Complexity of pharmacotherapeutic regimens for older adults in primary
care in Brazil: a cross-sectional study
Aims: Adherence to prescribed treatment is important for obtaining the
desired outcomes in older people care. Polypharmacy is strictly
associated with adherence, and complex pharmacotherapy can lead to poor
adherence and unexpected outcomes, which are aggravated by older age.
The medication regimen complexity index has been proven to be a valid
and reliable tool for quantifying the complexity of medication regimens.
The objective of the present study was to evaluate the therapeutic
complexity of drugs used by older people in a primary care setting in
Brazil. Methods: This was a cross-sectional study conducted in 22 basic
health units in Brazil. Older people from this sample who were treated
in a primary care setting were interviewed after a consultation with a
family practice physician. Data were collected from September 2016 to
March 2019. Patients aged ≥ 60 years who visited the primary care units
were included in the study. Pharmacotherapeutic complexity was assessed
according to the medication regimen complexity index. Results: In all,
675 individuals with a mean age of 70 years (±7.1 years) were included.
The mean number of drugs prescribed per capita was 2.9 (±1.8). The
median medication regimen complexity index for the sample was 8.0, and
26.1% of the patients interviewed had a high medication regimen
complexity index. Conclusion: The complexity of the drug regimen was
high in almost one-third of the prescriptions analysed. This high
complexity might contribute to non-adherence to medication regimens,
leading to safety- and effectiveness-related issues. Key words: drug
prescriptions, geriatrics, pharmaceutical preparations, polypharmacy,
primary health care, older patient.