Research Paper

Polypharmacy, Characteristics Of The Medications Usage In The Elder Patients In Emergency Room

Abstract :

Introduction.Polypharmacy, the concurrent use of five or more medications, highly risks connected for the medication-medication interaction, medication-disease and therapeutic competition (recommended treatment for a disease), could have a side effect or compete with comorbidity. Iatrogenic disease contributes sensitively in morbidity and mortality in the elders.Aim:To evaluate the use of medication in elder patients who show up at the emergency room in Elbasan hospital during spring and summer.Methodology. It is a retrospective transversal study where the patients cards accepted in the emergency room of the regional hospital of Elbasan from March to August 2016. Included are patients older than 65 years and are gathered the socio-demographic complaints, administrated medicines, and their numbers data. Categorical variables are shown in frequencies and chi-square is used to analyze any possible changes in the distribution of variables according to groups. The data are analyzed with SPSS 16.Results.From March-August 2016, 444 patients over 65 years were accepted in the emergency room (or 42 % of the cases). 43% were males, and 57 % lived in the villages. In most of the cases, patients have shown a concern (82%). Most frequent pathology are cardiological in 45% cases, neurological and gastrointestinal in 20 %.In 80 % of the cases, patients have used 3 or 4 medications and rarely 1, 5 or more medications. 78 % of males and 81% of females have used 3 or 4 medications showing statistically changes. 10 % of females and 13 % of males have used up to 2 medications, while 9 % e females and males have used 5 medications with no significant changes.76 % administrated medications are mostly analgesic (different types), 44 % are electrolytes, 40 % are diuretic and 40 % are benzodiazepine and 28 % cardiologic of cases.According to the gender, 28 % of females have taken cardiologic medications, 75 % analgesic, 47 % benzodiazepine, 43 % electrolyte and diuretic, while males respectively 13 % have taken cardiologic medications, 78 % analgesic, 31 % benzodiazepine, 47 % electrolyte and 35% diuretic. According to gender, this difference in the distribution of the used medication is significantly statistically (chi-square, p<0.05).According to the place of residence, 10% of the patients who live in rural areas have used up to two medications, 80 % of them have used 3-4 medications, and 10 % of the cases have used 5 medications. 14% of the patients who live in the urban areas have used up to two medications, 77 % have used 3-4 medications, and 6 % take 5 medications. These changes in the number of medications used according to the place of residence are statistically significant (chi-square p<0.05).Conclusion. Elders, females, and patients who live in the rural area are frequent users of the emergency service. In most of the cases, they use 3 or 4 medications mainly electrolyte, different kinds of analgesic and benzodiazepine or diuretic and cardiologic. Females use more often benzodiazepine, and diuretics compare to males. Patients who live in the rural area rarely use 1 or 2 medications compare to the patients who live in the urban area, but more often 3-4 or 5 medications.

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