Introdução: O crescente aumento da população idosa faz aumentar a necessidade de recursos de saúde, entre eles o uso de medicamentos.Objetivo: Estudar os riscos de polifarmácia em idosos no município de São Paulo, Brasil. Métodos: Este estudo faz parte do projeto SABE – Saúde,Bem-estar e Envelhecimento – através de questionários por amostra em domicílios de 2143 idosos com 60 anos e mais composta por sorteio. Os dados finais foram ponderados e expandidos de modo que representem a população idosa no ano de 2000. A polifarmácia foi definida como o uso de quatro ou mais medicamentos, e utilizado o estudo de regressão logística por passos (IC 95%). Resultados: A média do número de medicamentos foi de 2,72 e a prevalência de polifarmácia de 31,5%. A polifarmácia foi mais prevalente em mulheres com 75 anos e mais (52,1%), religião espírita(51,2%), que declaram estado de saúde ruim (40,2%) e escolaridade acima de 12 anos (46,9%). Verificou-se que 71,1% adquirem medicamentos do próprio bolso, 15,95% se automedicam e a não adesão é devida ao custo (9,1%). Os riscos para polifarmácia foram mulheres (OR 2,2), idade acima de 75 anos (OR 1,5), consulta e internação em quatro meses (OR de 1,9 e 3,8) e problemas cardíacos (OR 3,8). Quanto ao medicamento impróprio a prevalência foi de 15,6%. Conclusão: Os riscos identificados na polifarmácia mostram uma necessidade de políticas públicas que visem promover o uso racional de medicamentos. / Introduction: The continuous growth of the elderly population increases the need for further health resources; amongst them is the use of drugs.Object: Study the risks’ Polypharmacy in the population of elderly people within the city of São Paulo, Brasil. Method: This study is part of the ‘SABE’ project – Health, Well-being and aging. This survey is carried out by using a sample questionnaire in the residence of 2143 people aged 60 and over. The final data are pondered and expanded to represent the population of elderly people in the year 2000. In order to analyze, polypharmacy was defined as four or more drugs, using the study of stepwise logistical regression (IC95%). Results: The average number of drug stays at 2,72, with a prevalence of polyfarmacy of 31,5%. Polyfarmacy is more prevalent amongst women aged 75 and over (52,1%); spiritualists (51,2%); those who claim poor self perceived health status (40,2%); those whose level of education is at least 12 years (46,9%). It has been observed that 71,1% use their own money to buy drugs; 15,9% practice self-medication; the cost of treatment being the cause of nonadherence (9,1%). Women are more at risk (OR 2,2), aged 75 and over (OR 1,5), visit to the physician and hospitalization within four months(OR from 1,9 to 3,8), cardiovascular conditions (OR 3,8). As for inappropriate use of medications, the prevalence is 15,6%. Conclusion: The identified risks in polypharmacy show a need for public policies that would promote a more rational use of medications.

