Frecuencia de deprescripción de medicamentos en pacientes que asisten a consulta externa de geriatría en un Hospital Universitario
ilustraciones, diagramas
- Autores:
-
López Guerrero, Vanessa
Díaz Suárez, Lucia Cristina
- Tipo de recurso:
- Fecha de publicación:
- 2023
- Institución:
- Universidad Nacional de Colombia
- Repositorio:
- Universidad Nacional de Colombia
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.unal.edu.co:unal/84638
- Palabra clave:
- 610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría
Servicios de salud para ancianos
Prescripciones de medicamentos
Health Services for the Aged
Drug Prescriptions
Deprescripción
Polifarmacia
Adulto mayor
Geriatría
Deprescription
Polypharmacy
Elderly
Geriatrics
- Rights
- openAccess
- License
- Atribución-NoComercial-SinDerivadas 4.0 Internacional
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Frecuencia de deprescripción de medicamentos en pacientes que asisten a consulta externa de geriatría en un Hospital Universitario |
| dc.title.translated.eng.fl_str_mv |
Frequency of medication deprescription in geriatric outpatient Clinic of a University Hospital |
| title |
Frecuencia de deprescripción de medicamentos en pacientes que asisten a consulta externa de geriatría en un Hospital Universitario |
| spellingShingle |
Frecuencia de deprescripción de medicamentos en pacientes que asisten a consulta externa de geriatría en un Hospital Universitario 610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría Servicios de salud para ancianos Prescripciones de medicamentos Health Services for the Aged Drug Prescriptions Deprescripción Polifarmacia Adulto mayor Geriatría Deprescription Polypharmacy Elderly Geriatrics |
| title_short |
Frecuencia de deprescripción de medicamentos en pacientes que asisten a consulta externa de geriatría en un Hospital Universitario |
| title_full |
Frecuencia de deprescripción de medicamentos en pacientes que asisten a consulta externa de geriatría en un Hospital Universitario |
| title_fullStr |
Frecuencia de deprescripción de medicamentos en pacientes que asisten a consulta externa de geriatría en un Hospital Universitario |
| title_full_unstemmed |
Frecuencia de deprescripción de medicamentos en pacientes que asisten a consulta externa de geriatría en un Hospital Universitario |
| title_sort |
Frecuencia de deprescripción de medicamentos en pacientes que asisten a consulta externa de geriatría en un Hospital Universitario |
| dc.creator.fl_str_mv |
López Guerrero, Vanessa Díaz Suárez, Lucia Cristina |
| dc.contributor.advisor.none.fl_str_mv |
Alfonso Hernández, Gladys |
| dc.contributor.author.none.fl_str_mv |
López Guerrero, Vanessa Díaz Suárez, Lucia Cristina |
| dc.contributor.researchgroup.spa.fl_str_mv |
Grupo de Apoyo Pedagógico y Formación Docente (GAPFD) |
| dc.subject.ddc.spa.fl_str_mv |
610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría |
| topic |
610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría Servicios de salud para ancianos Prescripciones de medicamentos Health Services for the Aged Drug Prescriptions Deprescripción Polifarmacia Adulto mayor Geriatría Deprescription Polypharmacy Elderly Geriatrics |
| dc.subject.decs.spa.fl_str_mv |
Servicios de salud para ancianos Prescripciones de medicamentos |
| dc.subject.decs.eng.fl_str_mv |
Health Services for the Aged Drug Prescriptions |
| dc.subject.proposal.spa.fl_str_mv |
Deprescripción Polifarmacia Adulto mayor Geriatría |
| dc.subject.proposal.eng.fl_str_mv |
Deprescription Polypharmacy Elderly Geriatrics |
| description |
ilustraciones, diagramas |
| publishDate |
2023 |
| dc.date.accessioned.none.fl_str_mv |
2023-09-04T19:48:42Z |
| dc.date.available.none.fl_str_mv |
2023-09-04T19:48:42Z |
| dc.date.issued.none.fl_str_mv |
2023-09-04 |
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Trabajo de grado - Especialidad Médica |
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info:eu-repo/semantics/masterThesis |
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https://repositorio.unal.edu.co/handle/unal/84638 |
