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Colegio de Medicina Interna de México.

2016, Number 2

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Med Int Mex 2016; 32 (2)

Polypharmacy in not geriatric patients with hematological diseases during intrahospitalary care

Alvarado-Ibarra M, Aguilar-Luévano J, López-Hernández MA

Language: Spanish
References: 24
Page: 176-184
PDF size: 528.20 Kb.


ABSTRACT

Background: Polypharmacy (PF) is defined as the concomitant administration of multiple medications. It represents an unnecessary use of drugs. It is common in the geriatric population, and studies are limited to these ages with ambulatory prescription.
Objetive: To investigate the prevalence of PF and inappropriate medication (IM) in hospitalized and not nursing home patients at the Hematology Service of CMN 20 de Noviembre, Mexico City.
Material and Method: A prospective, observational, descriptive and transversal study. We included patients hospitalized during November 2014. There were registered: disease, comorbidities, IM and potential drug interactions. PF was considered the administration of more than 5 medicines for day.
Results: 72 patients were included. The average age was 45 years. Main illnesses were: leukemia or lymphoma (n=45, 70%), multiple myeloma (n=10, 16%) and the rest had other diseases (n=9, 14%); comorbidities were present in 23 patients (32%). The prevalence of PF was of 64 (89%). The average of drugs administered by patients was 7. IM: 77 drugs, with prevalence in patients with PF (p=0.008). Variables associated with PF (p‹0.06) were: acute leukemia or lymphoma, comorbidities and febrile neutropenia. The IM was predominant in patients with PF (0.008). Duplication of medications was seen in patients with PF only, as well as potential interactions, type C, with 117, predominated (81%).
Conclusion: The prevalence of PF, IM and duplication of drugs is comparable to that described in geriatric population, non-hospitalized patients and with not exclusively hematological disease.


REFERENCES

  1. Stewart RB. Polypharmacy in the elderly: a fait accompli? DICP 1990;24:321-323.

  2. Maggiore RJ, Gross CP, Hurria A. Polypharmacy in older adults with cancer. Oncologist 2010;15:507-522.

  3. Rollason V, Vogt N. Reduction of polypharmacy in the elderly: a systematic review of the role of the pharmacist. Drugs Aging 2003;20:817-832.

  4. Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA. Recent patterns of medication use in the ambulatory adult population of the United States: the Slone survey. JAMA 2002;287:337-344.

  5. Philp I. A recipe for care–not a single ingredient. Clinical case for change. Department of Health, 2007.

  6. Information Centre. Prescriptions dispensed in the community. Statistics for 1996-2006. England, 2007.

  7. Beers MH, Ouslander JG, Rollingher I, Reuben DB, et al. Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine. Arch Intern Med 1991;151:1825-1832.

  8. Fillenbaum GG, Horner RD, Hanlon JT, Landerman LR, et al. Factors predicting change in prescription and nonprescription drug use in a community-residing black and white elderly population. J Clin Epidemiol 1996;49:587-593.

  9. Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother 2007;5:345-351.

  10. Fulton MM, Allen ER. Polypharmacy in the elderly: a literature review. J Am Acad Nurse Pract 2005;17:123-132.

  11. Prybys KM. Polypharmacy in the elderly: clinical challenges in emergency practice. Part 1: Overview, etiology and drug interactions. Emergency Medicine Reports 2002;23:145-153.

  12. Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D. STOPP (Screening Tool of Older Person´s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus Validation. Int J Clin Pharmacol Ther 2008;46:72-83.

  13. Aronson JK. Polypharmacy, appropriate and inappropriate. Br J Gen Pract 2006;56:484-485.

  14. Aronson JK. In defense of polypharmacy. Br J Clin Pharmacol 2004;57:119-120.

  15. Knight EL, Avorn J. Quality indicators for appropriate medication use in vulnerable elders. Ann Intern Med 2001;135:703-710.

  16. Maggiore RJ. Polypharmacy and potentially inappropriate medication use in older adults with cancer undergoing chemotherapy: effect on chemotherapy-related toxicity and hospitalization during treatment. J Am Geriatr Soc 2014;62:1505-1512.

  17. Prithviraj GK, Koroukian S, Margevicius S, Berger N, et al. Patient characteristics associated with polypharmacy and inappropriate prescribing of medications among older adults with cancer. J Geriatr Oncol 2012;3:228-237.

  18. Elliot K, et al. The prognostic importance of polypharmacy in older adults treated for acute myelogenous leukemia (AML). Leuk Res 2014;7:1145-1226.

  19. Lurlo A, Ubertis A, Artuso S, Bucelli C, et al. Comorbidities and polypharmacy impact on complete cytogenetic response in chronic myeloid leukaemia elderly patients. Eur J Intern Med 2014;25:63-66.

  20. Guía de la buena prescripción, OMS. Disponible en: http:// apps.who.int/medicinedocs/pdf/h2991s/h2991s.pdf

  21. Lexicomp UpTodate. www.uptodate.com

  22. Bradley MC, Motterli N, Padmanabhan S, Cahir C, et al. Potentially inappropriate prescribing among older people in the United Kingdom. BMC Geriatr 2014;14:72-81.

  23. van Leeuwen RW, Swart EL, Boom FA, Schuitenmaker MS, Hugtenburg JG. Potential drug interactions and duplicate prescriptions among ambulatory cancer patients: a prevalence study using an advanced screening method. BMC Cancer 2010;10:679-684.

  24. Lu J, Yang M, Luo L, Hao Q, Dong B. Polypharmacy among nonagenarians and centenarians in rural China. Intern Med J 2014;44:1193-1199.




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