Existem vários métodos para medir tipo e grau de uso de medicamentos. Esse estudo teve como objetivo caracterizar a prescrição médica para idosos, por meio de indicadores, em diferentes ambientes de atendimento à saúde em 4 municípios do Rio Grande do Sul. Buscou-se caracterizar a prescrição em locais de formação e atuação universitária, estabelecendo a prevalência de intervenções nãofarmacológicas e farmacológicas em prescrições para idosos, avaliando diferentes indicadores quanto a sua aplicabilidade em idosos e realizando inferências em relação ao uso racional de medicamentos. Fizeram parte do estudo serviços de atenção básica em saúde, além daqueles de média e alta complexidade, vinculados a ambientes de formação universitária na área da saúde, no sul do Brasil. A amostra foi constituída por prescrições médicas, obtidas diretamente dos pacientes, em nível de atenção primária em saúde e ambientes de média complexidade, ou por meio de prontuários hospitalares, durante o período de um ano. Para caracterização dos idosos, foram considerados aqueles com idade igual ou superior a 65 anos. A coleta de dados foi realizada ao longo de doze meses, em semanas, dias e turnos definidos por meio de sorteio. sorteio. Como resultados, observou-se que, nos ambientes de atenção básica em saúde e nos ambientes de média complexidade estudados, os idosos do Rio Grande do Sul apresentaram maior média de medicamentos prescritos e prevalência considerável de medicamentos inapropriados, em comparação com outros estudos que envolveram dados da população em geral em outros estados do país. Em contrapartida, esses idosos receberam menor percentual de prescrições com antimicrobianos e baixo percentual de prescrições com agentes injetáveis. As classes de medicamentos mais comumente prescritas no ambiente ambulatorial foram aquelas de uso contínuo, provavelmente em função das enfermidades crônicas apresentadas por pacientes desta faixa etária. Destacaram-se os fármacos que agem no sistema cardiovascular, no sistema nervoso e no trato gastrintestinal e metabolismo. Por sua vez, na internação de idosos nos hospitais estudados, independentemente de município, sazonalidade, gênero ou faixa etária mais avançada, identificou-se um perfil elevado de utilização de medicamentos, com polifarmácia (n=345, 85,4%) e prescrição de medicamentos inapropriados (n=325, 80,4%) em número significativo de idosos. Os medicamentos que mais apareceram nas prescrições hospitalares foram aqueles prescritos sob regime de demanda (se necessário). A prescrição inadequada aos idosos é frequentemente atribuída à falta de treinamento de uma equipe especializada em geriatria e gerontologia, além da deficiência da formação universitária. Nesse sentido, considerando-se o contexto demográfico e epidemiológico brasileiro e a caracterização da prescrição para o paciente idoso realizada no estudo, é importante priorizar ações multidisciplinares relacionadas a promoção, prevenção e recuperação de enfermidades e padronizar procedimentos, para evitar erros de prescrição, transcrição e dispensação. A educação continuada dos profissionais da área da saúde, a divulgação e a atualização de listas de medicamentos essenciais e das listas de medicamentos inapropriados para idosos podem ser ferramentas úteis para a qualificação da prescrição e a promoção do uso racional de medicamentos em idosos. A partir dos pontos vulneráveis da prescrição para idosos que foram levantados, podem ser estabelecidas mudanças nos ambientes de formação em saúde estudados, visando a construção de um perfil profissional que paute suas ações pela comunicação efetiva, interdisciplinar e compromisso social. / There are several methods to measure type and degree of drug use. This study aimed to characterize the prescription for the elderly by means of indicators in different environments of health care and 4 cities of Rio Grande do Sul. It was characterized the prescription in academic and training environments, establishing the prevalence of non-pharmacological interventions and pharmacotherapy prescriptions for the elderly, assessing the applicability of different indicators to the elderly prescriptions, and making inferences about the rational use of medicines. Participants of the study were elderly people attended in primary health care services and in medium and high complexity health care services, linked to universities located in the south of Brazil. The sample consisted of prescriptions obtained directly from patients, at the level of primary health care and environments of medium complexity, or through