Drug Utilization in Homes for the Aged in Brasilia, Brazil

Mirna Poliana Furtado de Oliveira, Maria Rita Carvalho Garbi Novaes

Faculty of Health Sciences, Post Graduation in Health Sciences, University of Brasilia, Brasilia, Brazil.

DOI: 10.4236/ijcm.2012.32021                

Abstract

This paper aims to describe the socioeconomic and epidemiological profile, as well as the standards of medicine consumption in a group of 154 elderly people from five homes for the aged in Brasilia, in order to expand the understanding about some characteristics and individual needs of this population and its influence on the quality of drug’s therapy. Data were collected between January and December of 2007, it was used a questionnaire adapted from Dader’s method (2002) and a pharmacotherapeutic follow up method and it was responded by the elders and caregivers. Data were supplemented with information from medical records and prescriptions available in the institutions. The studied group has an average age of 74.6 years, living in their current homes for about 5.4 years and the group consists mainly of men with preserved cognitive status. The members of the group have low monthly income, low education level and are sedentary. They consume 4 - 5 drugs and are affected mainly by cardiovascular and psychiatric diseases. Results suggest that low monthly income, low education level, the prevalence of sedentary lifestyle, elders with compromised cognitive status, the increasing number of chronic diseases and the high consumption of drugs in the researched group may be important factors for the emergence or injury drugs-related problems (DRP) as non-adherence to treatment, medication errors, drug interactions and adverse drug reactions compromising the quality of medication therapy. This study points out the necessity of including a pharmacotherapeutic follow-up for the elderly people in order to minimize such problems and provide better quality of life for patients.

Keywords

Elderly; Homes for the Aged; Health of the Elderly; Health of Institutionalized Elderly; Drug Therapy; Drug Utilization

