The importance of pharmaceutical care as a tool for promoting the rational use of medicines in elderly people who use polypharmacy: an integrative review
DOI:
https://doi.org/10.33448/rsd-v10i15.23560Keywords:
Pharmaceutical Assistance; Multimorbidity; Polypharmacy.Abstract
According to projections around the world, the elderly population tends to grow in the coming decades. With this growth, the appearance of several pathologies in parallel in a single patient tends to become more common (multimorbidity profile), which is characteristic of this age group. This process, in most cases, is accompanied by the consumption of several medications simultaneously (polypharmacy), which is alarming, considering the physiological changes in the elderly, which lead to greater fragility and propensity to problems related to medications. The Pharmaceutical Assistance is an assertive solution to this problem, through individual clinical monitoring. This is an integrative literature review study, of a qualitative nature, which gathered data dealing with the importance of Pharmaceutical Assistance as a tool for the rational use of medicines in polypharmacy elderly people, having as source the main databases, namely: Pubmed, Scielo, and LILLACS, where the following descriptors were used and combined: Pharmaceutical Care, Polypharmacy, Elderly and Rational Use of Medicines, and for PubMed: Pharmaceutical Care and Polypharmacy and Rational Use of Medicines and Elderly. 79 articles were separated, among which, after exhaustive reading, 17 were selected to compose this work. The literature has shown that the presence of a pharmacist performing Pharmaceutical Assistance interventions in these elderly people is extremely important in improving the quality of life, pharmacotherapy, and in the prevention of adverse events, pointing out the impact and multidimensionality of these interventions as well. bringing improvements about self-care.
References
Andres, T. M., McGrane, T., McEvoy, M. D., & Allen, B. F. S. (2019). Geriatric Pharmacology: An Update. Anesthesiol Clin, 37(3), pp. 475-492. DOI: 10.1016/j.anclin.2019.04.007.
Barros, D. S. L., Silva, D. L. M., & Leite, S. N. (2020). Serviços farmacêuticos clínicos na atenção primária à saúde do brasil. Trabalho, Educação e Saúde, 18(1), pp. 1-17. DOI: 10.1590/1981-7746-sol00240.
Bhagavathula, A. S., Vidyasagar, K., Chhabra, M., Rashid, M., Sharma, R., Bandari, D. K. & Fialová D. (2021). Prevalence of polypharmacy, hyperpolypharmacy and potentially inappropriate medication use in older adults in india: a systematic review and meta-analysis. Frontiers In Pharmacology, 12, pp. 1-15. DOI: 10.3389 / fphar.2021.685518.
Busa, G., Burlina, A., Damuzzo, V., Chiumente, M., & Palozzo, A. C. (2018). Comorbidity, polytherapy, and drug interactions in a neurological context: an example of a multidisciplinary approach to promote the rational use of drugs. J Pharm Pract. 31(1), pp. 58-65. DOI: 10.1177/0897190017699138.
Busfield, J. (2015). Assessing the overuse of medicines. Social Science & Medicine, (131), pp. 1-8. DOI: 10.1016/j.socscimed.2014.10.061.
Caldas, A. L. L., Sá, S. P. C., & Filho, V. C. O. (2020). Perceptions of pharmaceutical services among elderly people on polymedication. Revista Brasileira de Enfermagem, 73(5), pp. 1-8, DOI: 10.1590/0034-7167-2019-0305.
Fialová, D. et al. (2019). Medication use in older patients and age-blind approach: narrative literature review (insufficient evidence on the efficacy and safety of drugs in older age, frequent use of pims and polypharmacy, and underuse of highly beneficial nonpharmacological strategies). European Journal Of Clinical Pharmacology, 75(4), pp. 451-466. DOI: 10.1007 / s00228-018-2603-5.
Gutiérrez-Valencia, M., Izquierdo, M., Cesari, M. Casas-Herrero, A., Inzitari, M., & Martínez-Valilla, N. (2018). The relationship between frailty and polypharmacy in older people: a systematic review. Br J Clin Pharmacol. 84(7), pp.1432-1444. DOI: 10.1111/bcp.13590.
Halli-Tierney, A. D., Scarbrough, C., & Carroll, D. (2019). Polypharmacy: evaluating risks and deprescribing. Am Fam Physician, 100(1), pp. 32-38.
Hashinomoto, Y. & Tensho, M. (2016). Effect of pharmacist intervention on physician prescribing in patients with chronic schizophrenia: a descriptive pre/post study. Bmc Health Services Research, 16(1), pp. 1-5. DOI: 10.186 / s12913-016-1408-4.
Hughes, C. M., Cadogan, C. A., Patton, D., & Ryan, C. A. (2016). Pharmaceutical strategies towards optimising polypharmacy in older people. Int J Pharm, 512(2), pp. 360-365. DOI: 10.1016/j.ijpharm.2016.02.035 .
Lima, M. G. & Acurcio, F. A. (2017). Indicators related to the rational use of medicines and its associated factors. Rev Saude Publica, 51. DOI: 10.11606/S1518-8787.2017051007137.
Linsky, A., Simon, S. R., Stolzmann, K., & Meterko, M. (2018). Patient attitudes and experiences that predict medication discontinuation in the Veterans Health Administration. Journal Of The American Pharmacists Association, 58(1), pp. 13-20. DOI: 10.1016 / j.japh.2017.10.012.
