Banca de QUALIFICAÇÃO: LUCIANA SOARES RODRIGUES

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : LUCIANA SOARES RODRIGUES
DATE: 21/02/2022
TIME: 09:00
LOCAL: Videoconferência
TITLE:

DESCRIPTION OF BENZODIAZEPINENICS IN ELDERLY USERS OF THE SINGLE HEALTH SYSTEM (SUS)

KEY WORDS:

Deprescriptions; Aged; Benzodiazepines; Drugs of Continuous Use; Primary Health Care.

PAGES: 137
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: Benzodiazepines (BZD) are among the drugs with a high prevalence of consumption by the elderly population. They are drugs indicated for short-term therapeutic effects, acting as sedatives, hypnotics, antiepileptics, anxiolytics, against alcohol withdrawal symptoms, muscle relaxants and anesthetic adjuvants, however they are usually used in the long term for the treatment of insomnia and anxiety, and may cause undesirable effects such as falls, fractures, car accidents, cognitive impairment, physical and psychological dependence, being a drug considered inappropriate for the geriatric population. Therefore, it is essential to plan strategies to rationalize the use of BZD among the elderly. Objectives: To identify the profile of elderly people who use BZD, validate an instrument that highlights the facilitating and hindering aspects of the deprescription process in elderly people from the patient's perspective, and to assess the effect and feasibility of a protocol for describing BZD in the elderly. Methods: This research has so far been divided into two sub-studies. Sub-study 1, corresponds to the development and validation of an instrument on the facilitating and hindering aspects of the BZD deprescription process in the elderly, it is a study developed in three stages, namely: (1) methodological, (2) interview semistructured pilot with 25 elderly people in describing clonazepam and (3) content validation using the Delphi technique. As measures to assess the results obtained, the agreement of the assessment was analyzed using the coefficient of content validity (CVC). An acceptable level of agreement was considered to be a value greater than or equal to 0.8. Sub-study 2 sought to analyze the possibility of identifying potential patients eligible for describing benzodiazepines through secondary data present in medical records of the elderly. For this, a cross-sectional study was carried out, using physical and electronic medical records of elderly patients in a Brazilian municipality, from July to November 2020. To identify potential patients who are candidates for deprescription, the following parameters were used: a) Record of insomnia by itself or insomnia caused by comorbidity already under treatment; b) Patients aged ≥ 60 years: using BZD regardless of duration. Results: In sub-study 1, validation was given by 50 specialists with training and/or experience in the area of Primary Health Care and/or Elderly Health, including physicians, pharmacists and nurses. The instrument was considered validated in the first round of evaluation, in which all items evaluated had a CVC greater than 0.8 in the experts' v evaluation. However, they proposed suggestions for improvements that were incorporated in the final version of the questionnaire. In sub-study 2, among the 332 medical records analyzed, 255 (76,8%) elderly were female and 264 (79,5%) were aged between 65 and 70 years. Most patients performed prescription renewals 267 (80,4%) within an interval of 0 to 3 months. A significant portion 202 (60,8%) did not contain information about the reason for prescribing benzodiazepines and when considering the date of the first prescription, it was identified that most elderly people 241 (72,6%) used for a period exceeding six years. In the information obtained, only 17 (5,1%) presented eligibility criteria for deprescription. Conclusion: Sub-study 1: The instrument is an important tool to be used by health professionals to optimize the process of describing benzodiazepines, with an adequate clarity and validity index. Sub-study 2: According to the data obtained in this study, the impossibility of using medical records as a screening strategy to identify potential candidates for describing benzodiazepines is perceived.

BANKING MEMBERS:
Interna - 1347706 - ALBA OTONI
Presidente - 1581667 - DANYELLE ROMANA ALVES RIOS
Externa à Instituição - RAQUEL DULLY ANDRADE - UEMG