Therapeutic competition in community-living elderly with multimorbidity (health, well-being and aging - SABE study)

• Grant number: 16/13700-9
• Support Opportunities: Scholarships in Brazil - Doctorate
• Start date: June 01, 2017
• End date: February 28, 2019
• Field of knowledge: Health Sciences - Pharmacy
• Agreement: Coordination of Improvement of Higher Education Personnel (CAPES)
• Principal Investigator: Eliane Ribeiro
• Grantee: Caroline de Godoi Rezende Costa Molino
• Host Institution: Faculdade de Ciências Farmacêuticas (FCF). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated research grant: 14/50649-6 - SABE study: a longitudinal study of multiple cohorts on the elderly life and health conditions in the municipality of São Paulo - cohort 2015, AP.TEM

Abstract

It is estimated that by 2025 Brazil will have the sixth largest population of elderly in the world. Aging implies increasing prevalence of chronic conditions which are a health problem of great magnitude, strongly affecting the poorest and most vulnerable population groups. The simultaneous occurrence of multiple chronic conditions, in the same individual, with their interrelations and implications for health, has received the name of multimorbidity. Multimorbidities requires a complex pharmacotherapy, leading to the use of several drugs at the same time (polypharmacy), increasing the risk of adverse effects and drug interactions and between medicine and disease. Frequently older adults present health problems induced by drugs due to drug interactions, therapeutic competitions and a higher frequency of unpredictable adverse reactions. Therapeutic competition is known as a type of drug-disease interaction in which the treatment recommended for a certain condition can negatively alter (compete) another coexisting condition. Reports have found that many medications are prescribed without assessing their effect on other coexisting conditions, which may adversely affect it, namely therapeutic competition. Although, concerns to the multimorbidity high prevalence are increasing, few studies and clinical practice guidelines address the pharmacological treatment of older adults with multimorbidity. Clinical practice guidelines rarely consider the presence of more than one chronic condition in their recommendations, meaning the cumulative impact of multiple treatment recommendations is usually not considered. Aging is a reality in Brazil which makes the investigation of therapeutic competition crucial to promote high quality health care and patient safety. The main purpose of this project is to investigate and evaluate the prevalence of therapeutic competition in community-living elderly people. For this study, we will analyze the cohort database Health, Well-being and Aging (SABE Study), and clinical practice guidelines for the treatment of most prevalent chronic conditions in older adults. We expected that the results of this project will assist in choosing the best pharmacological therapy for elderly with multimorbidities. (AU)

Scientific publications

(4)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

ERNST, RAHEL; FISCHER, KARINA; MOLINO, CAROLINE DE GODOI REZENDE COSTA; ORAV, ENDEL J.; THEILER, ROBERT; MEYER, URSINA; FISCHLER, MANUEL; GAGESCH, MICHAEL; AMBUEHL, PATRICE M.; FREYSTAETTER, GREGOR; et al. Polypharmacy and Kidney Function in Community-Dwelling Adults Age 60 Years and Older: A Prospective Observational Study. JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, v. 21, n. 2, p. 254+, FEB 2020. (16/13700-9)

LEITE-SANTOS, NATHALIA C.; DE MELO, DANIELA O.; MANTOVANI-SILVA, RAFAEL A.; GABRIEL, FRANCIELE C.; FORNASARI, GUIDO S.; DOREA, EGIDIO L.; MOLINO, CAROLINE DE G. R. C.; RIBEIRO, ELIANE; CHRONIDE. Guidelines for hypertension management in primary care: is local adaptation possible?. Journal of Hypertension, v. 38, n. 10, p. 2059-2073, OCT 2020. (16/13700-9)

WAINBERG, SHEILA KALB; LEITE SANTOS, NATHALIA CELINI; GABRIEL, FRANCIELE CORDEIRO; DE VASCONCELOS, LUCIANA PEREIRA; NASCIMENTO, JESSICA SANTOS; REZENDE COSTA MOLINO, CAROLINE DE GODOI; DE MELO, DANIELA OLIVEIRA. Clinical practice guidelines for surgical antimicrobial prophylaxis: Qualitative appraisals and synthesis of recommendations. JOURNAL OF EVALUATION IN CLINICAL PRACTICE, v. 25, n. 4, p. 591-602, AUG 2019. (16/13700-9)

REZENDE COSTA MOLINO, CAROLINE DE GODOI; LEITE-SANTOS, NATHALIA CELINI; GABRIEL, FRANCIELE CORDEIRO; WAINBERG, SHEILA KALB; DE VASCONCELOS, LUCIANA PEREIRA; MANTOVANI-SILVA, RAFAEL AUGUSTO; RIBEIRO, ELIANE; ROMANO-LIEBER, NICOLINA SILVANA; STEIN, AIRTON TETELBOM; DE MELO, DANIELA OLIVEIRA; et al. Factors Associated With High-Quality Guidelines for the Pharmacologic Management of Chronic Diseases in Primary Care A Systematic Review. JAMA INTERNAL MEDICINE, v. 179, n. 4, p. 553-560, APR 2019. (16/13700-9)

Academic Publications

(References retrieved automatically from State of São Paulo Research Institutions)

MOLINO, Caroline de Godoi Rezende Costa. Therapeutic competition in community-living elderly with multimorbidity (Health, Well-being and Aging - SABE study). 2019. Doctoral Thesis - Universidade de São Paulo (USP). Conjunto das Químicas (IQ e FCF) (CQ/DBDCQ) São Paulo.