Publicado

2023-11-01

Use of potentially inappropriate medications in long-stay institutions for the elderly: systematic review

Uso de medicamentos potencialmente inapropiados en instituciones de larga estancia para ancianos: revisión sistemática

DOI:

https://doi.org/10.15446/rsap.v25n6.98641

Palabras clave:

Drug therapy, aged, inappropriate prescribing, homes for the aged, nursing homes, potentially inappropriate medication list (en)
Quimioterapia, anciano, prescripción inadecuada, hogares para ancianos, casas de salud, lista de medicamentos potencialmente inapropiados (es)

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Objective To analyse the prevalence of the use of potentially inappropriate medications (PIM) in Long Stay Institutions for the Elderly (LSIE).

Method Systematic review was used to obtain articles from online databases BVS, Google Scholar, MEDLINE, SciELO and CINAHL. The search and selection process of the studies followed the PRISMA 2020 recommendations. The eligibility criteria were observational and experimental studies, in English and Portuguese languages, conducted in the last 10 years with elderly patients ≥ 60 years and studies of the prevalence of PIM use in elderly residents in LSIE.

Results The final sample comprised 11 articles. The main type of study was cross-sectional with 10 (90.90%) articles, published between 2012 and 2019, with 2012 being predominant (36.36%). The mean prevalence of PIM use was 43.86% (7.8%-80%), highlighting greater relationship with female gender (58.5%) and polypharmacy (58.7%).

Discussion The observed results point out high and worrisome prevalence of PIM for institutionalized elderly. It is essential the proposition and implementation of strategies aimed at reducing the use of these drugs. The educational interventions, deprescription and computerization of the prescription systems stood out. Therefore, the identification of such drugs and the discussion, together with the prescriber and other members of the health team, becomes of great value in the process of prescription review and decrease in the use of PIM.

Conclusion The results of this study reinforce the need for the reduction of inappropriate prescriptions and the importance of rational use of medicines for residents in LSIE.

Objetivo Analizar la prevalencia del uso de medicamentos potencialmente inapropiados (PIM) en las instituciones de larga estancia para ancianos (IEP).

Método Se utilizó una revisión sistemática para obtener artículos de las bases de datos en línea BVS, Google Scholar, MEDLINE, SciELO y CINAHL. El proceso de búsqueda y selección de los estudios siguió las recomendaciones PRISMA 2020. Los criterios de elegibilidad fueron estudios observacionales y experimentales, en idiomas inglés y portugués, realizados en los últimos 10 años con pacientes ancianos ≥ 60 años y estudios de prevalencia de uso de PIM en ancianos residentes en LSIE.

Resultados La muestra final estuvo compuesta por 11 artículos. El tipo de estudio principal fue el transversal con 10 (90,90%) artículos, publicados entre 2012 y 2019, predominando el año 2012 (36,36%). La prevalencia media de uso de PIM fue del 43,86% (7,8%-80%), destacando una mayor relación con el género femenino (58,5%) y la polifarmacia (58,7%).

Discusión Los resultados observados señalan una alta y preocupante prevalencia de PIM en los ancianos institucionalizados. Es fundamental el planteamiento y la implementación de estrategias dirigidas a reducir el uso de estos fármacos. Destacan las intervenciones educativas, la desprescripción y la informatización de los sistemas de prescripción. Por tanto, la identificación de tales medicamentos y la discusión, junto con el prescriptor y otros miembros del equipo de salud, se vuelve de gran valor en el proceso de revisión de la prescripción y la disminución del uso de PIM.

Conclusiones Los resultados de este estudio refuerzan la necesidad de reducir las prescripciones inadecuadas y la importancia del uso racional de los medicamentos para los residentes en LSIE.

 

Referencias

1. Oliveira JM de, Rozendo CA. Instituição de longa permanência para idosos: um lugar de cuidado para quem não tem opção?. Rev Bras Enferm. 2014; 67(5):773–9. https://doi.org/10.1590/00347167.2014670515.

2. Gerlack LF, Cuentro VDS, Estrela MFB, Karnikowski MG de O, Pinho DLM, Bós ÂJG. Interações medicamentosas na farmacoterapia prescrita a idosos residentes em uma instituição de longa permanência brasileira. Estud Interdiscip sobre o Envelhec. 2014; 19(2). https://doi.org/10.22456/23162171.43273.

