0009/2021 - Uso de medicamentos com ação anticolinérgica em idosos e comparação entre escalas de risco – estudo de base populacional Use of anticholinergic drugs in the elderly and divergences between risk scales - population-based study
O padrão de morbimortalidade tem-se modificado nos últimos anos com aumento das doenças crônicas não-transmissíveis levando a múltiplas comorbidades e ao uso de muitos medicamentos. O objetivo foi avaliar o uso de medicamentos com ação anticolinérgica por idosos. Métodos: Estudo transversal de base populacional, com indivíduos de 60 anos ou mais. Foram investigados fatores socioeconômicos, problemas de saúde e utilização de medicamentos nos últimos 15 dias. Para a classificação dos medicamentos com atividade anticolinérgica foram utilizadas as escalas: Anticholinergic Drug Scale (ADS), Anticholinergic Risc Scale (ARS), Anticolinergic Cognitive Burden Scale (ACB). Resultados: Entrevistados 1451 idosos, destes, 1305 utilizaram medicamentos, sendo que 60,7% usaram fármacos com ação anticolinérgica, sobretudo aqueles com mais de 80 anos e os menos escolarizados. No total, 5703 medicamentos foram usados, sendo 1282 (22,5%) com ação anticolinérgica. Observou-se concordância kappa de 0,63 quando se avaliou as escalas de risco ACB e ADS. Conclusão: A prevalência de uso de fármacos com ação anticolinérgica foi alta, deve-se estar atento às consequências relativas ao seu uso, tendo em vista a tomada de decisão mais racional na prática clínica.
Palavras-chave:
uso de medicamentos, idosos, antagonistas colinérgicos
Abstract:
The pattern of morbidity and mortality has changed due to the increase in chronic no communicable diseases, leading to multiple comorbidities and the use of several medications. The aim was to evaluate the anticholinergic drugs used by elderly people, according to risk scales. Methods: Population-based cross-sectional study, with elderly people. Socioeconomic factors, health problems, and medication use were investigated in the last 15 days. We used the Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS) and Anticholinergic Cognitive Burden Scale (ACB) for risk classification according to anticholinergic activity of the drugs. Results: 1451 elderly people were interviewed, 1305 used medications, of these, 60.7% with anticholinergic action, especially the group older than 80 years and the least educated. Risk agreement was observed between 95 drugs (7.4%) when the three scales were evaluated, with the nervous system being the most frequently used (84.2%). Kappa concordance of 0.63 was observed when assessing the ACB and ADS risk scales. Conclusion: The prevalence of anticholinergic drugs used was high, it is important for the health professional paying attention to the consequences related to their use, making more rational decisions in clinical practice.
Use of anticholinergic drugs in the elderly and divergences between risk scales - population-based study
Resumo (abstract):
The pattern of morbidity and mortality has changed due to the increase in chronic no communicable diseases, leading to multiple comorbidities and the use of several medications. The aim was to evaluate the anticholinergic drugs used by elderly people, according to risk scales. Methods: Population-based cross-sectional study, with elderly people. Socioeconomic factors, health problems, and medication use were investigated in the last 15 days. We used the Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS) and Anticholinergic Cognitive Burden Scale (ACB) for risk classification according to anticholinergic activity of the drugs. Results: 1451 elderly people were interviewed, 1305 used medications, of these, 60.7% with anticholinergic action, especially the group older than 80 years and the least educated. Risk agreement was observed between 95 drugs (7.4%) when the three scales were evaluated, with the nervous system being the most frequently used (84.2%). Kappa concordance of 0.63 was observed when assessing the ACB and ADS risk scales. Conclusion: The prevalence of anticholinergic drugs used was high, it is important for the health professional paying attention to the consequences related to their use, making more rational decisions in clinical practice.
Miranda, V.I.A, Silveira, M.P.T, Lutz, B. H., Pirolli, F., Zambiasi, L., Bielemann, R.M, Gonzalez, M.C, Bertoldi, A.D. Uso de medicamentos com ação anticolinérgica em idosos e comparação entre escalas de risco – estudo de base populacional. Cien Saude Colet [periódico na internet] (2021/jan). [Citado em 22/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/uso-de-medicamentos-com-acao-anticolinergica-em-idosos-e-comparacao-entre-escalas-de-risco-estudo-de-base-populacional/17908?id=17908
