Técnicas de desprescrição de medicamentos potencialmente inapropriados na atenção primária: Uma revisão sistemática

• Ano de defesa: 2024
• Autor(a) principal: Oliveira, Emanuel Miranda
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso embargado
• Idioma: por
• Instituição de defesa: Universidade Federal de Uberlândia; Brasil; Programa de Pós-graduação em Saúde da Família
• Palavras-chave em Português: Desprescrição; Idosos; Medicamentos Potencialmente Inapropriados; Atenção Primária à Saúde; Polifarmácia; Deprescribing; Elderly; Potentially Inappropriate Medications; Primary Health Care; Polypharmacy; CNPQ::CIENCIAS DA SAUDE; CNPQ::CIENCIAS DA SAUDE::MEDICINA; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA; Família - Saúde e higiene; ODS::ODS 3. Saúde e bem-estar - Assegurar uma vida saudável e promover o bem-estar para todos, em todas as idades.
• Link de acesso: https://repositorio.ufu.br/handle/123456789/44637; http://doi.org/10.14393/ufu.di.2025.5508

This master's thesis investigates effective techniques and strategies for deprescribing Potentially Inappropriate Medications (PIM) in older adult individuals within the context of Primary Health Care (PHC). The use of PIM and polypharmacy emerge as significant issues in the older adult population. They are often associated with an increase in adverse events, hospitalizations, and a decrease in quality of life, as well as increased healthcare system costs. The study employed a systematic literature review methodology, analyzing publications between 2010 and 2023 from the PubMed, EMBASE, and LILACS databases. Thirteen studies meeting the eligibility criteria were included, comprising traditional Randomized Controlled Trials (RCT) and cluster RCT. The studies were assessed for risk of bias using the Risk of Bias 2 tool, and the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations system. The results indicated that the use of automated deprescribing tools and medication review by pharmacists are the most effective techniques for long-term deprescribing, and that educational activities for the healthcare team are important for both healthcare professionals and patients. Medication review by family physicians alone is not effective for long-term deprescribing. Overall, deprescribing does not influence hospitalization frequency and mortality; however, it is a safe practice in the PHC context. It was concluded that the practical implementation of deprescribing strategies in PHC is feasible and can reduce treatment burden and medication use in the older adult population. The incorporation of these health practices and the conduct of additional studies to evaluate long-term clinical outcomes and the cost-effectiveness of these interventions in the PHC context are recommended.