3. Shah SM, Carey IM, Harris T, DeWilde S, Cook DG. Quality of prescribing in care homes and the community in England and Wales. Br J Gen Pract. 2012; 62(598):e329–36. https://doi.org/10.3399/bjgp12X641447.

4. Salcher EBG, Dellani MP, Portella MR, Doring M. Factors associated with the use of medicines potentially inadequate for urban and rural. Rev Saúde e Pesqui. 2018; 11(1):139–49. https://doi.org/10.17765/1983-1870.2018v11n1p139-149.

5. Krause O, Wiese B, Doyle IM, Kirsch C, Thürmann P, Wilm S, et al. Multidisciplinary intervention to improve medication safety in nursing home residents: protocol of a cluster randomised con- trolled trial (HIOPP-3-iTBX study). BMC Geriatr. 2019; 19(1):24. https://doi.org/10.1186/s12877-019-1027-0.

6. Lutz BH, Miranda VIA, Bertoldi AD. Potentially inappropriate medications among older adults in Pelotas, Southern Brazil. Rev Saúde Pública. 2017; 51:52. https://doi.org/10.1590/S15188787.2017051006556.

7. Endres HG, Kaufmann-Kolle P, Steeb V, Bauer E, Bottner C, Thurmann P. Association between potentially inappropriate medication (PIM) use and risk of hospitalization in older adults: an observational study based on routine data comparing PIM use with use of PIM alternatives. PLoS One. 2016; 11(2):e0146811. https://doi.org/10.1371/journal.pone.0146811.

8. American Geriatrics Society 2019. Updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019; 67:674-94. https://doi.org/10.1111/jgs.15767.

9. O’mahony D, O’sullivan D, Byrne S, O’connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: Version 2. Age Ageing. 2015; 44(2):213–8. https://doi.org/10.1093/ageing/afu145.

10. Moreira FSM, Jerez-Roig J, Ferreira LM de BM, Dantas AP de QM, Lima KC, Ferreira MÂF. Use of potentially inappropriate medications in institutionalized elderly: Prevalence and associated factors. Ciênc Saúde Colet. 2020; 25(6):2073–82. https://doi.org/10.1590/1413-81232020256.26752018.

11. Soares CB, Hoga LAK, Peduzzi M, Sangaleti C, Yonekura T, Silva DRAD. Revisão integrativa: conceitos e métodos utilizados na enfermagem. Rev Esc Enferm USP. 2014; 48(2):335–45. https://doi.org/10.1590/S0080-6234201400002000020.

12. Mendes KDS, Silveira RC de CP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm. 2008; 17(4):758–64. https://doi.org/10.1590/S0104-07072008000400018.

13. Hortelan M dos S, Almeida M de L de, Fumincelli L, Zilly A, Nihei OK, Peres AM, et al. Papel do gestor de saúde pública em região de fronteira: scoping review. Acta Paul Enferm. 2019; 32(2):229–36. https://doi.org/10.1590/1982-0194201900031.

14. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021; 372:71. https://doi.org/10.1136/bmj.n71.

15. Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Internet]. The Ottawa Hospital; 2000. Avaliable at: https://bit.ly/3Z8fFl7.

16. Fochat RC, de Oliveira Horsth RB, Sette MS, Barbosa Raposo NR, Chicourel EL. Perfil de utilização de medicamentos por idosos frágeis institucionalizados na Zona da Mata Mineira, Brasil. Rev Ciênc Farm Básica Apl [Internet]. 2012; 33(3):447-54. Cited on March 2021. Available at: https://bit.ly/3SnZH2C.

17. Garbin CAS, Lima TJV de, Araújo PC, Garbin AJÍ, Arcieri RM, Saliba O. Perfil da farmacoterapia utilizada por idosos institucionalizados. Arch Heal Investig. 2017; 6(7):322–7. https://doi.org/10.21270/archi.v6i7.2083.

18. García-Gollarte F, Baleriola-Júlvez J, Ferrero-López I, Cruz-Jentoft AJ. Inappropriate drug prescription at nursing home admission. J Am Med Dir Assoc. 2012; 13(1):83.e9-83.e15. https://doi.org/10.1016/j.jamda.2011.02.009.

19. Gautério-Abreu DP, Santos SSC, Ilha, S, Piexak DR. Uso de medicamentos inapropriados por pessoas idosas residentes em instituição de longa permanência. Rev Enferm UFPE on line [Internet]. 2016; 10(2):608-14. Available at: https://bit.ly/3YCj9w5.

