Estudo da iatrogenia por interação medicamentosa e sua relação com a fragilidade em idosos residentes na comunidade

Abstract

This study aimed to investigate the use of drugs and their potential drug interactions as factors associated with the fragility syndrome. Research of observational, transversal, descriptive, analytical, population-based design; Linked to the research "The Health of the Elderly in Primary Care". The study population was aged 60 years and older, both sexes, enrolled in one of the twelve Family Health Strategies (ESFs) of the urban area of the municipality in the northwestern region of Rio Grande do Sul. The study sample was probabilistic and the reference for the calculation Of the sample size were the data from the Brazilian Institute of Geography and Statistics and the number of elderly people attached to Thus, a size of 636 elderly people was reached and the stratified sampling technique was used by ESF and by sex. Due to losses during the study, the final sample occurred with 554 subjects. Data collection was performed in the home, with information on sociodemographic characteristics, pharmacotherapeutic profile and fragility evaluation, based on Fried et al., (2001) criteria. The results highlight the association between fragility and the variables: polypharmacy; Use of potentially inappropriate drugs (MPI); Potential drug interactions (MI) and more than two potential drug interactions with or without MPI. In addition, there was a relationship between: fragility and polypharmacy, where the elderly who used five or more drugs had a 2.24 times greater chance for this condition; (OR = 1.59, 95% CI 1.12-2.25), and in the elderly with more than two interactions with or without MPI. When considering specific IM potentials present in the fragile elderly, there was a higher frequency between Enalapril and Metformin; And between Digoxin and Omeprazole, when considered interactions between inappropriate drugs. A significant association between fragility and interactions between calcium and hydrochlorothiazide (p = 0.02) and between Digoxin and Omeprazole (p = 0.02) was observed. It is important to consider the problems arising from Elderly drug therapy, in order to meet the needs for the detection, prevention and resolution of iatrogenies caused by the use of drugs and how much they interfere in the fragility so that full care can be given to the elderly.