OBJECTIVE: This study aims to analyze pharmacological interactions among drugs taken by elderly patients and their age and gender differences in a population from Porto Alegre, Brazil. METHODS: We retrospectively analyzed the database provided by the Institute of Geriatric and Gerontology, Porto Alegre, Brazil. The database was composed of 438 elderly and includes information about the patients' disease, therapy regimens, utilized drugs. All drugs reported by the elderly patients were classified using the Anatomical Therapeutic and Chemical Classification System. The drug-drug interactions and their severity were assessed using the Micromedex® Healthcare Series. RESULTS: Of the 438 elderly patients in the data base, 376 (85.8%) used pharmacotherapy, 274 were female, and 90.4% of females used drugs. The average number of drugs used by each individual younger than 80 years was 3.2±2.6. Women younger than 80 years old used more drugs than men in the same age group whereas men older than 80 years increased their use of drugs in relation to other age groups. Therefore, 32.6% of men and 49.2% of women described at least one interaction, and 8.1% of men and 10.6% of women described four or more potential drug-drug interactions. Two-thirds of drug-drug interactions were moderate in both genders, and most of them involved angiotensin-converting enzyme inhibitor, non-steroidal anti-inflammatory, loop and thiazide diuretics, and β-blockers. CONCLUSION: Elderly patients should be closely monitored, based on drug class, gender, age group and nutritional status.

OBJETIVO: Descrever o uso de medicamentos que atuam no sistema nervoso central (SNC) e identificar as possíveis interações mais frequentes com esses medicamentos em idosos do sul do Brasil. MÉTODOS: Estudo de base populacional, transversal e observacional, realizado durante 2006-2007. Quatrocentos e oitenta idosos de ambos os sexos foram randomizados e entrevistados. Foram utilizados um questionário farmacoterapêutico validado e o programa Micromedex® Healthcare Series para analisar as potenciais interações com os medicamentos. Foi utilizada uma escala para descrever a gravidade das interações nas categorias de "leve", "moderada" e "grave". RESULTADOS: A população idosa, moradora do sul do Brasil, que utilizava medicamentos para o SNC, era formada por 98 pacientes, 75,5% mulheres e 25,5% homens. Destes pacientes, 32,0% apresentaram interações farmacológicas graves ou moderadas relacionadas com a utilização de outros medicamentos. Alprazolam e Imipramina, usados pela população, apresentaram riscos de potenciais interações com tabaco. Foram encontradas vinte potenciais interações moderadas medicamento/etanol. As potenciais interações medicamento/cafeína foram classificadas como leves. CONCLUSÃO: Os pacientes idosos deveriam ser rigorosamente monitorizados, e ainda, é necessário advertir quanto às potenciais interações de medicamentos que atuam no SNC com outros medicamentos, etanol e tabaco.

OBJECTIVE: To describe the use of CNS drugs and to identify the most frequently observed potential drug interactions in the elderly living in Southern Brazil. METHODS: A population-based, transversal and observational study was carried out during 2006-2007. Four hundred and eighty elderly individuals of both genders were randomly recruited and interviewed. A validated pharmacotherapeutic questionnaire and the Micromedex® Healthcare Series were utilized to analyze potential drug interactions. A severity rating scale employing the categories of "mild", "moderate" and "severe" was used to describe the interactions. RESULTS: A population of elderly living in Southern Brazil was interviewed and 98 reported using CNS drugs, 74.5% female and 25.5% male. Out of these patients, 32.0% reported severe or moderate pharmacological interactions related to the use of other drugs. Alprazolam and imipramine were reported to potentially interact with tobacco. Twenty potential moderate drug/ethanol interactions were found. The potential drug/caffeine interactions were classified as mild on the severity scale. CONCLUSION: Elderly being prescribed drugs that act on the CNS should be closely monitored, and furthermore, should be warned against potential drug-drug, drug-ethanol, and drug-tobacco interactions.

Polifarmácia e falta de adesão à prescrição médica são problemas freqüentes na terapêutica farmacológica de idosos que podem prejudicar o resultado do seu tratamento. Realizou-se um estudo transversal exploratório e quantitativo em base populacional para levantar a freqüência de idosos aderentes e avaliar se a polifarmácia interfere na adesão. A pesquisa foi realizada com 466 idosos de Porto Alegre, RS. Os instrumentos foram aplicados por entrevista individual. A freqüência de idosos aderentes foi de 173 (37,1%) e maior entre os que utilizavam menos fármacos. Os resultados encontrados sugerem a implementação de programas educacionais para auxiliar os idosos no seguimento à terapêutica farmacológica.

