Assessment of drug prescription for elderly in primary care, Brazil

INTRODUCTION: The number of prescribed drugs is increasing all around the world and the larger consumers are the older adults. The aim of this study is to know if the prescription is inappropriate to the elderly and its possible risks.

METHODS: A quantitative cross-sectional study, from primary data. The drug prescription patterns of 151 people over 60 years old who were attended in a primary health care service in southern Brazil were analyzed. Innapropriate medicines use were defined using the Beers-Fick Criteria. Association between inappropriate medicines and some patients characteristics were estimated using Chi-Square test.

RESULTS: The average of drugs by patient is 3,35 (higher among women=4,5) and 23,9% were in use of 5 or more drug (polypharmacy). Most of  drugs were prescribed to cardiovascular system, followed by the alimentary tract and metabolism and, third, the nervous system. The psicholeptics and the psichoanaleptics represented the totality of inappropriate prescriptions according to the Beers-Fick Criteria. (chi2 = 76.49 ; p = 0.00). There is an association between lower education and higher prevalence of inappropriate drugs (chi2 = 18,86 ; p = 0,001). The self-reported side effects were associated to the use of inappropriate drugs (chi2 = 14,14 ; p = 0.00). There is no association between non-adherence to treatments and high prevalence of inappropriate prescription (chi2 = 3,16 ; p = 0,07).

CONCLUSIONS: Doctors should attempt when prescribing for the elderly and could use tools such as the Beers-Fick criteria to better prescribe. We also recommend that safer drugs for elderly should be included to Brazilian National List of Medicines.