scholarly journals Drug safety among institutionalized elderly people: potential interactions

2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Maria Lígia Silva Nunes Cavalcante ◽  
Renata Kelly Lopes de Alcântara ◽  
Isabelly Costa Lima de Oliveira ◽  
Samia Freitas Aires ◽  
Ana Lívia Araújo Girão ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Elderly People ◽  
Drug Safety ◽  
The Elderly ◽  
Northeastern Brazil ◽  
Start Time ◽  
Safety Measures ◽  
Institutionalized Elderly ◽  
High Consumption ◽  
Potential Interactions

ABSTRACT Objective: to identify the drug interactions among institutionalized elderly. Method: retrospective and documentary study with a quantitative approach developed in two Long Stay Institutions for Elderly, located in northeastern Brazil. Drug interactions were identified by using Drug-Reax® software from the Micromedex database, and they were classified by severity, start time, and documentation. Result: in the 286 analyzed prescriptions, 136 drug interactions were detected in both institutions, most of them classified as severe. The average number of drugs prescribed by the elderly was 4.5. In the analysis of Pearson's correlation, the number of drug interactions showed a statistically significant correlation with the time of institutionalization and with the amount of drugs administered on the day. Conclusion and implications for practice: the high consumption of drugs and serious drug interactions detected with significant clinical repercussions was evidenced in the study. Knowledge of these interactions is essential for the establishment of preventive safety measures in pharmacotherapy.

Drug safety among institutionalized elderly people: potential interactions

2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Maria Lígia Silva Nunes Cavalcante ◽  
Renata Kelly Lopes de Alcântara ◽  
Isabelly Costa Lima de Oliveira ◽  
Samia Freitas Aires ◽  
Ana Lívia Araújo Girão ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Elderly People ◽  
Drug Safety ◽  
The Elderly ◽  
Northeastern Brazil ◽  
Start Time ◽  
Safety Measures ◽  
Institutionalized Elderly ◽  
High Consumption ◽  
Potential Interactions

ABSTRACT Objective: to identify the drug interactions among institutionalized elderly. Method: retrospective and documentary study with a quantitative approach developed in two Long Stay Institutions for Elderly, located in northeastern Brazil. Drug interactions were identified by using Drug-Reax® software from the Micromedex database, and they were classified by severity, start time, and documentation. Result: in the 286 analyzed prescriptions, 136 drug interactions were detected in both institutions, most of them classified as severe. The average number of drugs prescribed by the elderly was 4.5. In the analysis of Pearson's correlation, the number of drug interactions showed a statistically significant correlation with the time of institutionalization and with the amount of drugs administered on the day. Conclusion and implications for practice: the high consumption of drugs and serious drug interactions detected with significant clinical repercussions was evidenced in the study. Knowledge of these interactions is essential for the establishment of preventive safety measures in pharmacotherapy.

Drug—Drug Interactions in the Elderly

2002 ◽  
Vol 36 (11) ◽  
pp. 1675-1681 ◽  
Author(s):  
Ingeborg K Björkman ◽  
Johan Fastbom ◽  
Ingrid K Schmidt ◽  
Cecilia B Bernsten ◽  
Cecilia B Bernsten ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Elderly People ◽  
The Elderly ◽  
Drug Regimen ◽  
European Countries ◽  
Elderly Persons ◽  
Potential Ddis ◽  
Negative Effects ◽  
Outpatient Group ◽  
The Impact

