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PROPER GERIATRIC PHARMACOTHEARPY - ONE OF THE BIGGEST CHALLENGE FOR GERIATRICS?
A. Rajska-Neumann, K. Wieczorowska-Tobis
Proper geriatric pharmacotherapy represent an important public health concern. According to existing literature on appropriateness of treatment medication errors are reported in 7,8% to 30,0% older subjects and seems to increase in recent years.
In this paper we show the results of the analysis concerning the appropriateness of the pharmacological treatment of 1000 elderly subjects in Poland. The analysis was done based on the questionnaire consisted of questions that characterize respondents and those referred to quantitative and qualitative aspects of pharmacotherapy. The data were screened for the potential inappropriateness of medication based on Explicit Criteria for Determining Potentially Inappropriate Medication Use by the Elderly published by Beers and coworkers in 1997.
Our analysis has showed that 1/3 of the studied elderly subjects were prescribed at least one potentially improper drug. Most commonly there were chlordiazepoksyd and diazepam, long-acting benzodiazepines, non-prescription paracetamol with pseudoefedrine and indomethacin (10.0%, 7.7%, 5.5%, 2.5% of all the studied individuals, respectively).
Also, following potentially improper combinations of drugs were used: nonsteroidal anti-inflammatory drugs with angiotensin-converting enzyme inhibitors (34.6% of the people taking the first group of drugs) or with diuretic drugs (18.9%), potassium saving diuretics with potassium supplementation (27.3%), benzodiazepin-tranquilzeer with benzodiazepin-hypnotics (14.9%) and angiotensin-converting enzyme inhibitors with potassium supplementation (12.3%). Moreover, in eight subjects declaring that they suffer from glaucoma drugs absolutely contraindicated in this disease were used.
In conclusion, the potential inappropriateness of pharmacotherapy were very common in studied subjects. This phenomenon increase the risk of disability in elderly and may be danger for their functional independence.
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