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Universidad Nacional de Colombia |
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Repositorio Institucional Universidad Nacional de Colombia |
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https://repositorio.unal.edu.co/ |
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https://repositorio.unal.edu.co/handle/unal/84638 https://repositorio.unal.edu.co/ |
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Universidad Nacional de Colombia Repositorio Institucional Universidad Nacional de Colombia |
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spa |
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spa |
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Jordan, Joaquín; Garrido, Maria; Fernández I. Modificaciones farmacocinéticas y farmacodinámicas en el anciano. En: Abizanda Soler P, editor. Tratado de Medicina Geriátrica Fundamentos de la atención sanitaria a los mayores. 2a ed. Madrid; 2020. p. 72–8. Halli-Tierney AD, Scarbrough C, Carroll D. Polypharmacy: Evaluating risks and deprescribing. Am Fam Physician. el 1 de julio de 2019;100(1):32–8. RAE. No Title [Internet]. Diccionario de la lengua española. 2023. p. versión 23.6 en línea. Disponible en: https://dle.rae.es. Pazan F, Wehling M. Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. Eur Geriatr Med [Internet]. 2021;12(3):443–52. Disponible en: https://doi.org/10.1007/s41999-021-00479-3. Wastesson JW, Morin L, Tan ECK, Johnell K. An update on the clinical consequences of polypharmacy in older adults: a narrative review. Expert Opin Drug Saf. 2018;17(12):1185–96. Salud OMD La. Informe mundial definición polifarmacia. GINEBRA: OMS; 2013. Scott IA, Hilmer SN, Reeve E, Potter K, Couteur D Le, Rigby D, et al. Reducing inappropriate polypharmacy: The process of deprescribing. JAMA Intern Med. 2015;175(5):827–34. Scott IA, Anderson K, Freeman CR, Stowasser DA. First do no harm: A real need to deprescribe in older patients. Med J Aust. 2014;201(7):390–2. Hovstadius B, Petersson G. Factors Leading to Excessive Polypharmacy. Clin Geriatr Med [Internet]. 2012;28(2):159–72. Disponible en: http://dx.doi.org/10.1016/j.cger.2012.01.001. OMS. Promoción del uso racional de medicamentos: componentes centrales. Perspect políticas sobre Medicam la OMS [Internet]. 2016;5:6. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/67532/WHO_EDM_2002.3_spa.pd f;jsessionid=D617F4B0991FF7D3766BA237F05506AB?sequence=1. Midão L, Giardini A, Menditto E, Kardas P, Costa E. Polypharmacy prevalence among older adults based on the survey of health, ageing and retirement in Europe. Arch Gerontol Geriatr [Internet]. 2018;78:213–20. Disponible en: https://doi.org/10.1016/j.archger.2018.06.018. Ministerio de Salud y Protección Social. Estudio nacional de salud, bienestar y envejecimiento (SABE) Colombia 2015. Resumen ejecutivo. Minsalud [Internet]. 2015;1:1–11. Disponible en: http://asuntosmayores.org/sitio/especiales/cifras/1188- comienza-sabe,-encuesta-sobre-condiciones-de-salud-y-bienestar-de-mayores-de 60-años.htm. Carrillo, Ana Julia; Portilla A. Polifarmacia en pacientes ambulatorios de 5 aseguradoras colombianas 2010-2014. En: Memorias VIII Encuentro Red Latinoamericana De Cuidado Al Paciente Crónico y La Familia. Bogotá: Universidad Nacional de Colombia; 2017. p. 15. Redston MR, Hilmer SN, McLachlan AJ, Clough AJ, Gnjidic D. Prevalence of Potentially Inappropriate Medication Use in Older Inpatients with and without Cognitive Impairment: A Systematic Review. J Alzheimers Dis. 2018;61(4):1639– 52. Pravodelov V. Thoughtful Prescribing and Deprescribing. Med Clin North Am [Internet]. 