde pública e menos gastos para o sistema financiador. Neste
estudo, foram analisados os padrões de prescrição potencialmente inapropriada em
utentes idosos e de que forma as caraterísticas demográficas dos prescritores (género,
idade e estatuto) influenciam estes padrões. Métodos: Uma base de dados eslovena com
todas as prescrições realizadas em 2018 à população maior ou igual a 65 anos, com
informação relativa à substância prescrita e com caraterísticas demográficas do utente e
do médico prescritor, foi disponibilizada para este estudo. O software informático SPSS
IBM Statistics foi utilizado como ferramenta de análise da estatística descritiva, de
comparação de médias através do Teste-T independente e de cálculo de frequências sobre
o conteúdo da base de dados. As substâncias ativas foram definidas como potencialmente
inapropriadas através do Critério de Beers de 2019 e da lista europeia designada por
EU(7)PIM list. Discussão: Prescritores com idade maior ou igual a 65 anos,
desempregados e mulheres foram os que mais prescreveram medicamentos
potencialmente inapropriados. As prevalências de prescrição da maioria dos grupos
químicos sofreram influencia do género, idade e/ou estatuto. Conclusão: Há necessidade
de incluir idosos em ensaios clínicos de modo a ter mais evidências sobre que medicações
são inapropriadas, e de estabelecimento de guidelines terapêuticas em utentes com
diversas doenças de forma a evitar a polimedicação e a otimizar recursos.
Introduction: The population demographic ageing that is expected in Europe is due to the increase of life expectancy, combined with the decrease of fertility rates. In 2018, 19,41% of the Slovenian population was over 65 years old, but this share is expected to increase to 30,6% in 2050. One way to prevent the increasing of public investments is to optimize resources and to increase the health of citizens so they have lower morbidity and thus, that they rely less on the public system. The patterns of prescription among the elderly are critical to determine an efficient and optimized therapy, decreasing the complexity of the treatment to the older patient, to obtain better results of public health and lower costs for the financing system. In this study, the patterns of potentially inappropriate prescriptions were analyzed among older adults and in each way the demographic characteristics of physicians (gender and age) influence those patterns. Methods: A Slovenian database with every prescriptions to population equal or older than 65 years old from 2018, with information regarding the chemical substance prescribed and the patients’ and physicians’ demographic characteristics, was provided for this study. The SPSS IBM statistics software was used as a tool of statistical analysis and mean comparison through the independent t-test over the content of the database. Results were obtained. The chemical substances were defined as potential inappropriate based on AGS Beers Criteria 2019 and the European list named as EU(7) PIM list. Discussion: Female physicians equal or above 65 years old, were the ones who prescribed more potentially inappropriate medications. Most of the chemical groups prevalence of prescription were influenced by age and gender. Conclusion: There is the need to include older adults in clinical trials to have more evidence of the medication that are inappropriate for them, and the need to establish therapy guidelines for patients with multimorbidity so the polypharmacy can be prevented and the resources optimized.
Introduction: The population demographic ageing that is expected in Europe is due to the increase of life expectancy, combined with the decrease of fertility rates. In 2018, 19,41% of the Slovenian population was over 65 years old, but this share is expected to increase to 30,6% in 2050. One way to prevent the increasing of public investments is to optimize resources and to increase the health of citizens so they have lower morbidity and thus, that they rely less on the public system. The patterns of prescription among the elderly are critical to determine an efficient and optimized therapy, decreasing the complexity of the treatment to the older patient, to obtain better results of public health and lower costs for the financing system. In this study, the patterns of potentially inappropriate prescriptions were analyzed among older adults and in each way the demographic characteristics of physicians (gender and age) influence those patterns. Methods: A Slovenian database with every prescriptions to population equal or older than 65 years old from 2018, with information regarding the chemical substance prescribed and the patients’ and physicians’ demographic characteristics, was provided for this study. The SPSS IBM statistics software was used as a tool of statistical analysis and mean comparison through the independent t-test over the content of the database. Results were obtained. The chemical substances were defined as potential inappropriate based on AGS Beers Criteria 2019 and the European list named as EU(7) PIM list. Discussion: Female physicians equal or above 65 years old, were the ones who prescribed more potentially inappropriate medications. Most of the chemical groups prevalence of prescription were influenced by age and gender. Conclusion: There is the need to include older adults in clinical trials to have more evidence of the medication that are inappropriate for them, and the need to establish therapy guidelines for patients with multimorbidity so the polypharmacy can be prevented and the resources optimized.
Description
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2021, Universidade de Lisboa, Faculdade de Farmácia.
Keywords
Potentially inappropriate medications Physicians Age Gender Slovenia Mestrado integrado - 2021