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Polifarmacia, enfermedades y deprescripción en el adulto mayor. Una revisión exploratoria
Polypharmacy, diseases and deprescription in the elderly. A scoping review
Polifarmácia, doenças e desprescrição em idosos: uma revisão de escopo
DOI:
https://doi.org/10.15446/rcciquifa.v54n3.121506Palabras clave:
Adulto mayor, polifarmacia, prescripción potencialmente inapropiada, deprescripción (es)Older adults, polypharmacy, potentially inappropriate prescription, deprescribing (en)
Idosos, polifarmácia, prescrição potencialmente inadequada, desprescrição (pt)
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Introducción: la polifarmacia, definida como el uso concomitante de cinco o más medicamentos es común en adultos mayores. Las prescripciones potencialmente inapropiadas es uno de los principales factores de riesgo para la ocurrencia de reacciones adversas en adultos mayores. Objetivo: realizar una síntesis narrativa sobre la polifarmacia, enfermedades más frecuentes y las intervenciones de deprescripción en adultos mayores. Metodología: las estrategias de búsqueda siguieron las directrices PRISMA. La búsqueda se realizó en Medline/PubMed, con la finalidad de recopilar información sobre la polifarmacia en adultos mayores desde enero 2023 hasta mayo 2025. Se realizó una revisión narrativa consistente en cinco fases: I) búsqueda bibliográfica, II) revisión por título y resumen, III) Revisión de texto completo y IV) selección de las referencias y V) Análisis descriptivo. Se incluyeron artículos que presentaban datos específicos sobre polifarmacia, enfermedades y deprescripción de medicamentos en adultos mayores. Resultados: durante la estrategia de búsqueda se identificaron 157 publicaciones potencialmente relevantes. Se evaluaron un total de 81 artículos y se incluyeron 35 en el análisis descriptivo. Predominaron las revisiones mientras que 4 artículos reflejaron intervenciones de deprescripción. Conclusión: los estudios son aún insuficientes por lo que se requiere profundizar para implementar tratamientos farmacológicos más seguros y estrategias de deprescripción más efectivas que proporcionen mayor calidad de vida en los adultos mayores.
Introduction: polypharmacy, defined as the concurrent use of five or more medications, is common among to older adults. Potentially inappropriate prescribing is one of the main risk factors for adverse drug events in older people. Objective: to carry out a narrative synthesis about polypharmacy, the most common diseases and deprescribing interventions in older adults. Methodology: the search strategies followed PRISMA guidelines. The search was conducted in Medline/PubMed in order to collect information on polypharmacy in older adults from January 2023 to May 2025. A narrative review was carried out consisting of five phases: I) bibliographic search, II) review by title and abstract, III) full text review and IV) selection of references and V) descriptive analysis. Articles were included that presented specific data about polypharmacy, diseases and drug deprescribing in older adults. A narrative synthesis was performed due to the heterogeneity of the study designs and results. Results: during the search strategy 157 potentially relevant publications were identified. A total of 81 articles were evaluated and 35 were included in the descriptive analysis. Reviews predominated, while 4 articles reflected deprescribing interventions. Conclusions: studies are still insufficient, so it is necessary to deepen the implementation of safer pharmacological treatments and more effective deprescribing strategies that provide a higher quality of life in older adults.
Introdução: A polifarmácia, definida como o uso concomitante de cinco ou mais medicamentos, é comum em idosos. Prescrições potencialmente inapropriadas são um dos principais fatores de risco para reações adversas em idosos. Objetivo: Realizar uma síntese narrativa sobre polifarmácia, as doenças mais comuns e intervenções de desprescrição em idosos. Metodologia: As estratégias de busca seguiram as diretrizes PRISMA. A busca foi realizada no Medline/PubMed, com o objetivo de coletar informações sobre polifarmácia em idosos, de janeiro de 2023 a maio de 2025. Foi realizada uma revisão narrativa, composta por cinco fases: I) busca bibliográfica, II) revisão de títulos e resumos, III) revisão completa do texto, IV) seleção de referências e V) análise descritiva. Foram incluídos artigos que apresentaram dados específicos sobre polifarmácia, doenças e desprescrição de medicamentos em idosos. Resultados: A estratégia de busca identificou 157 publicações potencialmente relevantes. Foram avaliados 81 artigos, dos quais 35 foram incluídos na análise descritiva. Predominaram as revisões, enquanto quatro artigos abordaram intervenções de desprescrição. Conclusão: Os estudos ainda são insuficientes, sendo necessárias mais pesquisas para implementar tratamentos farmacológicos mais seguros e estratégias de desprescrição mais eficazes que proporcionem melhor qualidade de vida aos idosos.
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