hospital records, during the period of one year. It was considered elderly patients those with age over 65 years. Data collection was conducted over twelve months, in weeks, days and shifts defined by lot. It was observed that in primary health care and medium complexity services the Rio Grande do Sul elderly prescriptions had a higher mean number of medications and a considerable prevalence of inappropriate medications, compared to other studies involving data from the general population. However, these elderly received a lower percentage of prescriptions with antibiotics and injectable drugs. The classes of drugs most commonly prescribed in the outpatient setting were those of continuous use, probably due to the chronic diseases that frequently occurred in the old age. Those classes involved drugs that act on the cardiovascular system, nervous system and gastrointestinal tract and metabolism. In the hospitals studied, independently of the city, seasonality, gender or older age, it was identified high profile drug utilization, with polypharmacy (n = 345, 85.4%) and inappropriate prescription of medications (n = 325, 80.4%) in great number of elderly. The drugs that most appeared in the hospital prescriptions were those prescribed under the demand scheme ("if necessary"). Inappropriate prescribing for the elderly is often attributed to the lack of training in geriatrics and gerontology and disability of university education. Considering the Brazilian epidemiological and demographic context and the prescription pattern for the elderly observed in this study, it is important to prioritize disciplinary actions related to the promotion, prevention and recovery from illness and standardize procedures to avoid errors in prescribing, transcribing, and dispensing. The continuing education of professionals in the health, distribution and update of essential drugs lists and use of lists of inappropriate drugs for elderly may be useful tools for the improvement of the prescription and promotion of rational drug use in the elderly. Based on the vulnerabilities of the prescription for the elderly that have been raised, it is possible to establish changes in the studied healthy education environments, aiming to build a professional profile that bases its actions on effective communication, interdisciplinary and social commitment.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-11-06T13:20:47Z No. of bitstreams: 1 anacarmendossantosribeirosimoesjuliano.pdf: 2399268 bytes, checksum: 2d408565e43bdaeafd0fa433fc57d917 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-11-09T14:23:51Z (GMT) No. of bitstreams: 1 anacarmendossantosribeirosimoesjuliano.pdf: 2399268 bytes, checksum: 2d408565e43bdaeafd0fa433fc57d917 (MD5) / Made available in DSpace on 2017-11-09T14:23:51Z (GMT). No. of bitstreams: 1 anacarmendossantosribeirosimoesjuliano.pdf: 2399268 bytes, checksum: 2d408565e43bdaeafd0fa433fc57d917 (MD5) Previous issue date: 2017-08-24 / O uso de medicamentos potencialmente inapropriados em idosos (MPI) é um problema de saúde pública que demanda muita atenção, especialmente no ambiente hospitalar. Poucos estudos avaliaram mais detalhadamente a prevalência de MPI em momentos distintos da internação, assim como os fatores associados e as especialidades médicas envolvidas. Entender o padrão de prescrição inapropriada entre as diferentes especialidades pode auxiliar na identificação de medicamentos que poderiam ser substituídos por outros mais seguros. O presente estudo tem como objetivo avaliar a prevalência de MPI em um hospital geral terciário, comparando quatro diferentes momentos e investigando os fatores associados a esse padrão de prescrição, incluindo a comparação dos padrões de prescrição entre as especialidades médicas. Estudo de coorte retrospectivo, que incluiu todos os idosos que estiveram internados de janeiro a maio de 2015 nas especialidades clínicas de um hospital geral terciário. Todos os medicamentos prescritos foram coletados e divididos em quatro grupos: medicamentos de uso domiciliar, medicamentos da admissão, medicamentos acrescentados durante os dias subsequentes da internação e medicamentos da prescrição final, realizada no último dia da internação hospitalar. Os MPI foram identificados através dos critérios de Beers 2015 nos quatro grupos, e STOPP 2015 no primeiro e último dia da internação. As especialidades médicas (clínica médica, cardiologia, gastroenterologia, infectologia, nefrologia, neurologia, pneumologia e outras) também foram comparadas em relação à prevalência de MPI e aumento de MPI entre o