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Abstract(s)
Introdução: Pretende-se descrever a problemática do consumo de medicamentos inapropriados em estruturas residenciais para pessoas idosas, bem como, conhecer a participação do enfermeiro e as barreiras à sua intervenção, na monitorização terapêutica, no processo de gestão da medicação nestas unidades. Metodologia: Estudo exploratório, descritivo, correlacional e transversal. Analisaram-se as listas farmacoterapêuticas presentes numa amostra de processos clínicos, de três estruturas residenciais, escolhidas por conveniência, em três regiões diferentes de Portugal; aplicou-se um questionário a todos os enfermeiros que exerciam funções nessas instituições. Resultados: Selecionaram-se aleatoriamente 33 processos clínicos. Os residentes estão polimedicados (97%), tendo, em média, cerca de 11 fármacos prescritos. Segundo os Critérios de Beers de 2015, operacionalizados para Portugal, todos os processos contêm medicamentos potencialmente inapropriados, sendo em média 4,79±2,03, por residente. Os ansiolíticos (17,72%), os antidepressivos (17,72%) e os antipsicóticos (15,82%) englobam as principais prescrições inadequadas. A revisão da medicação, usando os critérios de Beers, induz uma poupança média mensal de 9,60 euros, por residente. A polimedicação (r=0,677; p<0,01) e a despesa mensal em medicamentos (r=0,505; p=0,003) correlacionam-se positivamente com o uso de medicamentos inapropriados. Todos os enfermeiros demonstram-se sensíveis para a importância da monitorização e vigilância farmacoterapêutica, por forma a preservar um ambiente seguro, embora apenas dois exerçam em locais onde essa prática está implementada. O acréscimo da carga de trabalho, a falta de tempo e a incerteza da relação causal entre o medicamento e a reação adversa são as principais barreiras elencadas para a condução deste procedimento. Conclusões: A qualidade e a segurança dos cuidados, na gestão do medicamento, nas estruturas residenciais para idosos, poderão ser incrementadas com a otimização e a redução de fármacos inapropriados e a sistematização da monitorização farmacológica. O enfermeiro, com a equipa multidisciplinar, deve assegurar a avaliação periódica do regime medicamentoso dos residentes, no sentido de garantir a eficiência e a segurança do medicamento.
Introduction: It is intended to describe the problem of inappropriate medication consumption in residential structures for the elderly, as well as to know the nurse’s participation and the barriers to their intervention, in therapeutic monitoring, in the medication management process in these units. Methodology: Exploratory, descriptive, correlational and cross-sectional study. The pharmacotherapeutic lists present in a sample of clinical files of three residential structures for the elderly, selected by convenience, in three different regions of Portugal were analyzed; a questionnaire was applied to all nurses who worked in these institutions. Results: A total of 33 clinical files were randomly selected. Residents are polymedicated (97%), with an average of about 11 prescribed drugs. According to the 2015 Beers Criteria, operated for Portugal, all processes contain potentially inappropriate drugs, with an average of 4,79±2.03 per resident. Anxiolytics (17,72%), antidepressants (17,72%) and antipsychotics (15,82%) comprise the main inadequate prescriptions. Revision of the medication, using the Beers criteria, would lead to an average monthly savings of 9,60 euros per resident. Polymedication (r=0,677; p<0,01) and monthly drug spending (r=0,505; p=0,003) positively correlated with the use of potentially inappropriate medications. All nurses are sensitive to the importance of pharmacotherapeutic monitoring and surveillance in order to preserve a safe environment, although only two nurses work in places where this practice is implemented. The increased workload, lack of time and uncertainty of the causal relationship between the drug and the adverse reaction are the main barriers listed for conducting this procedure. Conclusions: The quality and safety of drug management in residential structures for the elderly can be increased by optimizing and reducing inappropriate medications and systematizing pharmacological monitoring. The nurse, with the multidisciplinary team, should participate in the periodic evaluation of the medication regimen of the elderlty to ensure drug efficiency and safety.
Introduction: It is intended to describe the problem of inappropriate medication consumption in residential structures for the elderly, as well as to know the nurse’s participation and the barriers to their intervention, in therapeutic monitoring, in the medication management process in these units. Methodology: Exploratory, descriptive, correlational and cross-sectional study. The pharmacotherapeutic lists present in a sample of clinical files of three residential structures for the elderly, selected by convenience, in three different regions of Portugal were analyzed; a questionnaire was applied to all nurses who worked in these institutions. Results: A total of 33 clinical files were randomly selected. Residents are polymedicated (97%), with an average of about 11 prescribed drugs. According to the 2015 Beers Criteria, operated for Portugal, all processes contain potentially inappropriate drugs, with an average of 4,79±2.03 per resident. Anxiolytics (17,72%), antidepressants (17,72%) and antipsychotics (15,82%) comprise the main inadequate prescriptions. Revision of the medication, using the Beers criteria, would lead to an average monthly savings of 9,60 euros per resident. Polymedication (r=0,677; p<0,01) and monthly drug spending (r=0,505; p=0,003) positively correlated with the use of potentially inappropriate medications. All nurses are sensitive to the importance of pharmacotherapeutic monitoring and surveillance in order to preserve a safe environment, although only two nurses work in places where this practice is implemented. The increased workload, lack of time and uncertainty of the causal relationship between the drug and the adverse reaction are the main barriers listed for conducting this procedure. Conclusions: The quality and safety of drug management in residential structures for the elderly can be increased by optimizing and reducing inappropriate medications and systematizing pharmacological monitoring. The nurse, with the multidisciplinary team, should participate in the periodic evaluation of the medication regimen of the elderlty to ensure drug efficiency and safety.
Description
Keywords
Estruturas residenciais para pessoas idosas Medicamentos potencialmente inapropriados para idosos Gestão da segurança Enfermagem Residential structures for the elderly Potentially inappropriate medications Safety management Nursing