2020;104(5):751–65. Disponible en: ttps://doi.org/10.1016/j.mcna.2020.06.001. Connor MNO, Gallagher P, Mahony DO. Inappropriate prescribing. N Z Med J. 2002;115(1146):28. O’Connor MN, Gallagher P, O’Mahony D. Inappropriate prescribing: criteria, detection and prevention. Drugs Aging. junio de 2012;29(6):437–52. Ie K, Aoshima S, Yabuki T, Albert SM. A narrative review of evidence to guide deprescribing among older adults. Vol. 22, Journal of General and Family Medicine. John Wiley and Sons Inc; 2021. p. 182–96. Gnjidic D, Le Couteur DG, Hilmer SN. Discontinuing drug treatments: We need better evidence to guide deprescribing. BMJ. 2014;349(November):1–2. Abizanda Soler LRM. Fragilidad en el anciano. Tratado Med Geriátrica. 2020;2(71):671–87. Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried LP. Frailty: implications for clinical practice and public health. Lancet [Internet]. 2019;394(10206):1365–75. Disponible en: http://dx.doi.org/10.1016/S0140- 6736(19)31786-6. Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, et al. A global clinical measure of fitness and frailty in elderly people. C Can Med Assoc J. 2005;173(5):489–95. Van Kan GA, Rolland YM, Morley JE, Vellas B. Frailty: Toward a Clinical Definition. J Am Med Dir Assoc. 2008;9(2):71–2. Hernández CZ. Definición de fragilidad social en personas mayores: una revisión bibliográfica. Rev Med Chil. 2020;148(12):1787–95. Bunt S, Steverink N, Olthof J, van der Schans CP, Hobbelen JSM. Social frailty in older adults: a scoping review. Eur J Ageing. 2017;14(3):323–34. Palmer K, Villani ER, Vetrano DL, Cherubini A, Cruz-Jentoft AJ, Curtin D, et al. Association of polypharmacy and hyperpolypharmacy with frailty states: a systematic review and meta-analysis. Eur Geriatr Med [Internet]. 2019;10(1):9–36. Disponible en: https://doi.org/10.1007/s41999-018-0124-5. Hung C Di, Yang CC, Lee CY, Hu SCS, Chen SC, Hung CH, et al. Polypharmacy is significantly and positively associated with the frailty status assessed using the 5- item frail scale, cardiovascular health phenotypic classification of frailty index, and study of osteoporotic fractures scale. J Clin Med. 2021;10(19):4–13. Li Y, Zhang X, Yang L, Yang Y, Qiao G, Lu C, et al. Association between polypharmacy and mortality in the older adults: A systematic review and meta analysis. Arch Gerontol Geriatr. 2022;100:104630. Rankin A, Cadogan CA, Patterson SM, Kerse N, Cardwell CR, Bradley MC, et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane database Syst Rev. septiembre de 2018;9(9):CD008165. Park H-Y, Park J-W, Song HJ, Sohn HS, Kwon J-W. The Association between Polypharmacy and Dementia: A Nested Case-Control Study Based on a 12-Year Longitudinal Cohort Database in South Korea. PLoS One. 2017;12(1):e0169463. Niikawa H, Okamura T, Ito K, Ura C, Miyamae F, Sakuma N, et al. Association between polypharmacy and cognitive impairment in an elderly Japanese population residing in an urban community. Geriatr Gerontol Int. septiembre de 2017;17(9):1286–93. Rawle MJ, Cooper R, Kuh D, Richards M. Associations Between Polypharmacy and Cognitive and Physical Capability: A British Birth Cohort Study. J Am Geriatr Soc. mayo de 2018;66(5):916–23. Pagán Núñez FT, Tejada Cifuentes F. Prescripción en Cascada y Desprescripción . Vol. 5, Revista Clínica de Medicina de Familia . scieloes ; 2012. p. 111–9. Delgado Silveira E, Montero Errasquín B, Muñoz García M, Vélez-Díaz-Pallarés M, Lozano Montoya I, Sánchez-Castellano C, et al. Mejorando la prescripción de medicamentos en las personas mayores: una nueva edición de los criterios STOPP-START. Rev Esp Geriatr Gerontol. 2015;50(2):89–96. Morales F, Martínez Á, Hernández P. Anamnesis, exploración física y pruebas complementarias en el anciano. Tratado Med Geriátrica. 2020;5:35–49. Cristina Sanjoaquín Romero Elena Fernández Arín Ma Pilar Mesa Lampré Ernesto García-Arilla Calvo A. Capítulo 4 Valoración Geriátrica Integral. Tratado Geriatría para Resid [Internet]. 2004;1–10. Disponible en: https://www.segg.es/tratadogeriatria/PDF/S35-05 04_I.pdf. Sanjoaquín C, Romero E, Fernández M, Mesa E CA. Capítulo 4 Valoración Geriátrica Integral. Tratado Geriatría para Resid. 2004;1–10. Emmanuel R, Junghanns A, Humberto C, Gil Z. Bases y dominios de la valoración geriátrica. Tratado Med geriátrica [Internet]. 2020;(1910):322–9. Disponible en: https://www.clinicalkey.es/#!