Clinical Interventions in Aging (Feb 2022)

Inclusion of Potentially Inappropriate Medicines for the Older Adults in the Brazilian Consensus in Accordance with International Criteria

  • Pecce Bento A,
  • Costa Pereira L,
  • Ramos Garcia K,
  • Ramos Ferreira LF,
  • da Silva EV,
  • Karnikowski M

Journal volume & issue
Vol. Volume 17
pp. 151 – 161

Abstract

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Andréa Pecce Bento,1 Leonardo Costa Pereira,2 Kerolyn Ramos Garcia,1 Luiz Fernando Ramos Ferreira,3 Emília Vitória da Silva,1 Margô Karnikowski1 1Sciences and Health Technologies Program, University of Brasilia, Brasilia, DF, Brazil; 2Physical Education, University UNIEURO, Brasilia, DF, Brazil; 3Academic League of Project Management, Florence College, São Luis, Maranhão, BrazilCorrespondence: Margô Karnikowski, University Campus, s/n, Metropolitan Center, Brasília, DF, 72220-275, Brazil, Tel/Fax +5 613107 8418, Email [email protected]: The use of potentially inappropriate medications (PIM) can impair the safety and effectiveness of pharmacotherapy in the older adults. Thus, several countries have lists and criteria to indicate these drugs, in order to promote the safety of prescription and the rational use of drugs in geriatric practice.Objective: This study sought to contribute to the inclusion of PIM for the older adults in the Brazilian criterion (BCPIM/2016) – current list used in Brazil and reference in Latin American countries – through expert approval, comparing convergences with international AGS lists BEERS/2019, STOPP/START/2015, PRISCUS/2010 and EU (7)-PIM List/2015.Methods: This is a critical analysis of potentially inappropriate medications for use in the older adults present in the list of Brazilian criteria, together with their absence of some drugs that are on international lists (BEERS/2019; Priscus/2010; Stopp/Start/2015; EU7-PIM list/2015). This study was subdivided in 6 stages: selection of national criteria, classification of drugs according to Anatomic Therapeutic Chemical, comparison between BCPIM/2016 with international lists, selection of drugs not included in the Brazilian list, selection of experts for evaluation and suggestions about drugs not included in the Brazilian list and the synthesis of the analysis carried out by the specialists.Results: We cataloged 66 drugs marketed in Brazil that are on international lists, but not in the Brazilian consensus, of which 24 were validated by experts as necessary for inclusion in this consensus, considering the risks and benefits in health care for the older adults. However, the lists have divergences and similarities between them. We observed that eight drugs were common to all criteria studied, mainly related to the nervous system.Conclusion: The results suggest the need for periodic validation of PIM against research clinics, new drugs and the inclusion of this agenda by the Ministry of Health in the revision of the National List of Essential Drugs and other Clinical Protocols and Therapeutic Prescription Guidelines for the older adults.Keywords: list of potentially inappropriate drugs, seniors, aging, side effects, drug-related adverse reactions

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