CHARACTERIZATION OF POLYPHARMACY IN THE ELDERLY IN THREE UNITS OF HEALTH SERVICES IN PACHUCA, HIDALGO

Abstract

The aim of this study is to determine the characteristics of poly pharmacy in the elderly in three units of Health Services in the state of Hidalgo, Mexico. A cross-sectional study of 282 patients treated at three units of the Health Services of Hidalgo during July-August 2014. A questionnaire was applied to collect the variables age, gender, diagnosis, drugs (prescription or self-medication) and the presence of adverse drug reactions. Descriptive statistics were performed using SPSS version 18 and the freely available software "Drug Interaction Checker" was used for identifying drug interactions. Mean age was 72 ± 11 years and 74.46 % were women (ratio 3:1); the most frequent illnesses were hypertension (30.1 %) and type 2 diabetes mellitus (17 %); regarding co-morbidities,

43.61 % had two concomitant pathologies followed by 25.9 % who presented three. Of the patients studied, 66 % consumed 3-5 drugs (median 4). The longest administration of a drug was 38 years (glibenclamide). The predominant route of administration was oral (93 %) with tablets (83.8) being the most prescribed pharmaceutical form. The ratio for self-medication was 10:100 with herbal products (57 %) being the most consumed by self-medication. Patients felt unwell after administration of a drug in 22.3 % with the main reaction referred being dyspepsia. Losartan, naproxen and sertraline were the main drugs associated with a suspected adverse reaction. At least one drug interaction was identified in 60 % of patients, with a median of 2 interactions; 63 % were classified as clinically significant, 33.7 % as minor, and 3.3 % as severe. The drug most often involved in an interaction was metformin; however, the most frequent interaction was aspirin-losartan. The characterization of poly pharmacy in the elderly sets the tone for developing interventions aimed at the prevention of drug interactions and promoting the rational use of drugs.