Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward
Introduction: Polypharmacy is often observed in elderly patients and is associated with an increased risk of adverse drug reactions, side effects and interactions. Clinicians should be alert to inappropriate drug prescribing and reduce polypharmacy. Material and Methods: Observational, longitudina...
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2019-02-01
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doaj-8c4759549e2b477cbb1d03f7e6ac025f2020-11-25T01:48:33ZengOrdem dos MédicosActa Médica Portuguesa0870-399X1646-07582019-02-0132214114810.20344/amp.106834795Inappropriate Prescribing to Elderly Patients in an Internal Medicine WardJoana Urzal0Ana Bárbara Pedro1Inês Ferraz de Oliveira2Inês Romero3Miguel Achega4Iuri Correia5Fernando Aldomiro6João Augusto7Departamento de Medicina Interna. Hospital Professor Doutor Fernando Fonseca. Amadora.Departamento de Medicina Interna. Hospital Professor Doutor Fernando Fonseca. Amadora.Departamento de Medicina Interna. Hospital Professor Doutor Fernando Fonseca. Amadora.Departamento de Medicina Interna. Hospital Professor Doutor Fernando Fonseca. Amadora.Departamento de Medicina Interna. Hospital Professor Doutor Fernando Fonseca. Amadora.Departamento de Medicina Interna. Hospital Professor Doutor Fernando Fonseca. Amadora.Departamento de Medicina Interna. Hospital Professor Doutor Fernando Fonseca. Amadora.Departamento de Cardiologia. Hospital Professor Doutor Fernando Fonseca. Amadora.Introduction: Polypharmacy is often observed in elderly patients and is associated with an increased risk of adverse drug reactions, side effects and interactions. Clinicians should be alert to inappropriate drug prescribing and reduce polypharmacy. Material and Methods: Observational, longitudinal, retrospective and descriptive study in an internal medicine ward in a Portuguese hospital. Polypharmacy was defined as the use of five or more different medicines. The purpose of this study was to describe the prevalence of polypharmacy and inappropriate prescribing at admission and discharge in an internal medicine ward, according to deprescribing.org guidelines/algorithms. A total of 838 consecutive patients were admitted between January and July 2017. All patients were aged under 65 years old, and those who died before discharge were excluded. Patients’ medications were reviewed from a medical database at hospital admission and discharge. We examined whether patients were taking anticoagulants, proton pump inhibitors, benzodiazepines, antipsychotics and/or antihyperglycemic medication. Results: A total of 483 patients were included, mean age was 79.2 ± 8.0 years, and 42% of patients were male. Median number of medications at admission and discharge was six. Polypharmacy was present in more than 70% of admitted patients. Proton pump inhibitors were the most common inappropriate prescription at discharge (17.2%). Discussion: This study demonstrated a low use of inappropriate medicine (11.2% - 17.2%) in older people discharged from hospital, when compared to other studies. Conclusion: Our study shows that polypharmacy is present in more than 70% of elderly admitted patients. Nevertheless, the drug inappropriateness rate was not significantly affected by polypharmacy at both admission and discharge, being overall lower than published data.https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10683AgedDeprescriptionsInappropriate PrescribingPolypharmacyPortugal |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Joana Urzal Ana Bárbara Pedro Inês Ferraz de Oliveira Inês Romero Miguel Achega Iuri Correia Fernando Aldomiro João Augusto |
spellingShingle |
Joana Urzal Ana Bárbara Pedro Inês Ferraz de Oliveira Inês Romero Miguel Achega Iuri Correia Fernando Aldomiro João Augusto Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward Acta Médica Portuguesa Aged Deprescriptions Inappropriate Prescribing Polypharmacy Portugal |
author_facet |
Joana Urzal Ana Bárbara Pedro Inês Ferraz de Oliveira Inês Romero Miguel Achega Iuri Correia Fernando Aldomiro João Augusto |
author_sort |
Joana Urzal |
title |
Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward |
title_short |
Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward |
title_full |
Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward |
title_fullStr |
Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward |
title_full_unstemmed |
Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward |
title_sort |
inappropriate prescribing to elderly patients in an internal medicine ward |
publisher |
Ordem dos Médicos |
series |
Acta Médica Portuguesa |
issn |
0870-399X 1646-0758 |
publishDate |
2019-02-01 |
description |
Introduction: Polypharmacy is often observed in elderly patients and is associated with an increased risk of adverse drug reactions, side effects and interactions. Clinicians should be alert to inappropriate drug prescribing and reduce polypharmacy.
Material and Methods: Observational, longitudinal, retrospective and descriptive study in an internal medicine ward in a Portuguese hospital. Polypharmacy was defined as the use of five or more different medicines. The purpose of this study was to describe the prevalence of polypharmacy and inappropriate prescribing at admission and discharge in an internal medicine ward, according to deprescribing.org guidelines/algorithms. A total of 838 consecutive patients were admitted between January and July 2017. All patients were aged under 65 years old, and those who died before discharge were excluded. Patients’ medications were reviewed from a medical database at hospital admission and discharge. We examined whether patients were taking anticoagulants, proton pump inhibitors, benzodiazepines, antipsychotics and/or antihyperglycemic medication.
Results: A total of 483 patients were included, mean age was 79.2 ± 8.0 years, and 42% of patients were male. Median number of medications at admission and discharge was six. Polypharmacy was present in more than 70% of admitted patients. Proton pump inhibitors were the most common inappropriate prescription at discharge (17.2%).
Discussion: This study demonstrated a low use of inappropriate medicine (11.2% - 17.2%) in older people discharged from hospital, when compared to other studies.
Conclusion: Our study shows that polypharmacy is present in more than 70% of elderly admitted patients. Nevertheless, the drug inappropriateness rate was not significantly affected by polypharmacy at both admission and discharge, being overall lower than published data. |
topic |
Aged Deprescriptions Inappropriate Prescribing Polypharmacy Portugal |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10683 |
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