Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care.
Carine Teles Sangaleti, Maicon Henrique Lentsck, Dannyele Cristina da Silva and 5 others
PMID 38088658WHAT IT FOUND
Among older adults with hypertension in Brazilian primary care, 38.09% used five or more medications and 28.57% used potentially inappropriate medications.
Polypharmacy was associated with falls, poor sleep and inappropriate prescribing; lacking caregiver support was associated with inappropriate medications.
Key findings
0138.09% of the 189 older adults used five or more medications, and 28.57% were prescribed and continuously used potentially inappropriate medications.
02Polypharmacy was associated with inappropriate medication prescription, worse gait and balance functionality, and a higher rate of falls.
03In adjusted analysis, PIM use was associated with polypharmacy (3.92 times chance), lack of caregiver support (3.74 times chance), severely dysfunctional families (13.79 times chance), and altered cognition (0.43 times chance).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional and done at one Family Health Strategy unit, so it cannot show cause and may not apply to other places. Only 189 older adults were included, and the sample was limited to people already in regular care with at least one medical or nursing consultation and a community health worker visit, so older adults with less contact with services may be missing. The reported polypharmacy prevalence differs between the results (38.09%) and the conclusion (39.09%). The study did not follow participants over time, so it cannot tell whether polypharmacy led to falls, poor sleep or inappropriate prescribing, or the reverse.
The easy way to misread this
Do not conclude that reducing medicines caused or would prevent falls, poor sleep or inappropriate prescribing. The study measured associations at one time point in older adults already receiving primary care, so it cannot show cause or effect.