Abstract:
This study is a systematic literature review of the association between lists of potentially inappropriate medications (PIM) in clinical practice and health outcomes of older adults followed up in primary health care. For this purpose, the PRISMA protocol was used to systematize the search for articles in the PubMed, Web of Science, Scopus, Cochrane Central, LIVIVO and LILACS databases, in addition to the gray literature. Studies with randomized clinical trials were selected, using explicit criteria (lists) for the identification and management of PIM in prescriptions of older patients in primary care. Of the 2,400 articles found, six were used for data extraction. The interventions resulted in significant reductions in the number of PIM and adverse drug events and, consequently, in potentially inappropriate prescriptions (PIP) in polymedicated older adults. However, there were no significant effects of the interventions on negative clinical outcomes, such as emergency room visits, hospitalizations and death, or on improving the health status of the older adults. The use of PIM lists promotes adequate medication prescriptions for older adults in primary health care, but further studies are needed to determine the impact of reducing PIM on primary clinical outcomes.
摘要:
本研究是对临床实践中潜在不适当药物(PIM)列表与在初级卫生保健中随访的老年人的健康结果之间的关联的系统文献综述。为此,PRISMA协议用于系统化PubMed中的文章搜索,WebofScience,Scopus,CochraneCentral,LIVIVO和LILACS数据库,除了灰色文学。随机临床试验的研究被选中,使用明确的标准(列表)来识别和管理初级保健中老年患者的处方中的PIM。在找到的2400篇文章中,六个用于数据提取。干预措施导致PIM和不良药物事件的数量显着减少,因此,在多药老年人的潜在不适当处方(PIP)中。然而,干预措施对负面临床结果没有显著影响,例如急诊室就诊,住院和死亡,或改善老年人的健康状况。PIM清单的使用促进了老年人在初级卫生保健中的适当药物处方,但需要进一步的研究来确定降低PIM对主要临床结局的影响.