Prevalence of therapeutic competitions in pharmacotherapy of users of Family Health Units in Ribeirão Preto, São Paulo
DOI:
https://doi.org/10.33448/rsd-v10i5.15256Keywords:
Drug Utilization; Multimorbidity; Primary health care.Abstract
In the current epidemiological scenario, there is a high frequency of chronic non-communicable diseases with the increase in the use of drugs and therapeutic competitions. Thus, the aim of this study was to estimate the prevalence and identify therapeutic competitions in users who were followed up in six Family Health Units in Ribeirão Preto, São Paulo. This is a retrospective, longitudinal, descriptive and exploratory study with a sample consisting of 226 participants. Most were elderly (69.5%), belonged to the female sex (63.7%), were sedentary (48.2%) and had four or five chronic non-communicable diseases (50.8%), the most frequent being systemic arterial hypertension. The potential risk for the occurrence of therapeutic competitions was estimated at 64.2%. Among them, therapeutic competition between beta-blockers, used for the treatment of arterial hypertension, and type 2 diabetes mellitus stood out. The data show the need for a comprehensive approach in the care of the individual with multimorbidities in Primary Health Care. In addition, it alerts the risks of therapeutic competitions and the importance of monitoring the complications of the index disease in the presence of potential therapeutic competition.
References
Andrade, S. S. A., Stopa, S. R., Brito, A. S., Chueri, P. S., Szwarcwald, C. L., & Malta, D. C. (2015). Prevalência de hipertensão arterial autorreferida na população brasileira: análise da Pesquisa Nacional de Saúde, 2013. Epidemiologia e Serviços de Saúde, 24(2), 297–304. https://doi.org/10.5123/s1679- 49742015000200012
Brunton, L.L., Hilal-Dandan R., & Knollmann, B. C. (2019). Goodman & Gilman: As Bases Farmacológicas da Terapêutica. Editora Artmed.
Cerqueira Filho, E. A., Arandas, F. D. S., Oliveira, I. R., & Sena, E. P. (2006). Dislipidemias e antipsicóticos atípicos. Jornal Brasileiro de Psiquiatria, 55(4), 296–307. https://doi.org/10.1590/S0047-20852006000400006
Chang, C. L., Mills, G. D., McLachlan, J. D., Karalus, N. C., & Hancox, R. J. (2010). Cardio-selective and non-selective beta-blockers in chronic obstructive pulmonary disease: Effects on bronchodilator response and exercise. Internal Medicine Journal, 40(3), 193–200. https://doi.org/10.1111/j.1445- 5994.2009.01943.x
Dumbreck, S., Flynn, A., Nairn, M., Wilson, M., Treweek, S., Mercer, S. W., Alderson, P., Thompson, A., Payne, K., & Guthrie, B. (2015). Drug-disease and drug-drug interactions: Systematic examination of recommendations in 12 UK national clinical guidelines. BMJ (Online), 350, 1–8. https://doi.org/10.1136/bmj.h949
Fortin, M., Stewart, M., Poitras, M. E., Almirall, J., & Maddocks, H. (2012). A systematic review of prevalence studies on multimorbidity: Toward a more uniform methodology. Annals of Family Medicine, 10(2), 142–151. https://doi.org/10.1370/afm.1337
Gnjidic, D., Hilmer, S. N., Blyth, F. M., Naganathan, V., Waite, L., Seibel, M. J., McLachlan, A. J., Cumming, R. G., Handelsman, D. J., & Le Couteur, D. G. (2012). Polypharmacy cutoff and outcomes: Five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. Journal of Clinical Epidemiology, 65(9), 989–995. https://doi.org/10.1016/j.jclinepi.2012.02.018
Graham, D. J. (2006). The Seduction of Common Sense. 20993(13), 1–4.