primeiro e o último dia de internação. Um total de 1900 idosos foram incluídos. Para avaliação dos quatro grupos, foram excluídos os que não tinham prescrição domiciliar registrada no prontuário, totalizando 1381 pacientes. Neste grupo, encontrou-se importante aumento do número de medicamentos em geral e de MPI na admissão e durante a internação, persistindo até o último dia da internação. A prevalência de MPI foi em média 38% no domicílio, aumentando para 62,2% na admissão e 68,9% no último dia. Para comparação de Beers e STOPP e comparação entre as especialidades no primeiro e último dia da internação, foram incluídos os 1900 pacientes. A prevalência de MPI aumentou significativamente com ambos os critérios (62,3% para 66,6% com Beers e 43,4% para 50% com STOPP). Os MPI mais comuns foram insulina em escala móvel, antipsicóticos, óleo mineral, benzodiazepínicos, espironolactona e ácido acetilsalicílico. Os fatores associados a MPI foram idade, uso de MPI no domicílio, tempo de internação e óbito. Neurologia, infectologia e pneumologia tiveram maior utilização de MPI, e neurologia, pneumologia e cardiologia tiveram maior aumento de PIM durante a internação. Os achados do presente estudo reforçam o caráter iatrogênico hospitalar, enfatizando que o acréscimo desses medicamentos pode fazer com que eles se perpetuem até o último dia da internação. A especialidade médica é importante fator associado a MPI. Esforços são necessários para adoção de medidas educacionais e intervenções farmacêuticas que possam modificar essa situação. / The use of inappropriate prescribing in the elderly (PIM) is a public health problem that requires attention, especially in hospitalized patients. Few studies have evaluated in more detail the prevalence of PIM at different moments of hospitalization, as well as the associated factors and the medical specialties involved. Understanding the inappropriate prescribing pattern among the different specialties may help in the identification of drugs that could be replaced by safer options. The present study aims to evaluate the prevalence of PIM in a general tertiary hospital, comparing four different moments and investigating the factors associated with it, including the comparison of prescription patterns among medical specialties. A retrospective cohort study, including all the elderly who were hospitalized between January and May 2015 in the clinical specialties of a general tertiary hospital. All prescripted drugs were collected and divided into four groups: home-use drugs, admission medications, medications added during the subsequent days of hospitalization, and final prescription medications, performed on the last day of hospital stay. The PIM were identified using the Beers 2015 criteria in the four groups, and STOPP 2015 on the first and last day of hospitalization. The medical specialties (medical clinic, cardiology, gastroenterology, infectology, nephrology, neurology, pneumology and others) were also compared in relation to the prevalence of PIM and increase in PIM between the first and the last day of hospitalization. A total of 1900 elderly were included. The patients who did not have home prescription registered in the medical record were excluded of the evaluation of the four groups, totaling 1381 patients. There was an important increase in the number of medications in general and PIM at admission and during hospitalization, and persisted until the last day of hospitalization. The prevalence of PIM was about 38% at home, increasing to 62.2% on admission and 68.9% on the last day. For the comparison of Beers and STOPP and between the specialties on the first and last day of hospitalization, all the 1900 patients were included. The prevalence of PIM increased significantly with both criteria (62.3% to 66.6% with Beers and 43.4% to 50% with STOPP). The most common PIM were insulin on sliding scale, antipsychotics, mineral oil, benzodiazepines, spironolactone and acetylsalicylic acid. Factors associated with PIM were age, use of PIM at home, length of hospitalization and death. Neurology, infectology and pneumology had highest use of PIM, and neurology, pneumology and cardiology had a highest increase in PIM during hospitalization. These findings reinforce the hospital iatrogenic character, emphasizing that the addition of these medications on admission can be perpetuated until the last day of hospitalization. The medical specialty is an important factor associated with PIM. Educational measures and pharmaceutical interventions are important tools that may help to change this situation.

