Study on patient safety and rational use of medicines: Assessment of potential drug interactions in prescriptions for elderly patients
DOI:
https://doi.org/10.30968/jhphs.2025.162.1225Abstract
Drug therapy is the most widely used alternative and represents a major advance in the treatment of diseases. However, inappropriate use of medications can aggravate comorbidities and compromise patient safety, becoming a public health problem. Polypharmacy is especially common in the elderly, increasing the risk of drug interactions. Objectives: this study aimed to analyze potential drug interactions in elderly patients admitted to the cardiology ward of a university hospital. Methods: the drug prescriptions prescribed at admission and discharge of hospitalized elderly patients were evaluated, and drug interactions were checked using two software: Medscape and Drugs. com. Results: the most frequent drug interactions, according to the mechanism classification, were pharmacodynamic, both in Drugs. com (89%) and in Medscape (69%). In terms of severity, the most frequent were moderate, both at admission (776) and at discharge (929) in Drugs.com, and in Medscape also 760 (admission) and 904 (discharge). The most prevalent associated drugs were clopidogrel and acetylsalicylic acid (141). Most patients included in the study had more than five prescribed medications (89.14% at admission and 92.12% at discharge), which may be related to the increase in the number of potential drug interactions. Conclusions: the present study contributes to the reflection on therapeutic alternatives, dose adjustment and adequacy of drug posology.
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References
World Health Organization (WHO). Patient safety: making health care safer. Geneva: WHO;2017.
Bueno AAB, Reis AMM, Pinto LMC et al. Segurança do paciente: interações medicamentosas em pacientes adultos internados. Referência. 2020;V(3):e50038. doi: 10.12707/RV20038.
World Health Organization (WHO). The rational use of drugs: report of the conference of experts. Geneva:WHO;1987.
Ferreira LRS. Análise de prescrições: determinação do perfil das inadequações e correlações referentes às prescrições em uma instituição de saúde da cidade de Diamantina/ Minas Gerais. [Dissertação de Mestrado]. Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, 2017.
Santos BS, Nogueira PS, Mascarenhas AMS, et al. Interações medicamentosas potenciais e polifarmácia em prescrições de pacientes acompanhados por farmacêuticos clínicos em unidades de terapia intensiva. Recima 21. 2021;2(9):e29674. doi: 10.47820/recima21.v2i9.674.
Secoli SR. Polifarmácia: interações e reações adversas no uso de medicamentos por idosos. Rev Bras Enferm. 2010;63(1):136-140. doi:10.1590/S0034-71672010000100023.
Cortes ALB, Silvino ZR. Factors associated to potential drug interactions in one Intensive Care Unit: a cross-sectional study. Esc Anna Nery Rev Enferm. 2019;23(3):e20180326. doi: 10.1590/2177-9465-ean-2018-0326.
Pharmaceutical Care Network Europe Association (PCNE). Classification for Drug-Related Problems V 9.1. PCNE. 2020. Available in: https://www.academia.edu/73785592/PCNE_Classification_for_Drug_Related_Problems_V9_1_Page_1_Classification_for_Drug_related_problems. Acessed on:9 abr 2025.
Carvalho SKS. Prevalência de potenciais interações medicamentosas em pacientes internados na unidade de clínica de cardiologia de um hospital terciário. [Monografia]. Universidade de Brasília, Brasília, 2015.
Backes P. Identificação e avaliação de potenciais interações medicamentosas em prescrições de pacientes internados no Hospital Universitário da UFSC. [Dissertação de mestrado]. Universidade Federal de Santa Catarina, Florianópolis, 2013.
Veloso RCSG, Figueredo TP, Barroso SCC, Nascimento MMGD, Reis AMM. Factors associated with drug interactions in elderly hospitalized in high complexity hospital. Fatores associados às interações medicamentosas em idosos internados em hospital de alta complexidade. Cien Saúde Colet. 2019;24(1):17-26. doi:10.1590/1413-81232018241.32602016.
Wells B, Dipiro J, Schwinghammer T, et al. Manual de Farmacoterapia. 9. ed. Porto Alegre:AMGH;2016.
World Health Organization (WHO). The Anatomical Therapeutic Chemical Classification System with Defined Daily Doses (ATC/DDD). Geneva: WHO; 2010.
Drugs.com. Banco de dados de informações sobre medicamentos. Versão 5.2. Available in: https://www.drugs.com. Acessed on:25 jun 2024.
Medscape. Banco de dados de referência de medicamentos. Available in: https://www.medscape.com. Acessed on:25 jun 2024.
Cuentro VS, Souza VP, Silva JM, et al. Prevalência e fatores associados à polifarmácia entre idosos de um hospital público. Rev Contexto Saúde. 2016;16(30):28-35. doi: 10.21527/2176-7114.2016.30.28-35.
Petri AA, Schneider A, Kleibert KRU, et al. Interações medicamentosas potenciais em pacientes hospitalizados. Rev Aten Saúde. 2020;18(63):6248. doi: 10.13037/ras.vol18n63.6248.
Souza, CS de, Feijó IP, Miranda BVB, et al. Polifarmácia em idosos com doenças cardiometabólicas atendidos no Centro de Especialidades Médicas do CESUPA. Revista Ft. 2024;28(134):11117518. doi: 10.5281/zenodo.11117518.
Cooper JA, Cadogan CA, Patterson SM, et al. Interventions to improve the appropriate use of polypharmacy in older people: a Cochrane systematic review. BMJ. 2015; 5(12):e009235. doi:10.1136/bmjopen-2015-009235.
Terassi M, Rissardo LK, Peixoto JS et al. Prevalence of drug use in institutionalized elderly: a descriptive study. Online Braz J Nurs. 2012;11(1):0004. doi: 10.5935/1676-4285.20120004.
Sancar M, Kaşik A, Okuyan B, et al. Determination of Potential Drug-Drug Interactions Using Various Software Programs in a Community Pharmacy Setting. Turk J Pharm Sci. 2019;16(1):14-19. doi:10.4274/tjps.30932.
Santos KFS, Silva CML, Barros IM da C, et al. Potenciais interações medicamentosas em pacientes idosos da clínica médica de um hospital universitário. Scientia Plena. 2022;18(6):064501. doi: 10.14808/sci.plena.2022.064501.
Gómez-García J, Pérez J, Navarro L. Uso de ácido acetilsalicílico para prevenção de eventos trombóticos em pacientes com risco cardiovascular. Rev Cardiovasc Mex. 2017;87(1):34-42. doi:10.1016/j.rcmx.2016.05.015.
Jessup M, Abraham WT, Casey DE, et al. 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009;119:1977-2016. doi: 10.1161/CIRCULATIONAHA.109.192064.
Santos CO dos, Lazaretto FZ, Lima LH, et al. Reconciliação de medicamentos: processo de implantação em um complexo hospitalar com a utilização de sistema eletrônico. Saúde Em Debate. 2019;43(121):368-377. doi:10.1590/0103-1104201912106T.
Terribille M, Zortéa K, Schindler M, et al. Acompanhamento farmacoterapêutico: um estudo de caso. Seminário De Iniciação Científica E Seminário Integrado De Ensino, Pesquisa E Extensão (SIEPE). 2024; e35720. Available in: https://periodicos.unoesc.edu.br/siepe/article/view/35720. Acessed on:10 jan 2025.
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