/content/book/3-s2.0-B9788491132981000375. Montes JFG, Borrero CLC. Capacidad funcional en el anciano [Internet]. Salud del Anciano. Elsevier Espa8#241;a, S.L.; 2022. 191–200 p. Disponible en: http://dx.doi.org/10.1016/B978-84-9022-120-4/00021-5. Cristofori G. Síndromes geriátricos: aspectos fisiopatológicos, clínicos y terapéuticos comunes. Vol. 2, Tratado de Medicina Geriátrica. 2021. 651–657 p. Abizanda Soler P, Sáez Méndez L, Cano C. Formación y docencia en Geriatría. Tratado Med Geriátrica [Internet]. 2015;80–93. Disponible en: http://dx.doi.org/10.1016/B978-84-9022-120-4/00011-2. Reeve E, Thompson W, Farrell B. Deprescribing: A narrative review of the evidence and practical recommendations for recognizing opportunities and taking action. Eur J Intern Med [Internet]. 2017;38:3–11. Disponible en: http://dx.doi.org/10.1016/j.ejim.2016.12.021. Reeve E, Gnjidic D, Long J, Hilmer S. A systematic review of the emerging definition of “deprescribing” with network analysis: Implications for future research and clinical practice. Br J Clin Pharmacol. 2015;80(6):1254–68. Woodward MC. Deprescribing: Achieving Better Health Outcomes for Older People Through Reducing Medications. J Pharm Pract Res. 2003;33(4):323–8. Couteur David Le, Gnjidic D, McLachlan A. Deprescribing. Aust Prescr [Internet]. 2011/12/01. 2011;34(6):182–5. Disponible en: https://www.nps.org.au/australian prescriber/articles/deprescribing. Williams S, Miller G, Khoury R, Grossberg GT. Rational deprescribing in the elderly. Ann Clin psychiatry Off J Am Acad Clin Psychiatr. mayo de 2019;31(2):144–52. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. abril de 2019;67(4):674–94. Gallo C, Vilosio J, Saimovici J. Actualización de los criterios STOPP-START: una herramienta para la detección de medicación potencialmente inadecuada en ancianos New version of STOPP-START criteria: Tools for the detection of potentially inappropriate medications in the elderly. Actual en la Práctica Ambulatoria [Internet]. 2015;18(4):6. Disponible en: www.evidencia.org.ar. O’Mahony MS, Parbhoo A. Deprescribing in older people. Br J Hosp Med. 2020;81(1):114–20. Rollet Q, Bouvier V, Moutel G, Launay L, Bignon AL, Bouhier-Leporrier K, et al. Multidisciplinary team meetings: are all patients presented and does it impact quality of care and survival – a registry-based study. BMC Health Serv Res. 2021;21(1):1–11. Thio SL, Nam J, Van Driel ML, Dirven T, Blom JW. Effects of discontinuation of chronic medication in primary care: A systematic review of deprescribing trials. Br J Gen Pract. 2018;68(675):e663–72. Magin P, Quain D, Tapley A, van Driel M, Davey A, Holliday E, et al. Deprescribing in older patients by early-career general practitioners: Prevalence and associations. Int J Clin Pract [Internet]. el 1 de agosto de 2021 [citado el 6 de octubre de 2022];75(8). Disponible en: https://pubmed.ncbi.nlm.nih.gov/33960089. Potter K, Flicker L, Page A, Etherton-Beer C. Deprescribing in Frail Older People: A Randomised Controlled Trial. PLoS One. 2016;11(3):e0149984. Goyal P, Anderson TS, Bernacki GM, Marcum ZA, Orkaby AR, Kim D, et al. Physician Perspectives on Deprescribing Cardiovascular Medications for Older Adults. J Am Geriatr Soc. enero de 2020;68(1):78–86. Zimmerman KM, Linsky AM. A narrative review of updates in deprescribing research. J Am Geriatr Soc. septiembre de 2021;69(9):2619–24. Djatche L, Lee S, Singer D, Hegarty SE, Lombardi M, Maio V. How confident are physicians in deprescribing for the elderly and what barriers prevent deprescribing? J Clin Pharm Ther. 2018;43(4):550–5. Clough AJ, Hilmer SN, Kouladjian-O’Donnell L, Naismith SL, Gnjidic D. Health professionals’ and researchers’ opinions on conducting clinical deprescribing trials. Pharmacol Res Perspect. junio de 2019;7(3):e00476. Bloomfield HE, Greer N, Linsky AM, Bolduc J, Naidl T, Vardeny O, et al. Deprescribing for Community-Dwelling Older Adults: a Systematic Review and Meta-analysis. J Gen Intern Med. 2020;35(11):3323–32. Cubillos Álzate JC, Matamoris Cárdenas, Mariana Perea Caro SA. Boletines Poblacionales: Personas Adultas Mayores de 60 años. Minsalud - Gob Colomb [Internet]. 