Na atualidade, a questão dos eventos adversos a medicamentos nos idosos apresenta grande importância, dada a expansão populacional deste grupo e o impacto negativo destes eventos, que muitas vezes apresenta associação com o uso de medicamentos potencialmente inapropriados (MPI). Tendo em vista que os resultados dos estudos sobre o impacto do uso de MPI na mortalidade de idosos, ainda são inconclusivos, o objetivo foi identificar e analisar na literatura científica as evidências de que o uso de MPI em idosos, segundo critério de Beers, encontra-se associado a mortalidade. Trata-se de uma revisão sistemática finalizada em 20 de Julho de 2012, cujos procedimentos metodológicos seguiram as recomendações do Joanna Briggs Institutte e Systematic Reviews Centre for Reviews and Dissemination guidance for undertaking reviews in health care. Na busca das publicações foram utilizadas as bases de dados Pubmed/Medline, Lilacs, Scopus, Embase, International Pharmaceutical Abstracts, Web of science, Sciencedirect; CINAHL, Current contents connect, Proquest Dissertation and Theses, Banco de teses-CAPES. A seleção das publicações e extração das informações dos estudos foi realizada por dois investigadores de forma independente. A qualidade metodológica dos estudos foi avaliada pela lista de verificação Newcastle-Ottawa. A amostra da RS foi constituída por 17 estudos, sendo que destes, oito publicações compuseram a metanálise. Na síntese descritiva observou-se que a maioria dos estudos apresentou nível de evidência IV (94,1%), cujo delineamento foi coorte (94,1%), usou técnica de amostragem não probabilística (64,7%), coletou dados de modo prospectivo (64,7%), utilizou amostra superior a 1.000 idosos (64,7%), realizou seguimento de 12 a 24 meses (52,9%) e a obtenção do desfecho mortalidade ocorreu em bases de dados (64,7%). A metanálise que totalizou a participação de 90.611 participantes apontou que idosos que utilizaram MPI apresentaram maior risco relativo para o desfecho de mortalidade (RR=1,11; IC 95% 1,01 1,22; p = 0,023), de acordo com os critérios de Beers, independente do cenário do estudo, da existência de comorbidades, de polifarmácia ou do tipo de MPI usado. / Currently, the issue of adverse drug events in the elderly presents great importance, given the expansion of this population group and the negative impact of these events, which often presents association with the use of Potentially Inappropriate Medications (PIM). Having in mind that the results of studies on the impact of using MPI elderly mortality are still inconclusive, the aim was to identify and analyze the evidences in the scientific literature that the use of PIM in the elderly, according to the Beers criteria, is associated with mortality. This is a Systematic Review finalized in July 20, 2012, whose methodological procedures followed the recommendations of the Joanna Briggs Institutte and Systematic Reviews - Centre for Reviews and Dissemination Guidance for Undertaking Reviews in Health Care. In the search of the publications were used databases Pubmed / Medline, Lilacs, Scopus, Embase, International Pharmaceutical Abstracts, Web of science, Sciencedirect, CINAHL, Current Contents Connect, Proquest Dissertation and Theses database-CAPES. The selection of publications and extraction of the information of the studies was conducted by two researchers independently. The methodological quality of studies was assessed by checklist Newcastle-Ottawa. The sample was composed of RS 17 studies, of which eight publications were included in the meta-analysis. In the synthesis descriptive observed that most studies showed level of evidence IV (94.1%), whose design was cohort (94.1%) used non-probability sampling technique (64.7%), collected data from prospectively (64.7%) used sample of more than 1,000 elderly (64.7%), realized during 12 to 24 months (52.9%) and obtaining of outcome mortality occurred in databases (64.7% ). The meta-analysis which totaled the participation of 90,611 participants pointed out that the elderly who have used PIM had higher relative risk for the outcome of mortality (RR = 1.11, 95% CI 1.01 to 1.22, p = 0.023), according to Beers criteria, regardless of the setting of the study, the existence of co-morbidities, polypharmacy, or the type of PIM used.