OBJECTIVE: To detect the frequency of potential drug—drug interactions (DDIs) in an outpatient group of elderly people in 6 European countries, as well as to describe differences among countries. DATA SOURCES AND METHODS: Drug use data were collected from 1601 elderly persons living in 6 European countries. The study population participated in a controlled intervention study over 18 months investigating the impact of pharmaceutical care. Potential DDIs were studied using a computerized detection program. RESULTS: The elderly population used on average 7.0 drugs per person; 46% had at least 1 drug combination possibly leading to a DDI. On average, there were 0.83 potential DDIs per person. Almost 10% of the potential DDIs were classified to be avoided according to the Swedish interaction classification system, but nearly one-third of them were to be avoided only for predisposed patients. The risk of subtherapeutic effect as a result of a potential DDI was as common as the risk of adverse reactions. Furthermore, we found differences in the frequency and type of potential DDIs among the countries. CONCLUSIONS: Potential DDIs are common in elderly people using many drugs and are part of a normal drug regimen. Some combinations are likely to have negative effects; more attention must be focused on detecting and monitoring patients using such combinations. As differences in potential DDIs among countries were found, the reasons for this variability need to be explored in further studies.

scholarly journals Challenges experienced by Portuguese professionals in humanitude care for institutionalized elderly people during the pandemic

2022 ◽  
Vol 56 ◽  
Author(s):  
Kátia Lilian Sedrez Celich ◽  
Rosa Cândida Carvalho Pereira de Melo ◽  
Mara Ambrosina de Oliveira Vargas ◽  
Francielly Zilli ◽  
Liliana Vanessa Lúcio Henriques ◽  
...  
Keyword(s):  
Nursing Home ◽  
Family Support ◽  
Elderly People ◽  
The Elderly ◽  
Protective Equipment ◽  
Personal Protection ◽  
Institutionalized Elderly ◽  
Analysis Technique ◽  
Care Practices ◽  
Self Protection

Abstract Objective: To understand the challenges experienced by Portuguese workers in humanitude care for institutionalized elderly people during the pandemic. Method: This is a qualitative study, supported by reflections on the Humanitude Care Methodology, carried out with workers from different areas in a nursing home for elderly people in Portugal. Data collection took place between September and October 2020, from individual and online interviews. The categorization proposed by Bardin was adopted as the analysis technique. Results: Three categories emerged: (1) self-protection and of the other with the subcategories fear of being contaminated and fear of contaminating the elderly; (2) maintenance of affective relationships, broken down into the subcategories absence of family members in the nursing home and personal protective equipment as a barrier to communication and approximation; and (3) confinement of the elderly who attended the Day Center, with the subcategories lack of family support/loneliness and change in the elderly’s routine. Conclusion: The main challenges experienced by Portuguese workers are related to the necessary changes in the performance of care practices due to the use of personal protection that was not used before, limitations in affective relationships, and restrictions in interaction spaces.

Antidepressants: Prevalence of Duplicate Therapy and Avoidable Drug Interactions in Australian Veterans

2007 ◽  
Vol 41 (4) ◽  
pp. 366-370 ◽  
Author(s):  
Elizabeth E. Roughead ◽  
Brian McDermott ◽  
Andrew L. Gilbert
Keyword(s):  
Drug Interactions ◽  
Tricyclic Antidepressants ◽  
Antidepressant Drug ◽  
The Elderly ◽  
Potential Interaction ◽  
Inappropriate Drug ◽  
Department Of Veterans Affairs ◽  
Pharmacy Claims ◽  
High Level ◽  
Potential Interactions

Objective: This study assessed the prevalence of duplicate antidepressant prescribing and avoidable potential antidepressant drug interactions in the Australian war veteran population. Method: The Department of Veterans’ Affairs Pharmacy Claims database was interrogated, using specific criteria, to identify antidepressant duplication. In addition, potential drug interactions where safer alternative therapies were available were assessed. These included anticholinergic agents with tricyclic antidepressants and tramadol with antidepressants. Episodic tramadol dispensings with antidepressants were also assessed. Results: A total of 46 859 veterans had antidepressants regularly dispensed to them in the period 1 April–31 July 2005. Overall, 4037 potential interactions were identified in 3818 veterans (8.1%) to whom were dispensed antidepressants regularly. Antidepressant and tramadol co-prescribing was the most common potential interaction identified among 3.6% of veterans. Two or more interactions were identified in 212 veterans (0.5%). Analysis of episodic tramadol dispensings with antidepressants suggested a much higher prevalence of 7.7%. Conclusion: The increasing use of antidepressants and the high level of potentially avoidable interactions detected in the present study, highlight the necessity of ongoing vigilance concerning the use of potentially inappropriate drug combinations, particularly in the elderly.