20. Liew NY, Chong YY, Yeow SH, Kua KP, Saw PS, Lee SWH. Prevalence of potentially inappropriate medications among geriatric residents in nursing care homes in Malaysia: a cross-sectional study. Int J Clin Pharm. 2019; 41(4):895–902. https://doi.org/10.1007/s11096-019-00843-1.

21. Lima TJV de, Garbin CAS, Araújo PC, Garbin AJÍ, Rovida TAS, Saliba O. Reações adversas a medicamentos entre idosos institucionalizados: prevalência e fatores associados. Arch Heal Investig. 2017; 6(3):129–35. https://doi.org/10.21270/archi.v6i3.1921.

22. Lima TJV de, Garbin C, Garbin A, Sumida DH. Potentially inappropriate medications used by the elderly: Prevalence and risk factors in Brazilian care homes. BMC Geriatr. 2013; 13:52. https://doi.org/10.1186/1471-2318-13-52.

23. Ryan C, O'Mahony D, Kennedy J, Weedle P, Cottrell E, Heffernan M et al. Potentially inappropriate prescribing in older residents in Irish nursing homes. Age Aging. 2013; 42(1):116-20. https://doi.org/10.1093/ageing/afs068.

24. Al Aqqad SM, Chen LL, Shafie AA, Hassali MA, Tangiisuran B. The use of potentially inappropriate medications and changes in quality of life among older nursing home residents. Clin Interv Aging. 2014; 22; 9:201-7. https://doi.org/10.2147/CIA.S52356.

25. Smanioto FN, Haddad M do CL. Evaluation of pharmacotherapy prescribed to institutionalized elderly. Rev Bras Enferm. 2013; 66:523-7. https://doi.org/10.1590/S0034-71672013000400009.

26. Ubeda A, Ferrándiz ML, Maicas N, Gomez C, Bonet M, Peris JE. Potentially inappropriate prescribing in institutionalised older patients in Spain: the STOPP-START criteria compared with the Beers criteria. Pharmacy Practice [Internet]. 2012; 10(2):83-91. Cited on March 2021. Available at: https://bit.ly/3GJkWte.

27. Costa S de AL, Marques LF, Aleixo AG, Silva LF da, Santos NVP, Caramalac Junior AR de, et al. Effects of prolonged use of Proton Pump Inhibitors in the elderly. Brazilian J Heal Ver [Internet]. 2021; 4(2):4248-65. https://doi.org/10.34119/bjhrv4n2-023.

28. Praxedes MFS, Pereira GCS, Lima CFM, Santos DS, Berhends JS. Prescrição de medicamentos potencialmente inapropriados para idosos segundo os Critérios de Beers: Revisão sistemática. Cien Saude Colet [Internet]. 2020. Cited on June 2021. Available at: https://bit.ly/4m5QHwN. DOI: https://doi.org/10.1590/1413-81232021268.05672020

29. Gatto CM, Jorge MSG, Wibelinger LM, Bertolin TE, Portella MR, Doring M. Prevalência de polifarmácia, benzodiazepínicos e fatores associados em idosos institucionalizados. Rev Bras Ciências do Envelhec Hum. 2019; 16(3):47–58. https://doi.org/10.5335/rbceh.v16i3.7797.

30. Li H, Pu S, Liu Q, Huang X, Kuang J, Chen L et al. Potentially inappropriate medications in Chinese older adults: The beers criteria compared with the screening tool of older persons’ prescriptions criteria. Geriatr Gerontol Int. 2017; 17(11):1951–8. https://doi.org/10.1111/ggi.12999.

31. Kamble P, Chen H, Sherer JT, Aparasu RR. Use of antipsychotics among elderly nursing home residents with dementia in the US: An analysis of national survey data. Drugs Aging. 2009; 26(6):483–92. https://doi.org/10.2165/00002512-200926060-00005.

32. Converso MER, Iartelli I. Analysis and characterization of functional capacity and mental state in residents in old folk’s home. J Bras Psiquiatr. 2007; 56:267-72. https://doi.org/10.1590/S004720852007000400005.

33. Lenardt MH, Michel T, Wachholz PA, Borghi AS, Seima MD. O desempenho de idosas institucionalizadas no miniexame do estado mental. Acta Paul Enferm. 2009; 22(5). https://doi.org/10.1590/S0103-21002009000500007.