Orientador: Paulo José Fortes Villas Boas / Resumo: Introdução: A prescrição de Medicamentos Potencialmente Inapropriados (MPIs) é altamente prevalente em idosos e estes frequentemente estão associados à maior risco de interações medicamentosas, aumento das admissões hospitalares e Reações Adversas à Medicamentos (RAM), podendo ser prejudiciais à saúde do idoso. Objetivo: Analisar a prevalência de MPI em idosos em uma unidade de internação de hospital terciário e associação com a ocorrência de RAM durante a hospitalização. Material e Métodos: Trata-se de um estudo longitudinal, do tipo coorte, realizado em 2015 na Enfermaria da Clínica do HCFMB – UNESP com acompanhamento de 155 pacientes. Foram incluídos pacientes com 60 anos ou mais internados por condição clínica de ambos os sexos, e excluídos pacientes hospitalizados por um período inferior a 72 horas, e com internação prévia há menos de 30 dias. Foi utilizado como instrumento para identificar a associação entre o medicamento e a RAM o algorítimo de Naranjo, e utilizado os Critérios de Beers (2015) para categorizar os medicamentos como MPI. Resultados: Faziam uso contínuo de MPI antes da internação 113 (73,3%) idosos e receberam MPI durante a internação 139 (89,7%). Na análise multivariável observou-se associação de MPI na internação com uso de MPI antes da internação (RR=1,09; IC 95% = 0,00 – 0,57), Doença Arterial Coronariana (DAC) (RR = 1,39; IC 95% = 1,18 – 69,41) com p < 0,05. Identificou-se que 49 (36,1%) apresentam RAM, sendo no total 71 reações. Os principais medica... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Prescription of Potentially Inappropriate Medications (PIMs) is highly prevalent in the elderly, and these are often associated with increased risk of drug interactions, increased hospital admissions, and Adverse Drug Reactions (ADRs), which may be detrimental to the health of the elderly. Objective: To analyze the prevalence of PIM in the elderly in a tertiary hospital admission unit and association with the occurrence of ADR during hospitalization. Material and methods: This is a longitudinal study, cohort type, carried out in 2015 at the HCFMB Clinic Infirmary - UNESP, with follow-up of 155 patients. Patients with 60 years or more hospitalized due to clinical condition of both sexes, excluding patients hospitalized for less than 72 hours, and hospitalized for less than 30 days were included. The Naranjo algorithm was used as an instrument to identify the association between the drug and ADR and the criteria of Beers (2015) were used to categorize the drugs as PIM. Results: PIM were continuously used before hospitalization (73.3%), and received PIM during hospitalization (89.7%). In the multivariate analysis, the association of PIM was observed in the interment with PIM before admission (RR = 1.09, 95% CI = 0.00 - 0.57), Coronary Artery Disease (CAD) (RR = 1.39; 95% CI = 1.18 - 69.41) with p <0.05. It was identified that 49 (36.1%) presented ADR, being in total 71 reactions. The main drugs involved in ADR were furosemide (10), enoxoparin (5) and haloperidol (4... (Complete abstract click electronic access below) / Doutor

Title: Ageing of the population and specific aspects of prescribing of hypnotics in older adults (II.) Student: Karolína Puldová, Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Czech Republic Supervisor: Assoc. Prof. Daniela Fialová, PharmD, Ph.D., Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové and Department of Geriatrics and Gerontology, 1st Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic Introduction: World population is ageing and rational geriatric pharmacotherapy receives increasing attention. In seniors, rational pharmacotherapy is complicated by many risk factors, especially by physiological and pathological changes accompanying ageing, polymorbidity, polypharmacy, higher risk of adverse drug events, drug interactions and other risk factors. Particularly psychotropics belong to drug classes where rational prescribing in seniors often requires respecting of different rules. This diploma thesis focuses on specific aspects of irrational prescribing of hypnosedatives in ambulatory geriatric patients, particularly in the area of use of nongeriatric doses and nongeriatric lenght of therapy. Methodology: Data collection for this diploma thesis has been conducted between 2019-2020 years in the...