Social Representations of Nurses on Medical Safety Culture in Clinical Care for Elderly People

2021 ◽  
pp. 319-328
Author(s):  
Maria do Céu Mendes Pinto Marques ◽  
Francisca Tereza Galiza ◽  
Maria Célia Freitas ◽  
Maria Vilani Cavalcante Guedes
Keyword(s):  
Elderly Patients ◽  
Elderly People ◽  
Nursing Care ◽  
Drug Safety ◽  
Social Representations ◽  
Clinical Care ◽  
The Elderly ◽  
Exploratory Research ◽  
Care For The Elderly ◽  
Clinical Nursing

Evaluating the culture of drug safety, of certain services, and specific subjects, especially for the elderly population, makes it possible to identify gaps in clinical nursing care. The study aimed to analyze the social representations of nurses regarding the culture of drug safety in clinical care for the elderly people. This is a descriptive and exploratory research of qualitative nature, having the theoretical support of social representations. The chapter samples 38 nurses via interview and a non-participant observation. Analysis is done using Alceste software. This resulted in seven stable classes, and Class 3 had the largest representation, 23% of the corpus. Class 3 maintained hierarchical and semantic proximity to Class 2, which deals with technologies to ensure the safety of elderly patients in the use of medicines. For nurses, technologies help in the safety of elderly patients, but do not guarantee the extinction of adverse events. The chapter considered the need for patient safety to become an organizational culture favoring the quality of clinical nursing care in the handling of medicines.

Nutritional status and determinants of malnutrition in institutionalized elderly people, provisional data

2021 ◽  
pp. 21-25
Author(s):  
Gabriela Soric ◽  
◽  
Felicia Lupascu-Volentir ◽  
Ana Popescu ◽  
Elena Cosciug ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Elderly People ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Institutionalized Elderly ◽  
The Disabled ◽  
Geriatric Evaluation ◽  
Vulnerable Elderly

Nutrition is an important factor for health, physical and cognitive function, vitality, quality of life and longevity. Elderly people oft en have low food intake, induced by multifactorial causes, as a result, malnutrition is an independent risk factor for increased morbidity and mortality, regardless of the underlying pathologies (chronic organ failure, cognitive impairment, cancer, cardiovascular disease, type 2 diabetes etc.) including overweight or obese subjects.The prevalence of malnutrition varies from 4% to 10% in the elderly population from the community, from 15% to 38% for institutionalized elderly people and from 30% to 70% for hospitalized ones. The purpose of this study was to assess the nutritional status of institutionalized elderly people and establish correlations between the determinants of malnutrition and fragility syndrome.Th e epidemiological study is part of the project 20.80009.8007.25 “Fragility: diagnosis and prophylaxis in relation to medicopsychosocial problems of the vulnerable elderly”, included 50 patients institutionalized in the Republican Asylum for the Disabled and Retired in Chisinau.All persons were examined by the complex geriatric evaluation, approved by the order of the Ministry of Health no. 619 of 07.09.2010. According to the results, both malnutrition and the risk of malnutrition were high in institutionalized elderly people.Among the determinants of malnutrition, the highest association had the number of concomitant diseases, decreased functionality of the elderly, the presence of depression syndrome and cognitive disorders. At the same time, the malnutrition syndrome correlated with the fragility criteria but also with the degree of severity of frailty of the institutionalized elderly people.

scholarly journals Perfil sociodemográfico e de saúde de idosos institucionalizados