Lopes, L. M., Figueiredo, T. P., Costa, S. C. & Reis A. M. M. (2016). Use of potentially inappropriate medications by the elderly at home. Cien Saude Coletiva, 21(11) pp. 3429-3438. DOI: 10.1590/1413-812320152111.14302015.
Manso, M. E. G., Biffi, E. C. A. & Gerardi, T. J. (2015). Prescrição inadequada de medicamentos a idosos portadores de doenças crônicas em um plano de saúde no município de São Paulo, Brasil. Revista Brasileira de Geriatria e Gerontologia, 18(1), pp. 1-4. DOI: 10.1590/1809-9823.2015.14056.
Marconi, M. A. & Lacatos, E. M. (2021). Fundamentos da Metodologia Cinetífica. São Paulo: Atlas.
Mortazavi, S. S., Shati, M., Keshtkar, A., Malakouti, S. K., Bazargan, M., & Assari, S. (2016). Defining polypharmacy in the elderly: a systematic review protocol. BMJ Open, 6(3), pp. 1-4. DOI: 10.1136/bmjopen-2015-010989.
Nascimento, R. C. R. M. & Acurcio, F. A. (2017). Polypharmacy: a challenge for the primary health care of the brazilian unified health system. Revista de Saúde Pública, 51(2), pp. 1-12. DOI: 10.11606/S1518-8787.2017051007136.
Oliveira, H. S. B. & Corradi, M. L. G. (2018). Aspectos farmacológicos do idoso: uma revisão integrativa de literatura. Revista de Medicina, 97(2), pp. 165-176. DOI: 10.11606/issn.1679-9836.v97i2.
Perissé, C. & Marli, M. (2019). Longevidade - Viver Bem e Cada Vez Mais. Revista Retratos, 16, pp. 19-25.
Ramos, L. R., Tavares, N. U. L., Bertoldi, A. D., Farias, M. R., Oliveira, M. A., Luiza, V. L., Pizzol, T. S. D., Arrais, P. S. D., & Mengue, S. S. (2016). Polypharmacy and Polymorbidity in Older Adults in Brazil: a public health challenge. Rev Saude Publica, 50, pp. 1-13. DOI: 10.1590/S1518-8787.2016050006145.
Santos, P. C. J. L. (2016). Atenção Farmacêutica: contexto atual, exames laboratoriais e Acompanhamento Farmacoterapêutico. São Paulo: Atheneu.
Sarwar, M. R., Atif, M., Scahill, S., Saqib, A. Qamar-uz-Zaman, M., & Babar, Z. (2017). Drug utilization patterns among elderly hospitalized patients on poly-pharmacy in Punjab, Pakistan. J Pharm Policy Pract, 10(23), pp. 1-16. DOI: 10.1186/s40545-017-0112-z.
Sgnaolin, V., Engroff, P., Linkievicz, N. M., Gomes, I., & Neto, A. C. (2020). Potentially inappropriate medication and associated factors such as depression and dementia: an analysis of middle-aged and elderly people. Scientia Medica, 30(1), pp. 34478-34492. DOI: 10.15448/1980-6108.2020.1.344778.
Silva, P. L. N., Xavier, A. G., Souza, D. A., & Vaz, M. D. T. (2017). Atenção farmacêutica e os potenciais riscos da polifarmácia em idosos usuários de uma farmácia-escola de Minas Gerais: aspectos socioeconômicos, clínico e terapêutico. Journal Of Health & Biological Sciences, 5(3), pp. 247-252. DOI: 10.12662/2317-3076jhbs.v5i3.1187.
Unutmaz, G. F., Soysal, P., Tuven, B., & Isik, A.T. (2018). Costs of medication in older patients: before and after comprehensive geriatric assessment. Clin Interven Aging, 13, pp. 607-613. DOI: 10.2147/cia.s159966.
Van der Linden, L., Decoutere, L., Walgraeve, K., Milisen, K., Flamaing, J., Spriet, I., & Tournoy, J. (2017). Combined use of the rationalization of home medication by an adjusted stopp in older patients (rasp) list and a pharmacist-led medication review in very old inpatients: impact on quality of prescribing and clinical outcome. Drugs Aging, 34(2), pp.123-133. DOI: 10.1007/s40266-016-0424-8.
Van der Linden, L., Hias, J., Dreessen, L., Milisen, K., Flamaing, J., Spriet, I., & Tournoy, J. (2018). Medication review versus usual care to improve drug therapies in older inpatients not admitted to geriatric wards: a quasi-experimental study (RASP-IGCT). BMC Geriatr, 18, pp. 155-165. DOI: 10.1186/s12877-018-0843-y.
Whitman, A., DeGregory, K., Morris, A., Mohile, S., & Ramsdale, E. (2018). Pharmacist-led medication assessment and deprescribing intervention for older adults with cancer and polypharmacy: a pilot study. Support Care Cancer, 26(12), pp. 4105-4113. DOI: 10.1007/s00520-018-4281-3.
Williams, S., Miller, G., Khoury, R., & Grossberg, G.T. (2019). Rational deprescribing in the elderly. Ann Clin Psychiatry, 31(2), pp. 144-152.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 João Cláudio Costa e Silva; Renata Prado Silva Nogueira
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.
