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RESUMEN INTRODUCCIÓN La hipertensión arterial es muy prevalente en mayores de 60 años, dos tercios de los cuales están cubiertos en Argentina por el Programa de Atención Médica Integral (PAMI). El objetivo de este trabajo fue estimar la prevalencia de uso (PU) de antihipertensivos (AHT) en los adultos mayores de PAMI a partir de los datos de dispensa y describir su uso según tipo y cantidad. MÉTODOS Se realizó un estudio observacional retrospectivo. Se definieron como usuarios de AHT a los adultos de ambos sexos mayores de 60 años que recibieron al menos 2 envases de AHT durante 2018. Se comparó el resultado con el de la Encuesta Nacional de Factores de Riesgo (ENFR) 2013. RESULTADOS El 48,4% de los 4 397 188 afiliados de PAMI mayores de 60 años (63,8% mujeres; edad promedio: 74,3 años) usaron AHT durante 2018 (mujeres: 49,4%; varones: 46,6%). Este dato es similar al 47,8% observado en la ENFR 2013. La PU aumentó desde 37,5% a los 60-64 años hasta 55,1% a los 80-84 años, descendiendo luego. La PU ajustada varió desde 31,1% en Jujuy hasta 57,9% en Río Cuarto. Se dispensaron en promedio 13,6 envases/usuario/año. Los AHT más dispensados fueron los antagonistas del receptor de angiotensina II (36,5%), los betabloqueadores (27,0%) y los inhibidores de la enzima convertidora de angiotensina (23,1%). DISCUSIÓN El análisis de la base de datos administrativa de dispensas permite estimar datos epidemiológicos e identificar subpoblaciones destinatarias de intervenciones específicas.
ABSTRACT INTRODUCTION Arterial hypertension is highly prevalent in people older than 60, two thirds of which are covered in Argentina by the Comprehensive Medical Care Program (PAMI, according to the Spanish acronym). The objective of this work was to estimate the prevalence of antihypertensive drug (AHT) use in older adults of PAMI from the dispensation data and to describe its use in terms of type and quantity. METHODS A retrospective observational study was conducted. AHT users were defined as adults of both sexes over 60 years of age who received at least 2 packs of AHT during 2018. The result was compared with the one yielded by the National Risk Factor Survey 2013. RESULTS From the 4 397 188 beneficiaries of PAMI who were over 60 (63.8% women; average age: 74.3 years), 48.4% were AHT users during 2018 (women: 49.4%; men: 46.6%). This is similar to the 47.8% recorded in the National Risk Factor Survey 2013. The prevalence of use (PU) increased with age, from 37.5% at 60-64 years to 55.1% at 80-84 years, declining thereafter PU adjusted for age and sex varied from 31.1% in Jujuy to 57.9% in Rio Cuarto. On average, 13.6 packs/user/year were dispensed. The most widely distributed AHTs were angiotensin II receptor antagonists (36.5%), beta blockers (27.0%) and angiotensin converting enzyme inhibitors (23.1%). DISCUSSION The analysis of the administrative database of dispensed drugs allows the estimate of epidemiological data and to identify subpopulations that may benefit from specific interventions.
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OBJECTIVE: To analyze the prescribing pattern of psychotropic drugs to affiliates over 60 years of age at the National Institute of Social Services for Retirees and Pensioners of Argentina (PAMI). MATERIALS AND METHODS: We conducted a retrospective study of the at the National Institute of Social Services for Retirees and Pensioners of Argentina (PAMI) database on the population over 60 years of age who received at least one psychotropic drug during 2016. RESULTS: During the year 2016, 30% of the population over 60 years of age received the prescription of at least one psychotropic drug. There was a greater prescription of psychotropic drugs to women than to men (75.3% vs. 24.7%). Of the drugs prescribed, 67% were benzodiazepines, 20% were antidepressants, 9% were antipsychotics and 4% were non-benzodiazepine hypnotics. 54% of the drugs prescribed were clonazepam and alprazolam. 21% of the population received three or more prescriptions during the period studied. There was a relatively greater prescription of psychotropic drugs in the population of 75 years old or older. CONCLUSIONS: Taking into account the risks of adverse effects, interactions and the inclusion of some of these drugs among those that should not be prescribed among older adults, the high prescription rate of some of these drugs is alarming. It is necessary to develop strategies among general practitioners, specialists and also among the general population in order to reduce the prescription of psychotropic drugs.
