Safety assessment of medicines available in the ‘Brazilian list of essential medicines’ in the older persons according to the Beers Criteria

Abstract

Objective: To describe the safety of medicines available in the “Brazilian List of Essential Medicines” (RENAME/2022) for the main comorbidities that affect older persons according to the Beers criteria 2019. Methods: Medicines listed in RENAME and recommended by the respective Brazilian medical guidelines for the treatment of hypertension, heart failure, diabetes, and neurological/psychiatric diseases were evaluated for their safety profiles according to the Beers criteria 2019. Results: Fifty-eight out of 529 medicines in RENAME were evaluated. Of these, 29 were included in any of the Beers criteria: 20 were classified as potentially inappropriate, 17 should be avoided due to disease exacerbation, and 14 needed to be used with caution. Considering drugs used to treat cardiovascular, diabetes, and neurological/psychiatric disorders, 40.00, 37.50 and 60.00% respectively, had some criterion for their appropriate use in older persons. Conclusion: RENAME presents alternatives for the safe treatment of older patients. In the treatment of cardiovascular diseases, diabetes, and neurodegenerative diseases, the first choice recommendations are available in RENAME. Regarding psychiatric disorders, safe pharmacological alternatives are still scarce and need to be better discussed.

Keywords

• beers criteria
• potentially inappropriate medication list
• rename
• aged
• polypharmacy