Praktické lekárnictvo 2/2021

Polyfarmakoterapia a použitie potenciálne nevhodných liekov u pacientov vyššieho veku

PharmDr. Lucia Masaryková, PhD., Mgr. Michaela Havrilková

Proces starnutia organizmu je často sprevádzaný prítomnosťou viacerých ochorení, teda multimorbiditou, v jej dôsledku pacienti vyššieho veku užívajú väčší počet liekov. Polyfarmakoterapia však so sebou prináša zvýšené riziko predpisovania liečiv, ktoré sú pre seniorov potenciálne nevhodné. Cieľom nášho výskumu bolo zistiť, ako lekárnici vnímajú problematiku polyfarmakoterapie a použitia potenciálne nevhodných liekov u pacientov vyššieho veku. Ich postoj k tejto téme sme zisťovali prostredníctvom elektronického dotazníkového prieskumu, do ktorého sa anonymne zapojilo 134 lekárnikov v období od augusta 2019 do januára 2020. Zistili sme, že lekárnici denne prichádzajú do kontaktu so staršími pacientmi užívajúcimi 5 a viac liekov, pričom predpisovanie potenciálne nevhodných liečiv vôbec nie je neobvyklé. Napriek tomu, že si lekárnici uvedomujú riziká takej liečby, rešpektujú preskripciu lekára a pacientom liek vydajú. Seniori následne v lekárni konzultujú nežiaduce účinky, najčastejšie gastrointestinálne ťažkosti, a práve obavy z nežiaducich účinkov sú významnou príčinou non-kompliancie k liečbe. Adherencia k polyfarmakoterapii by sa podľa lekárnikov zvýšila vtedy, ak by seniori užívali menej liekov a boli by dostatočne informovaní o svojich ochoreniach a význame ich liečby. Na základe získaných výsledkov môžeme konštatovať, že problematika polyfarmakoterapie a užívania potenciálne nevhodných liečiv u pacientov vyššieho veku je v súčasnosti veľmi aktuálna. Zaslúži si preto patričnú pozornosť, ako aj zvýšenie zainteresovania lekárnikov - odborníkov na lieky, do optimalizácie liečby starších pacientov.

Kľúčové slová: verejný lekárnik, polyfarmakoterapia, potenciálne nevhodné lieky, pacienti vyššieho veku

Polypharmacotherapy and potentially inappropriate drug use in elderly patients

The aging process of the organism is often accompanied by the presence of several diseases, i.e., multimorbidity, as a result of which elderly patients take large amounts of drugs. However, polypharmacotherapy entail a higher risk of prescribing drugs that are potentially inappropriate for the elderly. The aim of our research was to find out how pharmacists perceive the issue of polypharmacotherapy and potentially inappropriate drug use in elderly patients. Their attitude to this topic was expressed by the way of an e-survey questionnaire, in which 134 pharmacists were anonymously involved during the period from August 2019 to January 2020. We found that the pharmacists come into daily contact with elderly patients, who take 5 or more drugs, and potentially inappropriate drug prescribing is not uncommon at all. Although the pharmacists are aware of the risks of such treatment, they still respect the prescription of the doctor and dispense such drugs to patients. Subsequently, the elderly have a discussion on side effects in the pharmacy, mostly about gastrointestinal discomfort, and such concerns about side effects are a significant cause of patient non-compliance with treatment. According to the pharmacists, patient adherence to polypharmacotherapy would increase if elderly people took fewer drugs and were sufficiently informed about their diseases and the importance of their treatment. Based on the results obtained, we can say that the issue of polypharmacotherapy and potentially inappropriate drug use in elderly patients is nowadays very topical. Therefore, it deserves due attention as well as an increase in the involvement of pharmacists – drug information specialists- in optimising the treatment of elderly patients.

Keywords: The aging process of the organism is often accompanied by the presence of several diseases, i.e., multimorbidity, as a result of which elderly patients take large amounts of drugs. However, polypharmacotherapy entail a higher risk of prescribing drugs that are potentially inappropriate for the elderly. The aim of our research was to find out how pharmacists perceive the issue of polypharmacotherapy and potentially inappropriate drug use in elderly patients. Their attitude to this topic was expressed by the way of an e-survey questionnaire, in which 134 pharmacists were anonymously involved during the period from August 2019 to January 2020. We found that the pharmacists come into daily contact with elderly patients, who take 5 or more drugs, and potentially inappropriate drug prescribing is not uncommon at all. Although the pharmacists are aware of the risks of such treatment, they still respect the prescription of the doctor and dispense such drugs to patients. Subsequently, the elderly have a discussion on side effects in the pharmacy, mostly about gastrointestinal discomfort, and such concerns about side effects are a significant cause of patient non-compliance with treatment. According to the pharmacists, patient adherence to polypharmacotherapy would increase if elderly people took fewer drugs and were sufficiently informed about their diseases and the importance of their treatment. Based on the results obtained, we can say that the issue of polypharmacotherapy and potentially inappropriate drug use in elderly patients is nowadays very topical. Therefore, it deserves due attention as well as an increase in the involvement of pharmacists – drug information specialists- in optimising the treatment of elderly patients.