2019 ◽  
Vol 13 (3) ◽  
pp. 674
Author(s):  
Renata Kelly Lopes de Alcântara ◽  
Maria Lígia Silva Nunes Cavalcante ◽  
Bruna Karen Cavalcante Fernandes ◽  
Valderina Moura Lopes ◽  
Saul Filipe Pedrosa Leite ◽  
...  
Keyword(s):  
Elderly People ◽  
Elderly Women ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Health Profile ◽  
Cross Sectional ◽  
Multiprofessional Team ◽  
Institutionalized Elderly ◽  
Individualized Care ◽  
Quantitative Descriptive

RESUMO Objetivo: buscou-se descrever o perfil sociodemográfico e de saúde de idosos institucionalizados. Método: trata-se de um estudo quantitativo, descritivo, transversal, realizado a partir da avaliação de 219 prontuários de idosos, mediante a aplicação de um instrumento semiestruturado. Analisaram-se os dados com o auxílio do SPSS, versão 20.0, e os apresentaram em tabelas. Resultados: obteve-se predomínio de idosos do sexo feminino, média de idade de 77 anos, escolaridade de 4 a 15 anos de estudo, solteiros, católicos, provenientes de domicílio próprio com tempo de institucionalização menor que 5 anos, aposentados e que recebiam visitas. Viu-se acerca das características clínicas que 44,7% tinham de 3 a 4 comorbidades e 49,3% faziam uso de 0 a 4 medicações. Observou-se sobre o grau de dependência que 35,6% dos idosos apresentavam grau III. Conclusão: ressalta-se que os dados descritos estimulam a reflexão sobre questões que influenciam diretamente o processo de adaptação do idoso à institucionalização, bem como a necessidade de a equipe multiprofissional prestar uma assistência individualizada a partir do conhecimento do perfil dos idosos institucionalizados. Descritores: Idoso; Instituição de Longa Permanência para Idosos; Institucionalização; Saúde do Idoso Institucionalizado; Perfil de Saúde; Envelhecimento.ABSTRACT Objective: to describe the sociodemographic and health profile of institutionalized elderly people. Method: This is a quantitative, descriptive, cross-sectional study based on the evaluation of 219 medical records of the elderly, using a semi-structured instrument. Data were analyzed with the help of the SPSS, version 20.0, and presented in tables. Results: there was a predominance of elderly women, mean age of 77 years, schooling from 4 to 15 years, single marital status, Catholics, coming from their own domicile, with institutionalization time of less than 5 years, retired, and elderly people who received visits. Regarding clinical characteristics, 44.7% had 3 to 4 comorbidities and 49.3% used 0 to 4 medicines. As for the degree of dependence, it was observed that 35.6% of the elderly presented grade III. Conclusion: it is noteworthy that the data described stimulate a reflection on issues that directly influence the process of adaptation of the elderly to institutionalization, as well as the need for the multiprofessional team to provide individualized care based on knowledge of the profile of the institutionalized elderly. Keywords: Elderly; Long Stay Institutions for the Elderly; Institutionalization; Health of Institutionalized Elderly; Health Profile; Aging.RESUMOObjetivo: se buscó describir el perfil sociodemográfico y de salud de adultos mayores institucionalizados. Método: se trata de un estudio cuantitativo, descriptivo, transversal, realizado a partir de la evaluación de 219 prontuarios de adultos mayores, mediante la aplicación de un instrumento semi-estructurado. Se analizaron los datos con el auxilio del SPSS, versión 20.0, y los presentaron en tablas. Resultados: se obtuvo un predominio de adultos mayores del sexo femenino, media de edad de 77 años, escolaridad de 4 a 15 años de estudio, solteros, católicos, provenientes de domicilio propio con tiempo de institucionalización menor que 5 años, jubilados y que recibían visitas. Se observó en las características clínicas que 44,7% tenían de 3 a 4 comorbilidades y 49,3% usaban de 0 a 4 medicamentos. Se observó el grado de dependencia en que 35,6% de los adultos mayores presentaban grado III. Conclusión: se resalta que los datos descriptos estimulan la reflexión sobre cuestiones que influyen directamente el proceso de adaptación del adulto mayor a la institucionalización, así como la necesidad del equipo multi-profesional prestar una asistencia individualizada a partir del conocimiento del perfil de los adultos mayores institucionalizados. Descriptores: Adulto mayor; Institución de Larga Permanencia para Adultos Mayores; Institucionalización; Salud del Adulto Mayor Institucionalizado; Perfil de Salud; Envejecimiento.

