RESUMO
Introducción: Frecuentemente en pacientes muy ancianos institucionalizados coexiste fragilidad y polifarmacia, por ello es importante valorar el grado de fragilidad y la adecuación terapéutica en este grupo poblacional. El objetivo de este estudio es valorar el grado de fragilidad de una población muy mayor institucionalizada y analizar la prescripción. Material y métodos: Estudio observacional y transversal de una población de 85 años o más, institucionalizada en una residencia geriátrica de Barcelona. Se valoró la fragilidad utilizando el Índice Frágil-VIG y la adecuación de la prescripción de cada grupo según los criterios STOPP-Frail. Resultados: Se incluyeron 79 pacientes con una media de 90,9+/-4,2 años. La mayoría (96,2%) tenían algún grado de fragilidad. Con fragilidad leve había un 21,5%, moderada un 37,7% y severa un 38%. Para estos 3 grupos, la mediana de fármacos fue de 7. En la mayoría de las prescripciones de los grupos no hallamos diferencias estadísticamente significativas. Solo existían diferencias para los que tenían dificultad en tomar la medicación, los que tomaban medicación para la hipertrofia prostática y suplementos nutricionales. Se encontró en los 3 grupos que hasta un tercio de la prescripción era inadecuada y que incluso algunas prescripciones estaban contraindicadas en los pacientes más frágiles. Conclusión: Nuestra población anciana tiene un elevado índice de fragilidad con alta prevalencia de polimedicación y prescripción inadecuada. La escasa individualización de la prescripción con relación al grado de fragilidad, sobre todo en aquellos con corto pronóstico de vida, nos indica una situación que debe mejorarse
Introduction: As frailty and multiple drug therapy often coexists in institutionalised elderly patients, it is important to assess the level of frailty and therapeutic appropriateness in this population group. The aim of the study is to: assess the frailty level of institutionalised elderly patients and to analyse their prescriptions. Material and methods: An observational and cross-sectional study of a geriatric population of 85 years or older, institutionalised in a nursing home in Barcelona. Frailty was assessed using the Frail-VIG index, and the adequacy of the prescription of each group was done according to the STOPP-Frail Criteria. Results: The study included 79 patients, with a mean age of 90.9+/-4.2 years. Most of them (96.2%) had some degree of frailty. Slight frailty was observed in 21.5%, moderate in 37.7%, and advanced in 38%. The patients were prescribed a median of 7 drugs. No statistically significant differences were found in the majority of the prescriptions of the frailty groups. Differences were only found for those who had difficulty taking the medication, those who took medication for prostatic hypertrophy, and nutritional supplements. In all 3 groups, it was found that up to one third of the prescription was inappropriate, and some were even contraindicated in the most frail patients. Conclusion: The elderly study population has a high frailty index with a high prevalence of multiple drug therapy with inappropriate prescription. The poor individualisation of these prescriptions in relation to the level of frailty, especially in those with short life prognosis, is a situation that should be improved
Assuntos
Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Fragilidade/diagnóstico , Institucionalização , Polimedicação , Lista de Medicamentos Potencialmente Inapropriados/estatística & dados numéricos , Contraindicações de Medicamentos , Estudos Transversais , Fragilidade/epidemiologia , Instituição de Longa Permanência para Idosos , Prescrição Inadequada/estatística & dados numéricos , Casas de Saúde , Prevalência , Espanha/epidemiologiaRESUMO
INTRODUCTION: As frailty and multiple drug therapy often coexists in institutionalised elderly patients, it is important to assess the level of frailty and therapeutic appropriateness in this population group. The aim of the study is to: assess the frailty level of institutionalised elderly patients and to analyse their prescriptions. MATERIAL AND METHODS: An observational and cross-sectional study of a geriatric population of 85 years or older, institutionalised in a nursing home in Barcelona. Frailty was assessed using the Frail-VIG index, and the adequacy of the prescription of each group was done according to the STOPP-Frail Criteria. RESULTS: The study included 79 patients, with a mean age of 90.9±4.2 years. Most of them (96.2%) had some degree of frailty. Slight frailty was observed in 21.5%, moderate in 37.7%, and advanced in 38%. The patients were prescribed a median of 7 drugs. No statistically significant differences were found in the majority of the prescriptions of the frailty groups. Differences were only found for those who had difficulty taking the medication, those who took medication for prostatic hypertrophy, and nutritional supplements. In all 3 groups, it was found that up to one third of the prescription was inappropriate, and some were even contraindicated in the most frail patients. CONCLUSION: The elderly study population has a high frailty index with a high prevalence of multiple drug therapy with inappropriate prescription. The poor individualisation of these prescriptions in relation to the level of frailty, especially in those with short life prognosis, is a situation that should be improved.