INTRODUCTION Cardiovascular diseases (CVD) are currently on the first place among the causes of death worldwide and also in the Czech Republic (CR). The most common causes of death among CVDs are disorders associated with atherosclerosis (ATS) and the prevalence of atherosclerosis and their complications increases with increasing age. The aim of this diploma thesis was to document CVS morbidity in geriatric patients in the sample of FIP7 program of the EUROAGEISM H2020 project, mainly the prevalence of CVS disorders associated with ATS, and to evaluate the controll of risk factors associatedwith general risks of progression of ATS. METHODS The data collection for this theses was carried out in the CR from September 2018 to January 2019 in patients in acute care at the age of 65 and older at geriatric wards in Hradec Králové (HK) and Brno. Patients involved in the study were those admitted to hospitalization at the time of data collection, were complying with inclusion criteria and undersigned the informed consent. The Ethics committee of the Faculy of Pharmacy, Charles University and ethics committee of participating healthcare facilities approved the project. Information have been obtained using the questionnaire for comprehensive geriatric assessment which is the secured instrument of the...

INTRODUCTION: In the world population, the number of seniors with very heterogeneous health care is increasing. Because of the aging of the organism they are much more sensitive to adverse effects of drugs, therefore geriatric care is more visitors and safety pharmacotherapy. It thus seeks to prevent risky medicines available in geriatric patients. Many explicit targets have been disclosed that can be reserved for the potentially endangered by the elderly. Diuretics are among the classes of drugs that are often prescribed in the geriatric population but which pose significant risks to the geriatric patient. Problems with their unpleasant effects, but also poor indication or combination with minimal drugs. OBJECTIVE: The main aim of this thesis was to describe the frequency and rationality of prescribing diuretics in seniors treated in geriatric outpatient clinics. The use of diuretics in appropriate and potentially inappropriate indications, the occurrence of changes accompanying adverse reactions (including laboratory changes in electrolytes and metabolic parameters) and whether these problems are controlled were monitored. The risks of hyponatraemia associated with diuretic therapy and the use of SIADH-inducing drugs were also assessed in more detail. METHODICS: This thesis was based on the...

Title: Analysis of the use of potentially inappropriate cardiovascular drugs in seniors in acute care in the project EUROAGEISM H2020 Author: Petra Gajdošová Department: Department of Social and Clinical Pharmacy Supervisor: Assoc. Prof. PharmDr. Daniela Fialová PhD. ABSTRACT INTRODUCTION: Population aging is a global problem for which all health and social systems of all countries needs be prepared, including the Czech Republic. It is assumed that in 2050 every third citizen of the Czech Republic will be 65 years and older. The group of seniors is characterized by high polymorbidity and polypharmacotherapy. Prescription of drugs is also very complicated in seniors due to changes accompanying aging (at the level of pharmacokinetics, pharmacodynamics and homeostasis). The aim of this diploma thesis was to determinate the prevalence of potentially inappropriate medications (PIMs) from the cardiovascular system (CVS) using the best-known explicit criteria of PIMs in the Czech sample of seniors in acute care assessed during the FIP7 program of the EUROAGEISM H2020 project. METHODOLOGY: Data collection was held during the FIP7 program of the EUROAGEISM H2020 project in acute care in seniors aged 65 years and over in two health facilities in Brno and Hradec Králové (HK) in the Czech Republic from August 2018 to...

Introduction: As the population is aging and the number of the seniors is rising, the importance of knowledge and methods of geriatry and gerontology grows bigger. The seniors represent highly specified group of patients whose health care and treatment should be paid especial attention. Multimorbidity, polypharmacotherapy and an enlarged risk of adverse drug events often make such treatment more complicated. Complex geriatric assessment and acceptance of principals of geriatric prescription both represent key values of rational treatment. This thesis is dedicated to the issue of insomnia and rating of sedative/hypnotic treatment in the czech sample of seniors in acute care. Methodology: The data for this thesis were collected between the years 2018-2019 within EUROAGEISM H2020 project. They include information on 438 patients 65 years of age and older which was collected from three geriatric medical acute care centres in Czech republic (Prague, Brno, Hradec Králové) and gained from the medical documentation combined with the information from patient and medical staff themselves, which were interviewed with use of standardized questionnaire of the EUROAGEISM H2020 research project. The questionnaire was composed from sociodemographic characteristics, assesment of functional ability, nutrition state...