Potentially Inappropriate Medications and their Use in Elderly Populations Residing in Long-Term Care Facilities
In recent decades, an aging population has caused a demographic change brought on by factors such as the improvement in sanitary conditions and technological advances in the medical and pharmaceutical industries. However, the demands of specific care coupled with new family arrangements have led to increasing institutionalization of the elderly. Medications used in these populations are not always appropriate for their needs, as the socioeconomic difficulties of long-term care facilities for the elderly result in collective rather than individualized consultations, increasing the possibility of drug and iatrogenic interactions. Elderly residing in long-term care facilities require special attention, since they may present specific vulnerable characteristics such as advanced age, high number of diseases, frailty, polypharmacy, physical as well as psychological and social dependence, low functionality, among others. Furthermore, they present particularities regarding the use of medications due to organ functions are minimized by physiological changes that alter pharmacokinetics and pharmacodynamics. Thus, to support this practice, several instruments that classify potentially inappropriate medications for the elderly have emerged. In Brazil, most studies on drug use in the elderly are related to outpatient, hospital, or community settings. However, few studies have investigated risk factors related to medication usage in institutionalized elderly. This review aims to contribute to the rational use of medications in the elderly, in order to complement the knowledge of health professionals and, consequently, maximize therapeutic efficacy in this population.