Association between Big Five personality factors and medication adherence in the elderly.

INTRODUCTION: Adherence to medications can be associated with circumstances related to the patient, with the pathology, with cultural health beliefs, with habits, and with quality of life. Behavioral patterns can also directly influence a patient's pharmacological adherence, since they are related to their perception and understanding of their own health status and of their drug and non-drug treatments. OBJECTIVE: To investigate the association between adherence to pharmacological treatment and personality factors, sociodemographic variables, and economic data in the elderly. METHODS: Cross-sectional descriptive study. The population studied were elderly people registered with the Family Health Strategy of Porto Alegre and enrolled on the Brain Aging Program (PENCE), from March 2013 to November 2015. Sociodemographic data, pharmacological adherence, and personality traits were evaluated. Exclusion criteria were incomplete data in the personality and pharmacological adherence assessments; cognitive impairment, evaluated using the instrument Mini-Mental State Examination (MMSE), or not having carried out this assessment. RESULTS: A total of 123 individuals were included with a mean age of 71.35±7.33 years, 58.6% of whom reported some level of non-adherence to their medication regime (low and moderate adherence). Elderly people with low adherence had significantly higher mean scores in the Neuroticism factor, while those with high adherence had significantly higher mean scores in the Agreeableness and Conscientiousness factors. CONCLUSION: The study suggests that pharmacological adherence among the elderly is negatively associated with the Neuroticism personality trait, while the Agreeableness and Conscientiousness traits are positively associated.

Association between Big Five personality factors and medication adherence in the elderly

Abstract Introduction Adherence to medications can be associated with circumstances related to the patient, with the pathology, with cultural health beliefs, with habits, and with quality of life. Behavioral patterns can also directly influence a patient's pharmacological adherence, since they are related to their perception and understanding of their own health status and of their drug and non-drug treatments. Objective To investigate the association between adherence to pharmacological treatment and personality factors, sociodemographic variables, and economic data in the elderly. Methods Cross-sectional descriptive study. The population studied were elderly people registered with the Family Health Strategy of Porto Alegre and enrolled on the Brain Aging Program (PENCE), from March 2013 to November 2015. Sociodemographic data, pharmacological adherence, and personality traits were evaluated. Exclusion criteria were incomplete data in the personality and pharmacological adherence assessments; cognitive impairment, evaluated using the instrument Mini-Mental State Examination (MMSE), or not having carried out this assessment. Results A total of 123 individuals were included with a mean age of 71.35±7.33 years, 58.6% of whom reported some level of non-adherence to their medication regime (low and moderate adherence). Elderly people with low adherence had significantly higher mean scores in the Neuroticism factor, while those with high adherence had significantly higher mean scores in the Agreeableness and Conscientiousness factors. Conclusion The study suggests that pharmacological adherence among the elderly is negatively associated with the Neuroticism personality trait, while the Agreeableness and Conscientiousness traits are positively associated.

The process of deprescribing in older adults: a methodological protocol / Processo de desprescrição em idosos: protocolo metodológico

Objective: To report, by means of a methodological protocol, the process of deprescribing implemented in a geriatric psychiatry outpatient clinic of a teaching hospital. Methods: The topic of interest was comprehensively reviewed in the scientific literature. Instruments and tools necessary to develop the protocol were selected, including the Treatment Adherence Measure, Beers criteria, the EURO-FORTA List, the Brazilian Consensus on Potentially Inappropriate Medications for Older Persons, Drugs.com, and deprescribing algorithms. Results: The protocol consists of the following steps: 1) Review: Assess older patients' physical and behavioral status and family context and list all medications used; 2) Analyze: Review patients' drug therapy; 3) Act: Initiate deprescribing (if indicated); 4) Adjust: Discuss patients' expectations, beliefs, and preferences and adjust the prescription to their real possibilities; 5) Monitor: Identify responses to treatment, assess adherence to the deprescribing process, and detect return of symptoms or worsening of the underlying disease. Conclusions: Health care professionals need to work together to provide comprehensive care for older persons. The inclusion of deprescribing in more research groups focused on the geriatric population will increase attention to the safety of pharmacological treatment for older patients.

