Polymedication among elderly: family physicians’ perception (research project)

• Main Author: Martins, Bárbara
• Publication Date: 2023
• Other Authors: Mendes, Ângela, Luis, Joana Gonçalves, Araújo, Rosa Maria
• Format: Article
• Language: por
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: https://doi.org/10.32385/rpmgf.v39i5.13518
• topic: Idoso; Polimedicação; Classes de fármacos potencialmente inapropriadas; Elderly; Polymedication; Potentially inappropriate drug classes

Introduction: Polymedication is defined by the simultaneous use, appropriate or not, according to the comorbidities of each patient, of at least five drugs in the same person. The family physician (FP) should identify and combat, when clinically appropriate, polypharmacy. Objectives: To identify the prevalence of polymedication and the main potentially inappropriate pharmacological classes used in the elderly patients of the participating Family Health Unit and to evaluate the perception of FP about this reality. Methods: Analytical cross-sectional observational study in the population of patients aged 80 years or older. Patients without clinical records in the last three years were excluded. A questionnaire was distributed to FP to assess their perception of polymedication in their file. Data on the medication used by patients were obtained from SClinico® and PEM® software and analyzed in Excel®. Results: 386 patients were included, with a mean age of 85.6 years, 62% female. 79.5% of the patients were polymedicated, with an average of 7.1±3.1 drugs per patient. Statins corresponded to the most prescribed pharmacological group (64.2%), with benzodiazepines and proton pump inhibitors (PPIs) being the most commonly used potentially inappropriate classes in equal proportion (35%). Five FPs agreed to participate in the study; three correctly defined polymedication and showed an approximate perception of the reality of their file. The percentage of benzodiazepine use was overestimated by four clinicians; the prescription of anticoagulants was underestimated by three professionals, contrary to the use of antiaggregants and sulfonyloreas, which were overestimated in equal proportion. Discussion/Conclusion: This study allowed us to characterize the problem of polymedication in the unit investigated, enhancing individual and team awareness about this problem. Polymedication prevalence was higher than that reported in other studies. The researchers conclude that it is imperative to develop strategies to combat polymedication.