A Polimedicação em Idosos: Reconciliação Terapêutica Ferramenta para a Gestão do Processo Terapêutico
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2018-01-23
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Globalmente, os sistemas de saúde evoluem para atingir três objetivos fundamentais: aumentar a qualidade dos cuidados, melhorar a acessibilidade e reduzir os custos, o que, embora não seja mutuamente exclusivo, pode ser muito difícil de equilibrar. A medicação é, de longe, a forma mais comum de intervenção médica para muitas condições agudas e crónicas. A terapia medicamentosa pode ser altamente eficaz na prevenção de doenças ou na desaceleração da progressão da doença, com diretrizes para doenças únicas, recomendando o uso de uma variedade de tratamentos com medicamentos baseados em evidências. No entanto, muitas vezes há uma incompatibilidade entre as diretrizes de prescrição para condições médicas específicas e a variedade de complexidade clínica encontrada no idoso. Além disso, o desperdício de medicamentos, em particular no que diz respeito à polimedicação nos idosos, está associado à falta de qualidade dos procedimentos implementados, representando um risco para a segurança do doente. A polimedicação é comum nos idosos, sendo que quase 50% destes tomam um ou mais medicamentos que não são adequadas e/ou necessários. Nesse sentido, pretendemos apresentar as consequências negativas da polimedicação e as intervenções para melhorar a prescrição. Foi realizado um estudo quantitativo com 594 idosos e verificou-se que 98% deles têm baixo nível de escolaridade, 87,4% refere um rendimento mensal inferior a 500 euros, 55,2% apresenta entre uma e quatro comorbilidades, sendo que 69,4% apresenta, pelo menos, uma patologia. Cerca de 77% apresenta uma patologia crónica, diagnosticada há mais de seis anos. O consumo diário de medicamentos prescritos (mais de três meses) é de 89,3% e apenas 36,6% refere-se a tomar menos de 5 medicamentos. Dos idosos, 51,7% esteve hospitalizado no ano anterior à aplicação do questionário. Cerca de 64,1% refere aderir com maior facilidade à prescrição do seu médico de família, mas 85% refere aderir parcialmente à medicação prescrita. E 40% refere como motivo da não adesão à terapêutica dificuldades económicas. No entanto, apenas 8,4% adquire medicamentos genéricos. De acordo com os resultados, é possível concluir que o desperdício de medicamentos está associado à falta de qualidade dos procedimentos implementados, representando um risco para a segurança do doente. É necessário implementar e desenvolver (novas) tecnologias de informação para melhorar a gestão da informação de saúde e a prescrição farmacológica.
Globally, health systems evolve to meet three fundamental objectives: increasing the quality of care, improving accessibility and reducing costs, which, while not mutually exclusive, can be very difficult to balance. The medication is by far the most common form of medical intervention for many acute and chronic conditions. Medication therapy can be highly effective in preventing disease or slowing disease progression, with guidelines for single diseases recommending the use of a variety of evidence-based medication treatments. However, there is often a mismatch between the prescribing guidelines for specific medical conditions and the variety of clinical complexity found in the elderly. In addition, the wastage in medications, in particular as regards polypharmacy in the elderly, is associated with the lack of quality of procedures implemented, and is also closely related to errors in health, representing a risk to patient's safety. Polypharmacy is common in the elderly and that almost 50% of them take one or more drugs that are not adequate and/or necessary. Therefore, in this sense, we intend to present the negative consequences of polypharmacy and the interventions to improve the prescription of therapy. A quantitative study was conducte with 594 elderly people and 98% of them had low educational level, 87.4% reported a monthly income below 500 euros, 55.2% had between one and four comorbidities, of which 69, 4% present at least one pathology. About 77% have a chronic condition diagnosed more than 6 years ago. The daily consumption of prescription drugs (more than three months) is 89.3% and only 36.6% refers to taking less than five medications. 51.7% were hospitalize the year before the questionnaire was applie. 64.1% reported adhering more easily to the prescription of their family doctor, but 85% reported adhering partially to the medication prescribed. Of the elderly surveyed, 40% reported economic difficulties as a reason for not adhering to the prescribed therapy. However, only 8.4% buy generic drugs According to the results, it is possible to conclude that the waste of medicines is associated with the lack of quality of the implemented procedures, representing a risk to patient safety. It is necessary to implement and develop (new) IT in order to improve health information management and pharmacological prescription.
Globally, health systems evolve to meet three fundamental objectives: increasing the quality of care, improving accessibility and reducing costs, which, while not mutually exclusive, can be very difficult to balance. The medication is by far the most common form of medical intervention for many acute and chronic conditions. Medication therapy can be highly effective in preventing disease or slowing disease progression, with guidelines for single diseases recommending the use of a variety of evidence-based medication treatments. However, there is often a mismatch between the prescribing guidelines for specific medical conditions and the variety of clinical complexity found in the elderly. In addition, the wastage in medications, in particular as regards polypharmacy in the elderly, is associated with the lack of quality of procedures implemented, and is also closely related to errors in health, representing a risk to patient's safety. Polypharmacy is common in the elderly and that almost 50% of them take one or more drugs that are not adequate and/or necessary. Therefore, in this sense, we intend to present the negative consequences of polypharmacy and the interventions to improve the prescription of therapy. A quantitative study was conducte with 594 elderly people and 98% of them had low educational level, 87.4% reported a monthly income below 500 euros, 55.2% had between one and four comorbidities, of which 69, 4% present at least one pathology. About 77% have a chronic condition diagnosed more than 6 years ago. The daily consumption of prescription drugs (more than three months) is 89.3% and only 36.6% refers to taking less than five medications. 51.7% were hospitalize the year before the questionnaire was applie. 64.1% reported adhering more easily to the prescription of their family doctor, but 85% reported adhering partially to the medication prescribed. Of the elderly surveyed, 40% reported economic difficulties as a reason for not adhering to the prescribed therapy. However, only 8.4% buy generic drugs According to the results, it is possible to conclude that the waste of medicines is associated with the lack of quality of the implemented procedures, representing a risk to patient safety. It is necessary to implement and develop (new) IT in order to improve health information management and pharmacological prescription.
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Polimedicação , Idosos , Reconciliação terapêutica , Gestão , Tecnologias de informação