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Prescripción inapropiada de medicamentos para los ancianos que viven en la comunidad
S M Willcox1, D U Himmelstein, S Woolhandler
1Victorian Health Department, Melbourne, Australia.
JAMA
|July 27, 1994
Resumen
Casi una cuarta parte de los estadounidenses mayores reciben medicamentos inadecuados, lo que aumenta los riesgos. Se necesitan iniciativas más amplias para mejorar la prescripción para las personas mayores.
Área de la Ciencia:
- Geriatría La geriatría es la especialidad de la geriatría.
- Farmacología Farmacología.
- Salud Pública La salud pública.
Sus antecedentes:
- La prescripción inadecuada de medicamentos es una preocupación significativa para los adultos mayores.
- Las personas mayores que viven en la comunidad son particularmente vulnerables a los efectos adversos de las drogas.
- Las estrategias existentes se han centrado principalmente en las poblaciones de ancianos institucionalizados.
Objetivo del estudio:
- Determinar la prevalencia de prescripción inapropiada de medicamentos entre los estadounidenses residentes en la comunidad de 65 años o más.
- Identificar medicamentos específicos que con frecuencia se prescriben de manera inapropiada para este grupo demográfico.
Principales métodos:
- Una encuesta transversal utilizando datos de la Encuesta Nacional de Gastos Médicos de 1987.
- El análisis incluyó a 6171 adultos mayores, con ponderación para garantizar la representatividad nacional.
- Utilizó criterios explícitos desarrollados por expertos en geriatría para identificar 20 medicamentos potencialmente inapropiados.
Principales resultados:
- El 23,5% de los adultos mayores (6,64 millones) recibieron al menos uno de los 20 medicamentos potencialmente inadecuados.
- Los medicamentos inadecuados comúnmente recetados incluyen dipyridamole, propoxyphene y amitriptyline.
- La inclusión de medicamentos cardiovasculares controvertidos elevó la incidencia al 32% (9,04 millones).
Conclusiones:
- Los médicos recetan medicamentos potencialmente inadecuados a una parte sustancial de los ancianos que viven en la comunidad.
- Esta práctica pone a los adultos mayores en riesgo de efectos adversos como deterioro cognitivo y sedación.
- Existe la necesidad de estrategias educativas y regulatorias más amplias más allá de las iniciativas centradas en los hogares de ancianos.
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