Po1736 Potentially Inappropriate Medications Used In Elderly: Prevalence And Associated Factors In Primary Health Care

Joana Sequeira1, Cláudia Rainho1, M. Catarina Sebe1 e Ana Carvalho1
1USF Flor de Sal
Introduction: The elderly are a vulnerable group with high incidence of chronic diseases and increased risk of polypharmacy and potentially inappropriate medication (PIM). Beers Criteria are one of the most used instruments for assessing appropriateness of prescriptions.
Objective: To determine the prevalence of PIM prescription and factors associated with PIM in older adults in primary health care.
Methods: We performed an analytical retrospective study by consulting the computerized clinical records of a randomly selected sample of patients aged 65 years or older, from primary health care unit. The study occurred in November 2013. Study variables were age, sex, number of co-morbidities, medication prescription in 2013 and number of consultations in 2013. The assessment of inappropriate medication was evaluated using 2012 Beers criteria. The statistical analysis was performed in SPSS® , with a significance level of 0.05.
Results: We have studied a sample of 256 patients, 57.4% were women and the average age was 74,3(7,5) years. We found 290 (14.3%) prescriptions. Prescription of at least one PIM occurred in 60.9% of patients. The majority of PIM prescribed were benzodiazepines (45.8%) and NSAIDs (28.9%). PIM to avoid in older adults with certain diseases were prescribed in 26.1% of cases (N=115). We verified that the patient group with some PIM prescription had on average more consultations in 2013 (6,41 vs 4,13), more medications prescript (9,64 vs 5,53) and more co-morbidities (5,58 vs 4,42), these differences were statistically significant (p0.001). The occurrence of PIM was associated with sex – it occurred in 76.2% of women and in 40.4% of men (p0.001). The number of medicines prescribed was significantly superior in women (8.86 vs 6.64, p0.001) and was correlated with the number of consults (r=0.577, p0.001).
Conclusions: This study, like others published, demonstrated a high rate of PIM in the elderly and that women, those who had more co-morbidities and those with more consultations are more affected. In Portugal, the few studies published confirmed the high rate of PIM prescribed, however they are discordant for prevalence, ranging from 28% to 72%. These results suggest that doctors are not concerned about the problem of PIM in older adults. It’s important that responsible entities of health care in Portugal accept these as a priority intervention area and that the operationalisation to Portugal of the new Beers Criteria are published.
Inappropriate prescribing; Aged; Primary Health Care