ABSTRACT
Introduction: The European population is aging, for every 100 young people there are 128 elderly. There is a decrease in the number of elderly people living in their family environment. The main objective of this study is to identify the differences in the general health status of the elderly according to their residence: in families or in others types of centres (nursing home, host family or national integrated network of integrated care (NINIC)). Material and Methods: This is an observational study, using a sample of 254 elderly patients admitted to the Internal Medicine Service. Results: Of the patients studied, 78,7% lived at home/with relatives, 15,4% in nursing homes, 3,15% in host families and 2,75% in NINIC. Age ranged from 65 to 99 years, with a median of 80 years (SD=7,97). Patients from their homes were more independent/mild dependence (X(3)=59.8, p<0.001), although there were no significant differences in the number of comorbidities (t(252)=0.029, p=0.999). However, patients from others centres had more neurological pathology (X(1)=12.39, p<0.001). There were no statistically significant differences in the number of medications usually taken, although patients from others centres had more potentially inappropriate medications (t(252)=5.85, p<0.001) and potential prescribing omissions (t(252)=3.71,p<0.001). Patients at home had fewer rehosts (X(1)=5.14, p=0.039). There were more intercurrences (X(1)=19.0, p<0.001) and more deaths at 6months after discharge (X(1)=16.3, p<0.001) from others centres. Conclusion: In a population less attended by families, these differences in relation to their dwelling places are paramount. (AU)
Subject(s)
Humans , Aged , Aged, 80 and over , Old Age Assistance , Adult Day Care Centers , Homes for the Aged , Health of the Elderly , HousingABSTRACT
INTRODUCTION: Europe presents 19% of the population aged 65 or over (elderly), who are especially susceptible to inadequate prescriptions (potentially inappropriate medications (PIM) and potential prescribing omissions (PPO)), identified by the STOPP and START criteria. This study has as main objectives the identification of PIM and PPO and associated factors. MATERIAL AND METHODS: This is a cross sectional study, using a sample of 254 elderly individuals from the Internal Medicine Service. RESULTS: 81.9% of patients are polymedicated, 72.4% have at least one PIM and 57.5% have at least one PPO. The most frequently identified PIM was benzodiazepine and PPO was the anti-pneumococcal vaccine. There was a direct correlation between the number of PIM and chronic medication (r(254)=0.348, p < 0.001) and inverse with the Katz scale (dependence) (r(254)=-0.324, p < 0.001). In the cases of the domicile it was verified association between PIM and the days of internment (U=3653, p = 0.025). PIM were associated with death in less than 6 months after discharge (U=3396, p = 0.007) and the presence of intercurrences at admission (U=5766, p = 0.005). There is a relationship between the number of co-morbidities and having at least one PIM (U=5378, p = 0.041) or at least one PPO (U=6271, p = 0.005). Diabetes mellitus (DM) type 2, neurological and psychiatric disease are associated with PIM, while obesity, DM type 2, arterial hypertension, dyslipidemia and cardiac pathology with PPO. Discussion and CONCLUSION: In a population that is older each year, with more comorbidities and more polymedicated, PIM and PPO are increasingly relevant
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