2020;10. Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/PS/boletines poblacionales-envejecimiento.pdf. Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform [Internet]. 2019;95(May):103208. Disponible en: https://doi.org/10.1016/j.jbi.2019.103208. Lindley D V. STATISTICS AS A MATHEMATICAL DISCIPLINE BY PREPARED UNDER GRANT DAAG29-77-G-0031 FOR THE U . S . ARMY RESEARCH OFFICE Reproduction in Whole or in Part is Permitted for any purpose of the United States Government Approved for public release ; distribution . 1979;(33). RStudio Team. RStudio: Integrated Development Environment for R [Internet]. Boston, MA; 2015. [Internet]. 2015. Disponible en: http://www.rstudio.com. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform [Internet]. 2009;42(2):377–81. Disponible en: http://dx.doi.org/10.1016/j.jbi.2008.08.010. Esteban Jiménez Ó, Arroyo Aniés MP, Vicens Caldentey C, González Rubio F, Hernández Rodríguez MÁ, Sempere Manuel M. Deprescribing to increase people health or when deprescribing could be the best pill. Aten Primaria [Internet]. 2018;50:70–9. Disponible en: https://doi.org/10.1016/j.aprim.2018.09.001. Song E, Ouellette CP, Reeve E. Deprescribing. UpToDate. 2022;1–69. David E, Bautista G. Costos de la deprescripción de medicamentos en adultos mayores. Repositorio Universidad Nacional de Colombia. 2023. Cano-Guitierrez C, Samper-Ternent R, Cabrera J, Rosselli D. Medication use among older adults in Bogota, Colombia. Rev Peru Med Exp Salud Publica. 2016;33(3):419–24. Baldoni A de O, Ayres LR, Martinez EZ, Dewulf N de LS, Dos Santos V, Pereira LRL. Factors associated with potentially inappropriate medications use by the elderly according to Beers criteria 2003 and 2012. Int J Clin Pharm. abril de 2014;36(2):316–24. Reeve J, Maden M, Hill R, Turk A, Mahtani K, Wong G, et al. Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis. Health Technol Assess (Rockv). 2022;26(32):VII–108. Stahl V. Deprescribing. Med Monatsschr Pharm. 2021;44(12):465–71. García-Peña ÁA, Ospina D, Rico J, Fernández-ávila DG, Muñoz-Velandia Ó, Suárez-Obando F. Prevalence of arterial hypertension in Colombia according to data from the Comprehensive Social Protection Information System (SISPRO). Rev Colomb Cardiol. 2022;29(1):29–35. Oliveros E, Patel H, Kyung S, Fugar S, Goldberg A, Madan N, et al. Hypertension in older adults: Assessment, management, and challenges. Clin Cardiol. febrero de 2020;43(2):99–107. Guerrero A. Patrón social del deterioro cognitivo en Colombia. Repos UniAndes. 2015;151(16):10–7. Scott IA, Hilmer SN, Le Couteur DG. Going Beyond the Guidelines in Individualising the Use of Antihypertensive Drugs in Older Patients. Drugs Aging. agosto de 2019;36(8):675–85. Sheppard JP, Benetos A, McManus RJ. Antihypertensive Deprescribing in Older Adults: a Practical Guide. Curr Hypertens Rep [Internet]. 2022;24(11):571–80. Disponible en: https://doi.org/10.1007/s11906-022-01215-3. Albasri A, Hattle M, Koshiaris C, Dunnigan A, Paxton B, Fox SE, et al. Association between antihypertensive treatment and adverse events: systematic review and meta-analysis. BMJ. febrero de 2021;372:n189. Corrao G, Mazzola P, Monzio Compagnoni M, Rea F, Merlino L, Annoni G, et al. Antihypertensive Medications, Loop Diuretics, and Risk of Hip Fracture in the Elderly: A Population-Based Cohort Study of 81,617 Italian Patients Newly Treated Between 2005 and 2009. Drugs Aging. noviembre de 2015;32(11):927–36. Horodinschi R-N, Stanescu AMA, Bratu OG, Pantea Stoian A, Radavoi DG, Diaconu CC. Treatment with Statins in Elderly Patients. Medicina (Kaunas). octubre de 2019;55(11). Kutner JS, Blatchford PJ, Taylor DH, Ritchie CS, Bull JH, Fairclough DL, et al. Safety and benefit of discontinuing statin therapy in the setting of advanced, life limiting illness a randomized clinical trial. JAMA Intern Med. 2015;175(5):691–700. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 13. Older Adults: Standards of Care in Diabetes—2023. Diabetes Care [Internet]. el 12 de diciembre de 2022;46(Supplement_1):S216–29. Disponible en: https://doi.org/10.2337/dc23-S013. Murillo Muñoz M. Potenciales omisiones en la prescripción médica en una muestra de pacientes Colombianos con riesgo cardiovascular [Internet]. Universidad Nacional de Colombia Sede Bogotá Facultad de Ciencias Departamento de Farmacia. 2016. Disponible en: https://repositorio.unal.edu.co/handle/unal/58239. Makizako H, Shimada H, Doi T, Tsutsumimoto K, Hotta R, Nakakubo S, et al. Social frailty leads to the development of physical frailty among physically non-frail adults: A four-year follow-up longitudinal cohort study. Int J Environ Res Public Health. 2018;15(3). Mantell R, Hwang YIJ, Radford K, Perkovic S, Cullen P, Withall A. Accelerated aging in people experiencing homelessness: A rapid review of frailty prevalence and determinants. Front public Heal. 2023;11:1086215. Mehrabi F, Béland F. Effects of social isolation, loneliness and frailty on health outcomes and their possible mediators and moderators in community-dwelling older adults: A scoping review. Arch Gerontol Geriatr. 2020;90:104119. Ministerio de Salud y Protección Social. Resolución No. 84-30 de 1993 (octubre 4). 1993. Pauff SM, Miller SC. The Medication Appropriateness Index at 20: Where it Started, Where it has been and Where it May be Going. Bone [Internet]. 2012;78(2):711–6. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3624763/pdf/nihms412728.pdf Chang TI, Park H, Kim DW, Jeon EK, Rhee CM, Kalantar-Zadeh K, et al. Polypharmacy, hospitalization, and mortality risk: a nationwide cohort study. Sci Rep [Internet]. 2020;10(1):1–9. Disponible en: https://doi.org/10.1038/s41598-020-75888-8. Lee EA, Brettler JW, Kanter MH, Steinberg SG, Khang P, Distasio CC, et al. Refining the Definition of Polypharmacy and Its Link to Disability in Older Adults: Conceptualizing Necessary Polypharmacy, Unnecessary Polypharmacy, and Polypharmacy of Unclear Benefit. Perm J. 2020;24:1–6. |
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Bogotá, Colombia |
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Universidad Nacional de Colombia - Sede Bogotá |
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Universidad Nacional de Colombia |
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Atribución-NoComercial-SinDerivadas 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Alfonso Hernández, Gladys396207bac16a4297105049fdae3b3027López Guerrero, Vanessa9ad96bd1ba1a0d73dbda6f1ae05b4fffDíaz Suárez, Lucia Cristina28c9812e3d3e6e498a8f6fb1c543f8aaGrupo de Apoyo Pedagógico y Formación Docente (GAPFD)2023-09-04T19:48:42Z2023-09-04T19:48:42Z2023-09-04https://repositorio.unal.edu.co/handle/unal/84638Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones, diagramasLa polifarmacia se ha asociado con incremento en la morbimortalidad y desenlaces adversos. El geriatra en este escenario realiza de forma sistemática el análisis para definir la pertinencia de continuar, modificar la dosis o sustituir un medicamento, teniendo en cuenta factores clínicos, farmacológicos y también las opiniones y preferencias del paciente; a este proceso se le denomina deprescripción. El objetivo del presente estudio fue identificar la frecuencia de deprescripción de medicamentos en la consulta de geriatría del HUN Métodos: Estudio descriptivo, observacional, retrospectivo. Se evaluaron historias clínicas de pacientes mayores de 60 años que asistieron por primera vez a la consulta externa de geriatría durante un periodo de 6 meses. Resultados: Se analizaron 426 historias clínicas. La edad promedio fue 83.4 años (DE 7.1). El 79.5% convivían con un cuidador familiar. Los síndromes geriátricos más frecuentes fueron fragilidad (75.4%) y trastorno neurocognitivo mayor (44.8%). Se encontró que el 56.6% tenían polifarmacia. La prevalencia de deprescripción fue de 68.3%. Los medicamentos más deprescritos fueron antihipertensivos no