34. Santalucia P, Franchi C, Djade CD, Tettamanti M, Pasina L, Corrao S, et al. Gender difference in drug use in hospitalized elderly patients. Eur J Int Med. 2015; 26(7):483-90. https://doi.org/10.1016/j.ejim.2015.07.006.

35. Mosca C, Correia P. O medicamento no doente idoso Acta farmacêutica Port [Internet]. 2012; 1(2):75-8. Cited on March 2021. Available at: https://bit.ly/4dc6dmK.

36. Sluggett JK, Hopkins RE, Chen EY, Ilomäki J, Corlis M, Van Emden J, et al. Impact of medication regimen simplification on medication administration times and health outcomes in residential aged care: 12 month follow up of the SIMPLER randomized controlled trial. J Clin Med [Internet]. 2020; 9(4):1053. https://doi.org/10.3390/jcm9041053.

37. Secoli SR. Polifarmácia: interações e reações adversas no uso de medicamentos por idosos. Rev Bras Enferm. 2010; 63(1):136-40. https://doi.org/10.1590/S0034-71672010000100023.

38. Najjar MF, Sulaiman SAS, Jeraisy AlM, Balubaid H. The impact of a combined intervention program: an educational and clinical pharmacist’s intervention to improve prescribing pattern in hospitalized geriatric patients at King Abdulaziz Medical City in Riyadh, Saudi Arabia. Ther Clin Risk Manag. 2018; 14:557. https://doi.org/10.2147/TCRM.S157469.

39. Praxedes MFDS, Telles Filho PCP, Pinheiro MLP. Identificação e análise de prescrições de medicamentos potencialmente inapropriados para idosos em uma instituição hospitalar. Ciênc Cuid Saúde. 2011; 10(2):338–44. https://doi.org/10.4025/cienccuidsaude.v10i2.10214.

40. Souza AAL, Néri EDR, Gomes GC, Lopes EM, Fonteles MDF, Meira AS et al. Avaliação do autoconhecimento da equipe médica, de enfermagem e farmácia sobre medicamentos potencialmente perigosos. Rev Med UFC. 2019; 59(1):21-29. https://doi.org/10.20513/2447-6595.2019v59n1p21-29.

41. Pitkälä KH, Juola AL, Kautiainen H, Soini H, Finne-Soveri UH, Bell JS, Björkman M. Education to reduce potentially harmful medication use among residents of assisted living facilities: a randomized controlled trial. J Am Med Dir Assoc. 2014; 15(12):892-8. https://doi.org/10.1016/j.jamda.2014.04.002.

42. Da Silva EF, Roderjan JG, Domingues JPF, De Oliveira W. Desprescrição/description. Braz J Develop. 2021; 7(8):80660-5. https://doi.org/10.34117/bjdv7n8-332.

43. Scott IA, Hilmer SN, Reeve E, Potter K, Le Couteur D, Rigby D, et al. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern Med. 2015; 175:827-34. https://doi.org/10.1001/jamainternmed.2015.0324.

44. Potter K, Flicker L, Page A, Etherton-Beer C. deprescribing in frail older people: a randomised controlled trial. PLoS One. 2016; 11:e0149984. https://doi.org/10.1371/journal.pone.0149984.

45. Bloomfield HE, Greer N, Linsky AM, Bolduc J, Naidl T, Vardeny O, et al. Deprescribing for community dwelling older adults: a systematic review and meta-analysis. J Gen Intern Med. 2020; 35(11):3323-32. https://doi.org/10.1007/s11606-020-06089-2.

46. Santos NS dos, Marengo LL, Moraes F da S, Barberato-Filho S. Intervenções para reduzir a prescrição de medicamentos inadequados em pacientes idosos. Rev Saúde Pública. 2019;530:7. https://doi.org/10.11606/S1518-8787.2019053000781.

47. Terrell KM, Perkins AJ, Dexter PR, Hui SL, Callahan CM, Miller DK. Computerized decision support to reduce potentially inappropriate prescribing to older emergency department patients: a randomized controlled trial. J Am Geriat Soc. 2009; 57:1388-94. https://doi.org/10.1111/j.1532-5415.2009.02352.x.

48. Monteiro L, Maricoto T, Solha I, Ribeiro-Vaz I, Martins C, Monteiro-Soares M. Reducing potentially inappropriate prescriptions for older patients using computerized decision support tools: systematic review. J Med Internet Res. 2019; 21(11):e15385. https://doi.org/10.2196/15385.

