ABSTRACT
This study investigates the 10-year trend in the sedative and anticholinergic burden among older adults in Slovenia, with the aim of identifying opportunities to optimize pharmacotherapy in this population. A retrospective drug utilization analysis was conducted based on a national anonymized database of dispensed prescriptions from 2009 to 2019. The study employed the sedative load model and the anticholinergic cognitive burden scale to assess the sedative and anti cholinergic burden, respectively. The findings indicate that in 2019, 45.6 % and 40.8 % of older adults (≥ 65 years) used sedative and anticholinergic medications, respectively. A high sedative load and a clinically significant anticholinergic burden were observed in a considerable proportion of older adults (13.2 % and 11.2 %, respectively, in 2019). The age-standardized prevalence of sedative load and anti-cholinergic burden significantly decreased over the 10-year study period by 5.6 % and 1.7 %, respectively (absolute difference), while the prevalence of clinically significant anticholinergic burden remained stable. Notably, the age groups 85-89 years and above 90 years had an increase in the proportion of individuals with a clinically significant anticholinergic burden over the years. These results emphasize the need for targeted interventions, particularly in the oldest age groups, to promote safe and effective medication use among older adults.
Subject(s)
Cholinergic Antagonists , Drug Utilization , Hypnotics and Sedatives , Humans , Slovenia , Aged , Aged, 80 and over , Male , Retrospective Studies , Female , Drug Utilization/trends , Drug Utilization/statistics & numerical data , Databases, Factual , Age Factors , PrevalenceABSTRACT
Psoriasis is a chronic inflammatory dermatosis, frequently presenting with chronic itch. This study investigated the prevalence and detailed clinical characteristics of chronic itch in 143 psoriatic patients, with regard to different age groups, comorbidities and pharmacotherapy. Chronic itch was reported by 72% of subjects. Patients aged 65 years and over presented higher 4-Item Itch Questionnaire (4IIQ) scores (8.6 ± 3.4 vs. 7.4 ± 2.5 points; p = 0.03) and rarely experienced itching at midday (p = 0.009). Chronic itch correlated with aspirin intake and xerosis intensity. 4IIQ scores were higher in patients with asthma/chronic obstructive pulmonary disease, peptic ulcer disease and those taking insulin. Logistic regression analysis found that chronic itch was positively correlated with the use of antacids, angiotensin receptor blockers, angiotensin enzyme converting inhibitors, beta-blockers, xerosis intensity and Physician's Global Assessment score, whereas psychiatric drugs other than selective serotonin reuptake inhibitors, allopurinol, coexistence of arterial hypertension and application of emollients acted conversely. Elderly psoriatic patients present several differences in the characteristics of chronic itch, and chronic itch may be associated with comorbidities and pharmacotherapy. To the best of our knowledge, this is the first study to report possible associations between psoriatic pruritus and co-administration of drugs utilized in various systemic conditions.
Subject(s)
Drug-Related Side Effects and Adverse Reactions/epidemiology , Pruritus/epidemiology , Psoriasis/epidemiology , Age Factors , Aged , Chronic Disease , Comorbidity , Cross-Sectional Studies , Drug-Related Side Effects and Adverse Reactions/diagnosis , Female , Humans , Male , Middle Aged , Poland/epidemiology , Prevalence , Pruritus/diagnosis , Psoriasis/diagnosis , Risk Factors , Surveys and QuestionnairesABSTRACT
O objetivo deste estudo é descrever o perfil socioeconômico, epidemiológico e farmacoterapêutico de 154 idosos de cinco Instituições de Longa Permanência de Brasília por meio de questionário adaptado do Método Dáder e complementado com informações dos prontuários. A amostra é caracterizada por indivíduos solteiros e viúvos, em sua maioria homens, com idade média de 74,6 anos, sedentários, com estado cognitivo preservado, baixa renda mensal e baixo nível de escolaridade. O grupo consome de quatro a cinco medicamentos e é acometido, principalmente, por distúrbios psiquiátricos e cardiovasculares. Os medicamentos mais utilizados são os cardiovasculares e os psicofármacos. A adesão à farmacoterapia é comprometida pela falta de conhecimento sobre a prescrição médica atual, dificuldade de acesso e recusa em tomar os medicamentos prescritos. Resultados sugerem que tal perfil influencia a qualidade e a eficácia da terapêutica medicamentosa indicando a necessidade de implementação de um acompanhamento farmacoterapeutico a esses idosos bem como de políticas públicas de saúde mais focadas nas particularidades dessa população a fim de proporcionar melhoria da qualidade de vida e redução dos custos com assistência à saúde.
The aim of this study is to describe the socioeconomic, epidemiological and pharmaco-therapeutic profile of 154 elderly individuals from five homes for the aged in Brasilia using a questionnaire adapted from the Dader method and supplemented with information from medical records. The sample is made up of single people and widowers, mostly men, mean age of 74.6 years, with preserved cognition, low income and low education level. The group consumes between four and five medicines and is mainly affected by cardiovascular and psychiatric diseases. The drugs most used are cardiovascular and psychotropic medication. The adherence to pharmacotherapy is prejudiced by lack of knowledge about current medical prescription, difficulty of access and refusal to use prescribed medicines. Results suggest that this profile influences the quality and effectiveness of pharmacotherapy showing the need for pharmacotherapeutic follow-up for these patients as well as public health policies more focused on the specificities of the elderly to provide better quality of life and reduction of costs with health assistance.