POLYPHARMACY BUT NOT POTENTIAL INAPPROPRIATE PRESCRIPTION WAS ASSOCIATED WITH FRAILTY IN OLDER ADULTS FROM A MIDDLE-INCOME COUNTRY OUTPATIENT CLINIC

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Ivan Aprahamian1, Marina Maria Biella2, Goretti Almeida3, Fernanda Pegoraro3, Anna Vitoria Alves Pedrini3, Bruna Cestari3, Luís Henrique Bignotto3, Brian Alvarez Ribeiro de Melo3, José Eduardo Martinelli3
1Investigation on Multimorbidity and Mental Health in Aging (IMMA) Lab, Department of Internal Medicine, Faculty of Medicine of Jundiaí, Rua Francisco Telles, 250, ZIP code: 13202-550. Vila Arens, Jundiaí, State of São Paulo, Brazil
2Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
3Investigation on Multimorbidity and Mental Health in Aging (IMMA) Lab, Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, Brazil

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Objectives: the aims of the present study were: (1) investigate the prevalence and association of polypharmacy and pre-frailty or frailty in a middle-income country sample of older adults; and (2) evaluate the prevalence of potential inappropriate prescription (PIP) and its association with pre-frailty or frailty. Design: Cross-sectional observational study. Setting: Outpatient center at a university-based hospital in the state of São Paulo, Brazil. Participants: 629 older adults from both sexes evaluated between June 2014 and July 2016. Measurements: Frailty was identified through the FRAIL scale. All medications received were analyzed by research staff. Presence of PIP was evaluated according to the 2015 updated Beers list. Binary logistic regression tested the association between 4 definitions of polypharmacy (≥ 3, 4, 5, and 6 drugs), and presence of PIP, and the dependent variable pre-frailty and frailty. Results: 15.7% of participants were frail. Polypharmacy was present in 219 (34.8%), and PIP was observed in 184 (29.3%) older adults. All definitions of polypharmacy were significantly associated with frailty (OR between 2.05 to 2.34, p < 0.001). Polypharmacy with 4 or 5 or more drugs were associated with pre-frailty (OR 1.53 and 1.47, respectively). PIP was not associated with frailty (OR 1.47, p = 0.149). Conclusions: Several definitions of polypharmacy were associated with frailty, but only two were associated with pre-frailty. The presence of PIP was not associated with pre-frailty or frailty.

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