49. Makeham M, Pont L, Verdult C, Hardie RA, Raban MZ, Mitchell R, et al. The General Practice and Residential Aged Care Facility Concordance of Medication (GRACEMED) Study. Int J Med Inform. 2020; 143:104264. https://doi.org/10.1016/j.ijmedinf.2020.104264.

50. Anvisa. Agencia Nacional de Vigilância Sanitária. Resolução da diretoria colegiada Nº 36, de 25 de julho de 2013 [Internet]. Cited on March 2021. Available at: https://bit.ly/4m6ZEpo.

51. Cavalcante MLSN, Borges CL, Moura AMFTDM, Carvalho REFLD. Indicators of health and safety among institutionalized older adults. Rev. Esc Enferm USP [Internet]. 2016; 50:0602-9. https://doi.org/10.1590/S0080-623420160000500009.

Cómo citar

APA

Argolo, R. S., Queiroz, J. S., Telles Filho, P. C. P. & Praxedes, M. F. da S. (2023). Use of potentially inappropriate medications in long-stay institutions for the elderly: systematic review. Revista de Salud Pública, 25(6), 1–8. https://doi.org/10.15446/rsap.v25n6.98641

ACM

[1]
Argolo, R.S., Queiroz, J.S., Telles Filho, P.C.P. y Praxedes, M.F. da S. 2023. Use of potentially inappropriate medications in long-stay institutions for the elderly: systematic review. Revista de Salud Pública. 25, 6 (nov. 2023), 1–8. DOI:https://doi.org/10.15446/rsap.v25n6.98641.

ACS

(1)
Argolo, R. S.; Queiroz, J. S.; Telles Filho, P. C. P.; Praxedes, M. F. da S. Use of potentially inappropriate medications in long-stay institutions for the elderly: systematic review. Rev. salud pública 2023, 25, 1-8.

ABNT

ARGOLO, R. S.; QUEIROZ, J. S.; TELLES FILHO, P. C. P.; PRAXEDES, M. F. da S. Use of potentially inappropriate medications in long-stay institutions for the elderly: systematic review. Revista de Salud Pública, [S. l.], v. 25, n. 6, p. 1–8, 2023. DOI: 10.15446/rsap.v25n6.98641. Disponível em: https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/98641. Acesso em: 12 feb. 2026.

Chicago

Argolo, Rosiléia Silva, Joseneide Santos Queiroz, Paulo Celso Prado Telles Filho, y Marcus Fernando da Silva Praxedes. 2023. «Use of potentially inappropriate medications in long-stay institutions for the elderly: systematic review». Revista De Salud Pública 25 (6):1-8. https://doi.org/10.15446/rsap.v25n6.98641.

Harvard

Argolo, R. S., Queiroz, J. S., Telles Filho, P. C. P. y Praxedes, M. F. da S. (2023) «Use of potentially inappropriate medications in long-stay institutions for the elderly: systematic review», Revista de Salud Pública, 25(6), pp. 1–8. doi: 10.15446/rsap.v25n6.98641.

IEEE

[1]
R. S. Argolo, J. S. Queiroz, P. C. P. Telles Filho, y M. F. da S. Praxedes, «Use of potentially inappropriate medications in long-stay institutions for the elderly: systematic review», Rev. salud pública, vol. 25, n.º 6, pp. 1–8, nov. 2023.

MLA

Argolo, R. S., J. S. Queiroz, P. C. P. Telles Filho, y M. F. da S. Praxedes. «Use of potentially inappropriate medications in long-stay institutions for the elderly: systematic review». Revista de Salud Pública, vol. 25, n.º 6, noviembre de 2023, pp. 1-8, doi:10.15446/rsap.v25n6.98641.

Turabian

Argolo, Rosiléia Silva, Joseneide Santos Queiroz, Paulo Celso Prado Telles Filho, y Marcus Fernando da Silva Praxedes. «Use of potentially inappropriate medications in long-stay institutions for the elderly: systematic review». Revista de Salud Pública 25, no. 6 (noviembre 1, 2023): 1–8. Accedido febrero 12, 2026. https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/98641.

Vancouver

1.
Argolo RS, Queiroz JS, Telles Filho PCP, Praxedes MF da S. Use of potentially inappropriate medications in long-stay institutions for the elderly: systematic review. Rev. salud pública [Internet]. 1 de noviembre de 2023 [citado 12 de febrero de 2026];25(6):1-8. Disponible en: https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/98641

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