Estudo de utilização de medicamentos em pacientes com doença de Parkinson

• Ano de defesa: 2019
• Autor(a) principal: Colatto, Luana Laura
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Espírito Santo; BR; Mestrado em Ciências Farmacêuticas; Centro de Ciências da Saúde; UFES; Programa de Pós-Graduação em Ciências Farmacêuticas
• Palavras-chave em Português: Elderly; Parkinson's disease; Beers criteria; Drug utilization; Treatment adherence and compliance; Utilização de medicamentos; Critério de Beers; Uso de medicamentos; Cooperação e adesão ao tratamento; Idosos; Parkinson, Doença de; Medicamentos; Farmácia; 615.1
• Link de acesso: http://repositorio.ufes.br/handle/10/10946

Aging is leading to an increasing incidence of chronic degenerative illnesses such as Parkinson’s disease. In addition, the elderly population is characterized by the concomitant presence of one or more chronic conditions that bring with it the challenge of polypharmacy, and with it the complexity of therapeutic regimens. Potentially inappropriate medications, which can cause severe adverse effects when given to the elderly, may interfere with the success of pharmacotherapy in these patients. Together with all these factors, depression and sociodemographic characteristics may influence adherence to pharmacological treatment. In this context, we identified the prevalence in the use of potentially inappropriate medications, according to the Beers criteria 2015 and, also, we evaluated the adherence to the drug treatment, both in patients with Parkinson’s disease. It is a cross-sectional study, developed in patients diagnosed with Parkinson’s disease and who are part of the Chronic Management Program of Unimed-Vitória. We evaluated the older adults with 60 years or more included in the digital Healthmap® platform in the year 2017. Data were collected using questionnaires (structured interview questionnaire, Hoehn and Yahr Scale, Morisky-Green Test, Brief Medication Questionnaire, MedTake) and through the digital Healthmap® platform. The association between the use of potentially inappropriate medications and the independent variables was analyzed by univariate logistic regression with their respective confidence intervals of 95%. For the multiple model, the variables that presented p < 0.20 were selected. The association between adherence and the independent variables was analyzed using Fisher's exact test. The prevalence of 83.3% was verified in the use of potentially inappropriate medications. In the multiple logistic regression model, the associated variables to use were female (p = 0.03), receive seven or more home visits (p = 0.03), some anatomical therapeutic chemical classification – code M: musculo-skeletal system (p = 0.04) and code A: alimentary tract and metabolism (p = 0.005), and the use of psychotropic medication (p = 0.03). Consulting with four or more different medical specialties was considered as a protection factor for the use of potentially inappropriate medications. The results found in the assessment of adherence ranged from 0.0% to 76.1%, considering total adherence to the prescribed treatment, according to the score of each questionnaire. There were no significant associations between the variables and adherence to treatment. This study demonstrated a high prevalence of potentially inappropriate medications in this population, evidencing the need to disseminate this criteria and the adoption of tools that promote the rational use of drugs and, on the other hand, a low therapeutic adherence of the patients, which corroborates the need for a multidisciplinary approach, particularly with the participation of a pharmacist, to develop strategies to facilitate understanding of the pharmacological treatment of patients with Parkinson’s disease.