Guthrie, B., Payne, K., Alderson, P., McMurdo, M. E. T., & Mercer, S. W. (2012). Adapting clinical guidelines to take account of multimorbidity. BMJ (Online), 345(7878), 1–5. https://doi.org/10.1136/bmj.e6341
Helfand, M., Peterson, K., Christensen, V., Dana, T., & Thakurata, S. (2009). Drug Class Review Beta Adrenergic Blockers. Oregon Health and Science University, July, 1–616. http://derp.ohsu.edu/final/BB_Final_Evidence Tables_Update 4_09_JUL.pdf
Ickowicz, E. (2012). Guiding principles for the care of older adults with multimorbidity: An approach for clinicians: American Geriatrics Society expert panel on the care of older adults with multimorbidity. Journal of the American Geriatrics Society, 60(10). https://doi.org/10.1111/j.1532-5415.2012.04188.x
Kveiborg, B., Christiansen, B., Major-Petersen, A., & Torp-Pedersen, C. (2006). Metabolic effects of β-adrenoceptor antagonists with special emphasis on carvedilol. American Journal of Cardiovascular Drugs, 6(4), 209–217. https://doi.org/10.2165/00129784-200606040-00001
Lorgunpai, S. J., Grammas, M., Lee, D. S. H., McAvay, G., Charpentier, P., Tinetti, M. E. (2014). Potential therapeutic competition in community-living older adults in the U.S.: Use of medications that may adversely affect a coexisting condition. PLoS ONE, 9(2). https://doi.org/10.1371/journal.pone.0089447
MacMahon FMedSci, S., Elliott FMedSci, P., Levitt, N. (2018). Advancing research to tackle multimorbidity: the UK and LMIC perspectives. June. https://acmedsci.ac.uk/file-download/11182404
MacMahon, S., & The Academy of Medical Sciences. (2018). Multimorbidity: a priority for global health research. Academy of Medical Sciences, April. https://acmedsci.ac.uk/file-download/82222577
Malta, D. C., Stopa, S. R., Szwarcwald, C. L., Gomes, N. L., Silva Júnior, J. B., Reis, A. A. C. (2015). A vigilância e o monitoramento das principais doenças crônicas não transmissíveis no Brasil – pesquisa nacional de saúde, 2013. Revista Brasileira de Epidemiologia, 18, 3–16. https://doi.org/10.1590/1980- 5497201500060002
Malta, D. C., Bernal, R. T. I., Lima, M. G., Araújo, S. S. C., Silva, M. M. A., Freitas, M. I. F., Barros, M. B. de A. (2017). Doenças crônicas não transmissíveis e a utilização de serviços de saúde: análise da Pesquisa Nacional de Saúde no Brasil. Rev Saúde Publica, 51(1), 1–10. https://doi.org/10.1590/S1518- 8787.2017051000090
Marengoni, A., Angleman, S., Melis, R., Mangialasche, F., Karp, A., Garmen, A., Meinow, B., & Fratiglioni, L. (2011). Aging with multimorbidity: A systematic review of the literature. Ageing Research Reviews, 10(4), 430–439. https://doi.org/10.1016/j.arr.2011.03.003
Melo, L. A., & Lima, K. C. (2020). Factors associated with the most frequent multimorbidities in Brazilian older adults. Ciência e Saúde Coletiva, 25(10), 3879– 3888. https://doi.org/10.1590/1413-812320202510.35632018
Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. (2006). Envelhecimento e saúde da pessoa idosa. Brasília: Ministério da Saúde.
Molino, C.G.R.C (2018). Estudo da prevalência de competições terapêuticas entre idosos com multimorbidades do estudo SABE (Saúde, Bem-Estar e Envelhecimento. Dissertação de doutorado. Universidade de São Paulo, São Paulo, SP, Brasil.
Nguyen, T. N., Ngangue, P., Haggerty, J., Bouhali, T., & Fortin, M. (2019). Multimorbidity, polypharmacy and primary prevention in community-dwelling adults in Quebec: A cross-sectional study. Family Practice, 36(6), 706–712. https://doi.org/10.1093/fampra/cmz023
Oliveira-Campos, M., Neto, J. F. R.-, Silveira, M. F., Neves, D. M. R., Vilhena, J. M., Oliveira, J. F., Magalhães, J. C., Drumond, D. (2013). The impact of risk factors of non-communicable chronic diseases on quality of life. Ciência e Saúde Coletiva, 18(3), 873–882. https://doi.org/10.1590/S1413-81232013000300033
Onder, G., Palmer, K., Navickas, R., Jurevičiene, E., Mammarella, F., Strandzheva, M., Mannucci, P., Pecorelli, S., & Marengoni, A. (2015). Time to face the challenge of multimorbidity. A European perspective from the joint action on chronic diseases and promoting healthy ageing across the life cycle (JA- CHRODIS). European Journal of Internal Medicine, 26(3), 157–159. https://doi.org/10.1016/j.ejim.2015.02.020
Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., … Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. https://doi.org/10.1016/S0140-6736(18)32203-7
Salive, M. E. (2013). Multimorbidity in older adults. Epidemiologic Reviews, 35(1), 75–83. https://doi.org/10.1093/epirev/mxs009
Steven, E. Nissen M.D, & Kathy Wolski M.P.H. (2007) Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. The New England Journal of Medicine, 356, 2457–2471.
Touger J. (2006). Introductory physics: building understanding. Diabetes Care, 27(2), 904.
Winkelmayer, W. C., Setoguchi, S., Levin, R., & Solomon, D. H. (2008). Comparison of cardiovascular outcomes in elderly patients with diabetes who initiated rosiglitazone vs pioglitazone therapy. Archives of Internal Medicine, 168(21), 2368–2375. https://doi.org/10.1001/archinte.168.21.2368
World Health Organization. (2005). Preventing chronic diseases a vital investment. Geneva: WHO.
World Health Organization. (2011).Global status report on noncommunicable diseases. Geneva: WHO.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Anelize Roveri Arcanjo; Rinaldo Eduardo Machado de Oliveira; Karoline Fonseca Costa; Mayara Barbosa Pieroni; Julieta Ueta
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.