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La administración de medicamentos en ancianos clínicamente complejos: "Tiene que haber un medio feliz"
Michael A Steinman1, Joseph T Hanlon
1Division of Geriatrics, University of California, San Francisco, and the San Francisco VA Medical Center, San Francisco, California 94121, USA. mike.steinman@ucsf.edu
JAMA
|October 14, 2010
Resumen
Los adultos mayores a menudo usan múltiples medicamentos, lo que puede provocar problemas. Este artículo revisa las estrategias para mejorar el uso de medicamentos y la depresión en pacientes de edad avanzada para mejorar los resultados de salud.
Área de la Ciencia:
- Gerontología Gerontología.
- Farmacología Farmacología.
- Medicina interna es la medicina interna de las enfermedades.
Sus antecedentes:
- La polifarmacia es prevalente en los adultos mayores, ofreciendo beneficios pero con riesgos significativos.
- Estos riesgos incluyen errores de prescripción, mala adherencia, eventos adversos de medicamentos y resultados negativos para la salud.
- La administración de múltiples medicamentos en los ancianos es un desafío crítico para la atención médica.
Objetivo del estudio:
- Revisar la literatura basada en la evidencia sobre la optimización del uso de medicamentos en adultos mayores.
- Discutir estrategias para la retirada segura de fármacos específicos y clases de fármacos (desprescripción).
- Presentar un enfoque sistemático para que los profesionales de la salud evalúen y mejoren los regímenes de medicamentos para pacientes ancianos.
Principales métodos:
- Revisión de la literatura de estudios basados en la evidencia sobre el manejo de la medicación en adultos mayores.
- Ilustración de un estudio de caso de un paciente mayor con uso múltiple de medicamentos.
- Síntesis de información sobre la mejora de los regímenes de medicación y la depresión.
Principales resultados:
- El uso múltiple de medicamentos presenta ventajas terapéuticas y riesgos sustanciales en poblaciones mayores.
- La evidencia apoya enfoques sistemáticos para la revisión de medicamentos y la desconscripción.
- Un mejor manejo de la medicación puede beneficiar a los pacientes, cuidadores y familias.
Conclusiones:
- La optimización de los regímenes de medicación y la desprescripción juiciosa son esenciales para mejorar la salud y la calidad de vida de los adultos mayores.
- Los profesionales de la salud requieren métodos sistemáticos para administrar eficazmente la polifarmacia.
- La evaluación de la medicación centrada en el paciente puede mitigar los riesgos asociados con el uso múltiple de drogas en los ancianos.
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