Objetivo: Relatar como ocorre o processo de desprescrição em um ambulatório de Psiquiatria Geriátrica de um hospital universitário, por meio de um protocolo metodológico. Metodologia: O assunto foi revisado na literatura científica e foram selecionados instrumentos e ferramentas necessários para desenvolver o protocolo, incluindo a Medida de Adesão aos Tratamentos, o Critério de Beers, a Lista Fit for the Aged (EURO-FORTA), o Consenso Brasileiro de Medicamentos Potencialmente Inapropriados para Idosos, Drugs.com e algoritmos de desprescrição. Resultados: O protocolo elaborado é composto das seguintes etapas: 1) revisar: avaliar o estado físico e comportamental e o contexto familiar do idoso e listar todos os medicamentos utilizados; 2) analisar: revisar a farmacoterapia do paciente; 3) agir: iniciar a desprescrição (se tiver indicação); 4) ajustar: pactuar expectativas, crenças e preferências do paciente, adaptando a prescrição às suas reais possibilidades; 5) monitorar: verificar as respostas ao tratamento, avaliar a adesão à desprescrição, detectar ressurgimento dos sintomas ou agravamento da doença de base. Conclusões: Os profissionais da saúde precisam trabalhar em conjunto para proporcionar atenção completa ao idoso. A inserção da desprescrição em mais grupos de pesquisa com o foco na população geriátrica possibilitará maior atenção à segurança dos tratamentos farmacológicos dos pacientes.

Potentially inappropriate medication and associated factors such as depression and dementia: An analysis of middle-aged and elderly people / Prevalência de medicamentos potencialmente inapropriados e fatores associados, como depressão e demência: uma análise de pessoas de meia-idade e idosos

AIMS: To establish the frequency potentially inappropriate medications use and the associated factors, such as signs and symptoms of depression and cognitive deficit among middle-aged and elderly people. METHODS: A cross-sectional population study was performed with 2,350 people, aged between 55-103 years, registered in the primary health care. Potentially inappropriate medications were defined by updated 2019 Beers criteria. Studied variables were sociodemographic, lifestyle and health, and signs and symptoms of depression and cognitive deficit. Multinomial regression analysis was executed. RESULTS: The frequency of potentially inappropriate medications use was 65.4%. Former and current smokers, regular self-perception of health, polypharmacy, and individuals with signs and symptoms of depression and cognitive deficit were significantly associated with potentially inappropriate medications use. Antiarrhythmics, antihistamines and antiadrenergic agents were the highest potentially inappropriate medications classes used for individuals with signs and symptoms of depression and cognitive deficit. CONCLUSIONS: The frequency of use of potentially inappropriate medications is high among middle-aged people, a population that was previously under-researched, as well as among elderly people. Cognitive impairment alone or together with depression symptoms were associated factor for a potentially inappropriate medications use. Knowledge of the pharmacoepidemiology of potentially inappropriate medications is an important for the promotion of the rational use of drugs in public health.

OBJETIVOS: Estabelecer a frequência de uso de medicamentos potencialmente inapropriados e fatores associados, tais como sinais e sintomas de depressão e déficit cognitivo, em indivíduos de meia-idade e idosos. MÉTODOS: Estudo transversal de base populacional com 2.350 indivíduos, de idade entre 55 e 103 anos, cadastrados na atenção primária à saúde. Medicamentos potencialmente inapropriados foram definidos pelos Critérios Beers atualizados em 2019. As variáveis estudadas foram sociodemográficas, estilo de vida, clínicas, bem como sinais e sintomas de depressão e déficit cognitivo. Foi realizada análise de regressão multinomial. RESULTADOS: A frequência de uso de medicamentos potencialmente inapropriados foi de 65,4%. O uso de medicações potencialmente inapropriadas foi significativamente associado a indivíduos ex-fumantes e fumantes atuais, com autopercepção de saúde regular, usuários de polifarmácia e com sinais e sintomas de depressão e déficit cognitivo. Antiarrítmicos, anti-histamínicos e antiadrenérgicos foram as classes de medicamentos potencialmente inapropriados mais utilizada pelos indivíduos com sinais e sintomas de depressão e déficit cognitivo. CONCLUSÕES: A frequência de utilização de medicamentos potencialmente inapropriados é alta em pessoas de meia-idade, faixa etária pouco pesquisada, bem como em idosos. O comprometimento cognitivo, isoladamente ou em conjunto com sintomas de depressão, foi um fator associado ao uso de medicações potencialmente inapropriadas. O conhecimento da farmacoepidemiologia de utilização de medicamentos potencialmente inapropriados é importante para a promoção do uso racional de medicamentos na saúde pública.