Utilização de medicamentos por idosos com diabetes do município de Goiânia, Goiás
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2013-10-30
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Universidade Federal de Goiás
Resumo
Introduction. In Brazil, the percentage of elderly people is increasing considerably
over the years. As a consequence, it is observes the increasing of chronical diseases
such as diabetes mellitus. It is a disease that requires special attention, because it
exposes elderly people to a long care period and to the continued use of medicines,
sometimes using multidrugs. Moreover, elderly people are often affected by other
comorbidities, by complications of the disease and its treatment. Objective. Analyze
the use of medicines by the elderly people with diabetes mellitus in the city of
Goiania, Goias, Brazil. Methodology. It is a population-based cross-sectional study
carried out with a sample of 173 elderly individuals with diabetes mellitus and
medications referred, selected by cluster. Data were collected by household
interviews from December 2009 to April 2010 and they were analyzed by the
Software Stata 12.0. The identified medicines were classified according to the
Anatomical Therapeutic Chemical classification of the World Health Organization.
The study was approved by Ethics Committee of the Federal University of Goias .
Results. The mean age of old people with diabetes mellitus was 72.5 years and
61.8% were female. The most used medicines were acetylsalicylic acid (20.2%),
enalapril (19.1%), dipyrone (13.3%), simvastatin (13.3%), levothyroxine sodium
(12.7%), captopril (11.0%), atenolol (11.0%), hydrochlorothiazide (10.4%), losartan
(9.8%) and paracetamol (9.8%). Approximately two thirds of the subjects used drugs
for treatment of diabetes mellitus, and biguanides, sulfonylureas and insulins that
have been most frequently used, showing respective values of 37.0%, 34.7% e
15.0%. Insulin alone was used in 7.5% of the elderly. It was found that 20.2% of the
subjects used glibenclamide, an inappropriate medicine for old people. Exclusively
oral antidiabetic therapy was observed in 51.5% of the individuals: 68.5% oral
monotherapy and 31.5% combined oral therapy. The exclusive use of oral
antidiabetic occurred with the utilization of metformin in monotherapy (15.6%),
glibenclamide in monotherapy (11.0%) and combined therapy using metformin and
glibenclamide (8.1%). The polypharmacy frequency was 38.7%. It was observed that
women, unmarried, aged over 75 years and those who were not engaged in physical
activity, hypertensive individuals, dyslipidaemic and those who had any
hospitalization in the last 12 months had a higher median number of drugs used (p
<0.05). However, after multivariate analysis hypertension was he only variable with
statistical significance. Older people with diabetes mellitus and hypertension had 3.28
times more likely to use five or more medications than those without hypertension.
Conclusion. This study allowed us to identify the profile of utilization of medicines by
elderly people with diabetes mellitus as well to verify that metformin, alone or in
combination, was the drug most often used for diabetes mellitus and indicated factors
that may compromise the safety of antidiabetic pharmacotherapy in this population.
Thus, health actions need to be developed, it is essential the work of the pharmacist
in the multidisciplinary team to promotion of rational use of medicines and ensuring
the safety of the elderly with diabetes mellitus.
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NUNES, Marcus Vinicius Oliveira. Utilização de medicamentos por idosos com diabetes do município de Goiânia, Goiás. 2013. 100 f. Dissertação (Mestrado em Saúde Coletiva) - Universidade Federal de Goiás, Goiânia, 2013.