Abordaje de la polifarmacia en el paciente mayor

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Course Overview

Una de las consecuencias directas del envejecimiento de la población es el  incremento de la prevalencia de enfermedades crónicas y de la multimorbilidad. Ello conlleva un mayor consumo de fármacos y, como consecuencia,  un aumento en la frecuencia y gravedad de los problemas relacionados con los medicamentos. La falta de adherencia, la automedicación, la multimorbilidad, y la polifarmacia son especialmente frecuentes en este grupo de edad y modifican el efecto esperado de los medicamentos.

Por otro lado, el envejecimiento conlleva una alteración en  el comportamiento farmacocinético y farmacodinámico de muchas sustancias, haciendo a los mayores especialmente vulnerables a los efectos negativos de los medicamentos.

Esta mayor sensibilidad a los efectos adversos debe hacernos particularmente cuidadosos a la hora de seleccionar y ajustar un tratamiento, pero no debe llevarnos a la infrautilización de recursos farmacológicos de eficacia probada. Los criterios STOPP-START para el uso de medicamentos en la población mayor constituyen una herramienta en la que se contempla tanto  el uso inapropiado ante un problema dado, como la necesidad  explicita  de uso en determinadas situaciones.

En este curso vamos a profundizar en los problemas relacionados con los medicamentos en los mayores institucionalizados, y los principios generales de una prescripción segura. Abordaremos diferentes herramientas para la mejora de la calidad de prescripción e incidiremos de una forma especial en “el arte de la deprescripción”.

 

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