diuréticos (19.4%), estatinas (13.2%) y diuréticos (10.2%). Conclusiones: Se encontró una alta prevalencia de deprescripción. La fragilidad y el trastorno neurocognitivo mayor son motivos frecuentes de ajuste de metas de tratamiento que junto con la falta de indicación clínica, son los motivos más frecuentes de deprescripción. La deprescripción en el HUN está basada en la VGI y la aplicación de criterios implícitos. (Texto tomado de la fuente)Polypharmacy has been associated with increased morbidity and mortality with adverse outcomes. The geriatrician in this scenario performs an analysis, in a systematic manner, to define the relevance of continuing or modifying the dose or replacing a drug taking into account clinical and pharmacological factors, as well as the opinions and preferences of the patient; this process is called deprescription. This study aims to determine the frequency of deprescription in the National University Hospital's Geriatric outpatient clinic. Methods: This was a descriptive, observational and retrospective study. Clinical records of patients aged 60 years and older, who attended the geriatric outpatient clinic of a university hospital over a 6-month period, were evaluated. Results: A total of 426 clinical records were analyzed. The mean age was 83.4 years (SD 7.1), and 79.5% lived with a family caregiver. The most frequent geriatric syndromes were frailty (75.4%) and major neurocognitive disorder (44.8%). It was found that 56.6% of patients had polypharmacy. The prevalence of medication deprescription was 68.3%. The most commonly deprescribed medications were non-diuretic antihypertensives (19.4%), statins (13.2%), and diuretics (10.2%). Conclusions: A high prevalence of medication deprescription was observed in this study. Frailty and major neurocognitive disorder were frequent reasons for treatment goal adjustments, which, along with the absence of clinical indication, were the most common reasons for deprescription. The deprescription process at HUN is based on the comprehensive geriatric assessment and the application of implicit criteria.Especialidades MédicasEspecialista en GeriatríaEvaluacióniv, 84 páginasapplication/pdfspa610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatríaServicios de salud para ancianosPrescripciones de medicamentosHealth Services for the AgedDrug PrescriptionsDeprescripciónPolifarmaciaAdulto mayorGeriatríaDeprescriptionPolypharmacyElderlyGeriatricsFrecuencia de deprescripción de medicamentos en pacientes que asisten a consulta externa de geriatría en un Hospital UniversitarioFrequency of medication deprescription in geriatric outpatient Clinic of a University HospitalTrabajo de grado - Especialidad Médicainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TMBogotá - Medicina - Especialidad en GeriatríaFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede BogotáColombiaJordan, Joaquín; Garrido, Maria; Fernández I. 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Vol. 2, Tratado de Medicina Geriátrica. 2021. 651–657 p.Abizanda Soler P, Sáez Méndez L, Cano C. Formación y docencia en Geriatría. Tratado Med Geriátrica [Internet]. 2015;80–93. Disponible en: http://dx.doi.org/10.1016/B978-84-9022-120-4/00011-2.Reeve E, Thompson W, Farrell B. Deprescribing: A narrative review of the evidence and practical recommendations for recognizing opportunities and taking action. Eur J Intern Med [Internet]. 2017;38:3–11. Disponible en: http://dx.doi.org/10.1016/j.ejim.2016.12.021.Reeve E, Gnjidic D, Long J, Hilmer S. A systematic review of the emerging definition of “deprescribing” with network analysis: Implications for future research and clinical practice. Br J Clin Pharmacol. 2015;80(6):1254–68.Woodward MC. Deprescribing: Achieving Better Health Outcomes for Older People Through Reducing Medications. J Pharm Pract Res. 2003;33(4):323–8.Couteur David Le, Gnjidic D, McLachlan A. Deprescribing. Aust Prescr [Internet]. 2011/12/01. 2011;34(6):182–5. 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