scholarly journals Institutionalized elderly people with dementia: an integrative review on nursing care

2020 ◽  
Vol 73 (suppl 3) ◽  
Author(s):  
Josiane Steil Siewert ◽  
Angela Maria Alvarez ◽  
Silvia Maria Azevedo dos Santos ◽  
Fabiana Almeida Brito ◽  
Karina Silveira de Almeida Hammerschmidt
Keyword(s):  
Elderly People ◽  
Nursing Care ◽  
Elderly Care ◽  
The Elderly ◽  
Integrative Review ◽  
Care Process ◽  
Institutionalized Elderly ◽  
People With Dementia ◽  
Nursing Team ◽  
Proper Training

ABSTRACT Objective: To ascertain the characteristics of the nursing care provided to institutionalized elderly people with dementia. Methods: Integrative review of studies published between 2013 and 2017, in English, Spanish, and Portuguese, from the databases BDENF, LILACS, CINAHL, PubMed, SciELO, TRIP, and National Guideline Clearing House. Thematic data analysis was used. Results: From the data collected in the 41 included studies, three themes emerged: Care with a focus on the needs of elderly people in LTCIEs; Care based on the work process of the nursing team; and Shared care. Final considerations: Elderly care can take place from different perspectives: that of the elderly; the nursing team; and it can be shared among the different parties involved. The importance of communication must be stressed, as do the development of skills and attitudes of the team, as well as proper training and support, good environment in the care process, and an approach centered on the institutionalized elderly.

scholarly journals Potentially inappropriate medication use among institutionalized elderly individuals in southeastern Brazil

2013 ◽  
Vol 49 (4) ◽  
pp. 709-717 ◽  
Author(s):  
Mauro Cunha Xavier Pinto ◽  
Dalila Pinto Malaquias ◽  
Felipe Ferré ◽  
Marcos Luciano Pimenta Pinheiro
Keyword(s):  
Drug Interactions ◽  
The Elderly ◽  
Drug Prescriptions ◽  
Alternative Form ◽  
Southeastern Brazil ◽  
Defined Daily Dose ◽  
Institutionalized Elderly ◽  
Elderly Individuals ◽  
Daily Dose ◽  
Inappropriate Prescriptions

In recent decades, the elderly population in Brazil has grown rapidly, as has concern for the health of this population. Institutionalization in nursing homes has appeared as an alternative form of health care for frail elderly that live alone. The present study evaluated the pharmacotherapy and inappropriate drug prescriptions for institutionalized elderly patients living in long-term institutions in southeastern Brazil. This research was conducted at five institutions with a total sample of 151 individuals aged at least 60 years. Databases were used to identify drug interactions, defined daily dose and inappropriate prescriptions. The prevalence of drug intake among the elderly was 95.36%, and there were an average of 3.31 ± 1.80 drug prescriptions per individual. Based on Beers criteria, the prevalence of inappropriate prescriptions was 25.83%. In addition, 70.2% of prescriptions were prescribed at a higher dosage than the defined daily dose (ATC/WHO). Potential drug interactions were identified for 54.11% of prescriptions; 81.42% of these were of moderate severity. The main inappropriate drugs were prescribed for cardiovascular and nervous system problems. Institutionalized elderly individuals presented a high consumption and misuse of medications, requiring professional intervention to monitor prescriptions and improve the quality of service for this population.

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