Associação entre o uso de polifarmácia e a ocorrência de quedas em idosos não institucionalizados

Abstract

Introduction: The elderly population faces multiple diseases, especially non-communicable chronic diseases that require continuous treatment. Polypharmacy, characterized by the use of five or more medications, is common in this age group, and the lack of training among healthcare teams can exacerbate the situation. This increases the prevalence of adverse effects and drug interactions, which in turn contributes to a higher risk of falls among the elderly. Objective: To estimate the occurrence of falls and their association with polypharmacy in the elderly. Method: It is divided into two studies: 1) Integrative literature review to investigate the prevalence of polypharmacy in the elderly in Primary Health Care, using the PCC strategy to formulate the review question "What is the occurrence of polypharmacy in the elderly in the scope of Primary Health Care?". Free full-text studies conducted with the elderly in this context and addressing polypharmacy were included, with no restrictions on methodology, language, or country of publication, during the years 2021 and 2022. and 2) Cross-sectional study conducted with 100 elderly individuals in a Basic Health Unit (UBS) in a municipality in Northeast Brazil. Data collection was carried out using the Elderly Health Notebook and Handgrip Strength (HGS). The explanatory variables for the outcome "Falls" were grouped according to demographic characteristics and health assessment of the elderly person. Descriptive and bivariate analyses were performed, followed by Multiple Poisson Regression analysis. Results: Polypharmacy was more frequent in elderly individuals undergoing treatment for chronic diseases, especially Systemic Arterial Hypertension (SAH) and Diabetes Mellitus, described in 71.4% of the studies. The frequency of polypharmacy in elderly individuals under follow-up in Primary Health Care (PHC) ranged from 18.8% to 100.0%. The most commonly used drugs were for the cardiovascular and metabolic systems. An average age of 71.5 years (SD: 6.08-6.34) was found with a predominance of females (68%). The prevalence of falls was 42%, and factors associated with the occurrence of falls were polypharmacy (p = 0.015; PR: 5.04; 95% CI 1.36-18.6), weak handgrip strength (p = 0.414; PR: 1.81; 95% CI 0.43- 7.63), and being 75 years old (p = 0.001; PR: 1.05; 95% CI 1.02-1.09). Most participants had one or more chronic diseases. Conclusion: Elderly individuals using polypharmacy require greater attention and care to prevent adverse events such as falls. The research data revealed that the prevalence of falls in the elderly was positively associated with polypharmacy, weak handgrip strength, and being 75 years old.