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Prescription of potentially inappropriate medications for older adults: a cross-sectional study in psychiatric institution

ABSTRACT

Objective

To estimate the frequency of prescription of potentially inappropriate medications (PIM) for institutionalized older adults in a psychiatric hospital.

Methods

Descriptive study, transversal, based on analysis of prescriptions for individuals aged over 65 years (n = 40), drawn up in January 2013 and collected from medical records in a public hospital. Sociodemographic and clinical variables were analyzed. Medications were categorized by Beers Criteria (BC): 1) PIM which should be avoided in any clinical condition; 2) PIM to avoid in older adults with certain diseases identified on the study; 3) medications to be used with caution in older adults.

Results

There was a predominance of females (62.5%, n = 25/40). Regarding age, the average was 73 years (66-93 years). The inpatient average time was 15 years and the main diagnosis was schizophrenia (56.4%; n = 22/39). The prevalence of polypharmacy was 70%. The most commonly prescribed drugs were promethazine and haloperidol. Regarding the CB, it was observed that 40.2% (n = 90/224) of the prescribed drugs have been classified as PIM in any clinical condition; 38.8% (n = 87/224) PIM in specific clinical conditions and 23.7% (n = 53/224) belonged to the category of drugs that should be used with caution in the older adults.

Conclusion

We obtained a high prevalence of PIM for older adults compared with similar studies. The BC contributed to the analysis of the requirements, enabling the identification of drugs that may enhance the risk of developing iatrogenic or worsening of preexisting conditions.

Prescription drugs; mental health; psychiatric hospitals; medical prescription

Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro Av. Venceslau Brás, 71 Fundos, 22295-140 Rio de Janeiro - RJ Brasil, Tel./Fax: (55 21) 3873-5510 - Rio de Janeiro - RJ - Brazil
E-mail: editora@ipub.ufrj.br