Banca de DEFESA: MARLON SILVA TINOCO

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : MARLON SILVA TINOCO
DATE: 10/02/2022
TIME: 14:00
LOCAL: Via plataforma virtual google meeting
TITLE:

DEPRESCRIPTION OF BENZODIAZEPINES IN THE ELDERLY: ANALYSIS OF PACKAGE INSERTS AND VALIDATION OF INSTRUMENTS FOR IDENTIFICATION OF SIGNS AND SYMPTOMS OF WITHDRAWAL

KEY WORDS:

benzodiazepine receptors; deprescription; package inserts; validation study; questionnaires.

PAGES: 55
BIG AREA: Ciências da Saúde
AREA: Farmácia
SUMMARY:

With population aging and the irrational use of benzodiazepines by society, health professionals need quality evidence to perform the deprescription of these drugs, as well as instruments for this process to occur effectively and safely for the elderly. That said, this study has been divided into two chapters.

Chapter 1: Objective: To analyze the presence and quality of content on drug deprescribing in Brazilian package inserts for benzodiazepine drugs Methodology: A documentary study was carried out, in which data contained in Brazilian package inserts for benzodiazepines (BZDs) were analyzed. The keywords “reduction”, “withdrawal” and “non-prescription” were sought. Furthermore, information relevant to the topic (directly related to the describing process) was verified, such as the maximum time of use, the risks of prolonged use and adverse reactions. For purposes of comparison of information, explicit and systematic guidelines for describing and warning of adverse reactions found in the literature were considered. Results: Twelve BZD inserts were found with valid registration and the inserts (100%) address the topic of descrip- tion through the suggestion of gradual dose reduction. Only one (8.33%) presented explicit and systematic guidance for dose reduction. As for the maximum time of use, different information according to each drug, and a package insert (8.33%) did not present this information. Regarding the risks of prolonged use of the drug, 11 (91.67%) package inserts reported a risk of dependence and/or tolerance and one (8.33%) stated that the data available in the literature do not provide a true estimate of the risk. 33.33% package inserts did not address the risk of falls and five (41.67%) did not address the risk of fractures in the elderly. The risk of cognitive impairment was not reported in six (50.00%) package inserts. The risk of a car accident is included in the 12 (100%) package inserts analyzed. Conclusion: The package inserts do not provide detailed or schematic descriptions. It is extremely important that health professionals are guided in their conduct and, therefore, there is a great need to update the package inserts.

 

Chapter 2: Objective: to develop and carry out the validation of an adequate instrument to assess the signs and symptoms of withdrawal from the benzodiazepine deprescription process in Brazilian elderly. Methodology: a two-step methodological study was carried out, the first being the preparation of an instrument to identify signs and symptoms arising from the gradual descrip- tion of benzodiazepines in elderly Brazilians. A second stage consisted of the validation of the instrument using the delphi technique by experts in the area of health and specialists in elderly health. Results: A systematized elaboration and validation was carried out with 36 experienced reviewers in elderly care, making it possible to build an instrument for the proper identification of withdrawal signs and symptoms present during the process of describing benzodiazepines in elderly Brazilians. The agreement percentage found was higher than the minimum awarded rate of 80% and the critical evaluation of the evaluators updated the improvement of the questionnaire. Conclusion: The instrument elaborated understood the signs and common to the process of describing BZD in the elderly, validated by a reviewer to be applicable in the Brazilian health context.

BANKING MEMBERS:
Presidente - 1039964 - ANDRE DE OLIVEIRA BALDONI
Externa à Instituição - LORENA ROCHA AYRES - UFES
Externo à Instituição - CAMILO MOLINO GUIDONI - UEL