Impacto clínico do cuidado farmacêutico na geriatria : overview de revisões sistemáticas

Abstract

The elderly represent a large portion of the population and, as they are more vulnerable, they are more susceptible to illness and use of medication. The use of medication is not without risks, and it can cause harm to the user's health, as well as morbidity and mortality, highlighting the importance of services aimed at identifying, solving and preventing these problems. Therefore, the importance of pharmaceutical services in gerontology in order to achieve better health outcomes is highlighted. Despite the great contributions of the pharmacist, more robust studies that demonstrate the impact of the services provided by these professionals are needed. Therefore, this study aims to provide an overview of systematic reviews to assess the clinical impact of pharmaceutical care in gerontology. The methodology used followed the PRISMA and COCHRANE recommendations, in which a search strategy was performed in the Medline/PubMed, Scopus and Scielo databases, followed by the stages of screening, selection, study eligibility and data extraction, carried out in duplicate. For quality assessment, the AMSTAR 2 tool was used. Thus, 24 systematic reviews were included and the results were grouped and presented in a narrative way, covering the general characteristics of the reviews, as well as the results of clinical outcomes. In the quality assessment, 45.8%, 29.2% and 25% of systematic reviews were considered of critically low, low and moderate quality, respectively. The main clinical outcomes evaluated were hospital admissions, mortality, falls, adverse events and problems related to medications, adherence and adequacy of medication or prescription. The results of this review allowed us to infer that reviews of pharmacotherapy and pharmaceutical interventions may have benefits in outcomes such as medication adequacy, including reduction of polypharmacy, identification and reduction of the use of potentially inappropriate medications and adherence, as well as the identification and resolution of problems related to medications. The impact of pharmaceutical care on outcomes such as mortality and hospitalizations was inconclusive. More primary studies, with good methodological quality, are needed in order to generate more robust results regarding the impact of pharmaceutical performance on health outcomes.