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	F. Chaimowicz, “Health of the Brazilian Elderly Population on the Eve of the 21st Century: Current Problems, Forecasts and Alternatives,” Journal of Public Health, Vol. 31, No. 2, 1997, pp. 184-200.
[2]	M. Z. Danilow, A. C. S. Moreira, C. G. Villela, B. B. Barra, M. R. C. G. Novaes and M. P. F. Oliveira, “Epidemiological, Socialdemographic and Psychosocial Profile of Institutionalized Elders of the Federal District,” Com Ciencias Saude, Vol. 18, No. 1, 2007, pp. 9-16.
[3]	L. M. Flores and S. S. Mengue, “Drug Use by the Elderly in Southern Brazil,” Revista de Saúde Pública, Vol. 39, No. 6, 2005, pp. 924-929.
[4]	M. P. F. Oliveira, “Pharmaceutical Assistance to Elderly Institutionalized from Federal District,” Master’s Degree Dissertation, Universidad de Brasília, Brasília, 2008.
[5]	A. Q. Ribeiro, S. Rozenfeld, C. H. Klein, C. C. Cesar and F. A. Acurcio, “Survey on Medicine Use by Elderly Retirees in Belo Horizonte, Southeastern Brazil,” Revista de Saúde Pública, Vol. 42, No. 4, 2008, pp. 724-32. doi:10.1590/S0034-89102008005000031
[6]	M. P. F. Oliveira and M. R. C. G. Novaes, “Drug-Related Problems in Institutionalized Elderly in Brasilia, Brazil,” Biomedicine & Aging Pathology, Vol. 1, No. 3, 2011, pp. 179-184. doi:10.1016/j.biomag.2011.09.007
[7]	C. H. Rocha, A. P. S. Oliveira, C. Ferreira, F. T. Faggiani, G. Schroeter, A. C. A. Souza, G. A. DeCarli, F. B. Morrone and M. C. Werlang, “Medication Adherence of Elderly in Porto Alegre, RS,” Ciência & Saúde Coletiva, Vol. 13, 2008, pp. 703-710.
[8]	S. Rozenfeld, “Prevalence, Associated Factors, and Misuse of Medication in the Elderly: A Review,” Cadernos de Saúde Pública, Rio de Janeiro, Vol. 19, No. 3, 2003, pp. 717-724.
[9]	C. R. K. Blanski and M. H. A. Lenardt, “Comprehension of Therapeutic Medication by the Elderly,” Revista Gaúcha de Enfermagem, Vol. 26, No. 2, 2005, pp. 180-188.
[10]	P. Medeiros-Souza, L. L. Santos-Neto, L. T. E. Kusano and M. G. Pereira, “Diagnosis and Control of Polypharmacy in the Elderly,” Revista de Saúde Pública, Vol. 41, No. 6, 2007, pp. 1049-1053. doi:10.1590/S0034-89102006005000050
[11]	N. M. O. G. Perlini, M. T. Leite and A. C. Furini, “Looking for a Nursing Home for an Elderly Person: Reasons Appointed by Relatives,” Revista da Escola de Enfermagem-USP, Vol. 41, No. 2, 2007, pp. 229-236. doi:10.1590/S0080-62342007000200008
[12]	M. Creutzberg, L. H. T. Goncalves, E. A. Sobottka and B. S. Ojeda, “Long-Term Care Institutions for Elders and the Health System,” Revista Latino-Americana de Enfermagem, Vol. 15, No. 6, 2007, pp. 1144-1149. doi:10.1590/S0104-11692007000600014
[13]	N. A. Chaudri, “Adherence to Long-Term Therapies Evidence for Action,” Annals of Saudi Medicine, Vol. 24, No. 3, 2004, pp. 221-222.
[14]	M. Machuca, F. Fernández-Llimós and M. J. Faus, “Método Dáder. Guia de Seguimento Farmacoterapeutico,” GIAF-UGR, 3rd Edition, 2003.
[15]	M. O. P. H. Araujo and M. F. Ceolim, “Assessment of the Level of Independence of elderly residents in Long-Term Care Institutions,” Revista da Escola de Enfermagem-USP, Vol. 41, No. 3, 2007, pp. 378-385.
[16]	J. I. Castellar, M. G. O. Karnikowski, L. G. Vianna and O. T. Nobrega, “Study of the Pharmacoterapy Prescribed Older-Adult in a Brazilian Long-Term Care Facility,” Acta Medica Portuguesa, Vol. 20, 2007, pp. 97-105.
[17]	F. A. Cintra, M. E. Guariento and L. A. Miyasaki, “Medicine Adhesion in Elderly People in an Ambulatorial Attendance,” Ciência & Saúde Coletiva, Vol. 15, Supl. 3, 2010, pp. 3507-3515.
[18]	M. E. R. Converso and I. Iartelli, “Analysis and Characterization of Functional Capacity and Mental State in Residents in Old Folk’s Home,” Jornal Brasileiro de Psiquiatria, Vol. 56, No. 4, 2007, pp. 267-272. doi:10.1590/S0047-20852007000400005
[19]	C. J. Correr, R. Pontarolo, L. C. Ferreira and S. A. M. Baptistao, “Drug-Related Problems Risks in Patients of a Geriatric Institution,” Brazilian Journal of Pharmaceutical Sciences, Vol. 43, No. 1, 2007, pp. 55-62.
[20]	A. I. Loyola Filho, “Influence of Income on the Association between Cognitive Impairment and Polypharmacy: Bambuí Project,” Revista de Saúde Pública, Vol. 42, No. 1, 2008, pp. 89-99. doi:10.1590/S0034-89102008000100012
[21]	J. J. V. Teixeira, F. G. Cano, A. C. C. Sanches, T. A. Carniel and D. S. L. G. Schneider, “Pharmacoepidemiological Survey of Middle-Age and Elderly Patients in Three Communities of Cascavel, PR-Brazil: Progressive Verification of Their Therapeutic Knowledge,” Brazilian Journal of Pharmaceutical Sciences; Vol. 44, No. 2, 2008, pp. 297-303.
[22]	B. D. Hayes, W. Klein-Schwartz and F. Barrueto Jr., “Polypharmacy and the Geriatric Patient,” Clinics in Geriatric Medicine, Vol. 23, No. 2, 2007, pp. 371-390. doi:10.1016/j.cger.2007.01.002
[23]	A. Rajska-Neumann and K. Wieczorowska-Tobis, “Polypharmacy and Potential Inappropriateness of Pharmacological Treatment among Commuinity-Dwelling Elderly Patients,” Archives of Gerontology and Geriatrics, Vol. 44, Suppl. 1, 2007, pp. 303-309. doi:10.1016/j.archger.2007.01.040
[24]	S. L. Nogueira, R. C. L. Ribeiro, L. E. F. P. L. Rosado, S. C. C. Franceschini, A. Q. Ribeiro and E. T. Pereira, “Determinant Factors of Funcional Status among the Oldest Old,” Revista Brasileira de Fisioterapia, Vol. 14, No. 4, 2010, pp. 322-329. doi:10.1590/S1413-35552010005000019
[25]	A. V. Cruz, I. Fulone, M. Alcalá, A. A. Fernandes, M. I. Montebelo and L. C. Lopes, “Long-Term Use of Diazepam in Elderly Patients Treated by the Public Health System in Tatuí (SP, Brazil),” Journal of Basic and Applied Pharmaceutical Sciences, Vol. 27, No. 3, 2006, pp. 259-267.
[26]	M. F. Lima-Costa, S. M. Barreto and L. Giatti, “Health Status, Physical Functioning, Health Services Utilization, and Expenditures on Medicines among Brazilian Elderly: A Descriptive Study Using Data from the National Household Survey,” Cadernos de Saúde Pública, Vol. 19, No. 3, 2003, pp. 735-743. doi:10.1590/S0102-311X2003000300006
[27]	V. M. V. Paniz, A. G. Fassa, L. A. Facchini, A. D. Bertoldi, R. X. Piccini, E. Tomasi, E. Thumé, D. S. Silveira, F. V. Siqueira and M. A. Rodrigues, “Access to Continuous-Use Medication among Adults and the Elderly in South and Northeast Brazil,” Cadernos de Saúde Pública, Vol. 24, No. 2, 2008, pp. 267-280. doi:10.1590/S0102-311X2008000200005