Polipharmacy and medication non-adherence are problems faced frequently in the treatment of elderly patients. An exploratory cross-sectional study and quantitative approach were conducted to assess the frequency of treatment-adherence in elderly and how polipharmacy can affect adherence. Four hundred and sixty six elderly answered a questionnaire in Porto Alegre, RS in individual interviews. The adherence frequency found was 173 (37.1%) and was higher among those, who use less medication. These results indicate the need for implementing educational programs for the elderly in order to help them to follow their drug therapy.

Polifarmácia e falta de adesão à prescrição médica são problemas freqüentes na terapêutica farmacológica de idosos que podem prejudicar o resultado do seu tratamento. Realizou-se um estudo transversal exploratório e quantitativo em base populacional para levantar a freqüência de idosos aderentes e avaliar se a polifarmácia interfere na adesão. A pesquisa foi realizada com 466 idosos de Porto Alegre, RS. Os instrumentos foram aplicados por entrevista individual. A freqüência de idosos aderentes foi de 173 (37,1%) e maior entre os que utilizavam menos fármacos. Os resultados encontrados sugerem a implementação de programas educacionais para auxiliar os idosos no seguimento à terapêutica farmacológica.

Polipharmacy and medication non-adherence are problems faced frequently in the treatment of elderly patients. An exploratory cross-sectional study and quantitative approach were conducted to assess the frequency of treatment-adherence in elderly and how polipharmacy can affect adherence. Four hundred and sixty six elderly answered a questionnaire in Porto Alegre, RS in individual interviews. The adherence frequency found was 173 (37.1%) and was higher among those, who use less medication. These results indicate the need for implementing educational programs for the elderly in order to help them to follow their drug therapy.

The elderly population is one of the most rapidly increasing populations in the world. Physiological alterations induced by the aging process make these individuals more susceptible to chronic diseases and, consequently, to increased drug utilization. Objective: To describe the profile of drug utilization in the elderly living in Porto Alegre, RS, Brazil. Methods: An observational and cross-sectional population-based study to investigate the characteristics of the population, sources of information and types of drugs used by the elderly was performed. Four hundred and eighty patients were recruited from data supplied by the City Hall of Porto Alegre. The elderly were interviewed individually during the period from January to May 2006 by trained interviewers. A validated pharmacotherapy questionnaire was used for data collection and data were tabulated and analyzed by the SPSS 11.5 computer program. Results: Of the 480 patients interviewed, 13.8% did not use any medication. Cardiovascular system drugs represented the pharmacological class most used by the elderly (64.0%). When ill, 71.9% of these individuals visited the doctor, while 36.9% self-medicated. For the majority (50.2%), drugs were identified by their labels. Only 41.2% of the elderly understood medical prescriptions and 68.3% of the patients studied obtained the necessary information for the appropriate use of therapy from their doctors. Conclusions: The present study suggests that a pharmaceutical care program for the treatment, prevention, and use of medications may provide a higher efficiency to elderly drug therapy.

La población anciana es una de las poblaciones que crece más rápidamente en el mundo. Las alteraciones fisiológicas producidas por la edad hacen a estos individuos más susceptibles a las enfermedades crónicas y, consecuentemente, a un aumento de uso de medicamentos. Objetivo: Describir el perfil de utilización de medicamentos en ancianos que viven en Porto Alegre, RS, Brasil. Métodos: Se realizó un estudio observacional transversal poblacional para investigar las características de la población, fuentes de información y tipos de medicamentos utilizados por los ancianos. Se reclutó a 484 pacientes de datos proporcionados por el Ayuntamiento de Porto Alegre. Se entrevistó a los ancianos individualmente durante un periodo de enero a mayo de 2006 por entrevistadores entrenados. Se usó un cuestionario farmacoterapéutico validado para la recogida de datos y los datos se tabularon y analizaron con el programa SPSS 11.5. Resultados: De los 480 pacientes entrevistados, el 13,8% no utilizaban medicación. Los medicamentos del aparato cardiovascular representaban el grupo terapéutico más usado por los ancianos (64,0%). Cuando enferman, el 71,9% de estos individuos visitaron al médico, mientras que el 36,9% se auto-medicó. Para la mayoría (50,2%), identificaron los medicamentos por las etiquetas. Sólo el 41,2% de los ancianos entendían las recetas médicas y el 68,3% de los pacientes estudiados obtuvieron la información necesario de sus médicos. Conclusiones: El presente estudio sugiere que un programa de atención farmacéutica para el tratamiento, prevención y uso de medicaciones puede proporcionar una mayor eficiencia a los tratamientos de los ancianos.