Polypharmacy Detection and Potentially Inappropriate Prescription in the Elderly in a Family Medicine Unit

Abstract

Objectives: determine the presence of polypharmacy and potentially inappropriate prescription in the elderly in a Family Medicine Unit. Methods: Cross-sectional study. 180 clinical records selected by systematic random sampling were analyzed. The inclusion criteria was: patients over 65 years, male and female, with chronic illnesses diagnosis, and assigned to the Family Medicine unit No. 24 of Ciudad Mante, Tamaulipas, México, and who monthly attended their appointments from August 2016 to July 2017. The Stopp/Start criteria were used to assess the relevance of prescription or omission of medications in the elderly based on the medical note; social and demographic data were collected and descriptive statistics were performed for the analysis of the studied variables. Results: 180 records were assessed, 123 women (68%) and 58 men (32%); the average age was 69.4 years. Polypharmacy was detected in 161 of them (89%), an average of four to six drugs per consultation in 94 patients (52%).  The stopp criteria is not fulfilled in 160 of the assessed records (89%), in 108 records (68.7%) patients received at least one incorrect medication, drugs that act in the musculoskeletal system as non-steroidal anti-inflammatory (nsaids) are mostly prescribed. According to the start criteria there was attachment in 132 records (73%), the drugs of the endocrine system were the most prescribed. Conclusions: It was detected the existence of polypharmacy and potentially inappropriate prescription in the elderly in more than half of the assessed records. The stopp/start criteria are underutilized, both criteria are applicable tools in the consultation of the Family Physician and allow, by their application, to avoid the risk of adverse effects or complications associated with the misuse of medicines.