Clinical-therapeutic profile of geriatric patients admitted in a reference psychiatric hospital: a case study Título em espanhol centralizado

Abstract

Psychiatric diseases are a very worrying clinical situation for public health in the midst of the number of cases that affect the population progressively, fully declining their psychological condition, changing their entire biopsychosocial state. The present study aimed to analyze the clinical and therapeutic profile of geriatric patients admitted with a psychiatric diagnosis to a referral hospital, through the investigation of drug interactions, the therapeutic classes used, psychiatric and non-psychiatric pathologies shown, as well as gender more evident. This is a case study, with a quantitative approach and an explanatory character, through a survey of data through the pharmacy records of the Areolino de Abreu Psychiatric Hospital, Teresina, for critical analysis of the therapy, followed by the investigation of potential interactions, from MicromedexSolutions®. Inclusion criteria were patients over 60 years hospitalized in the elderly sector. There was a higher prevalence of psychiatric diseases in male geriatric patients with 69% (n = 9) and female with 31% (n = 4). The most used therapeutic classes for psychiatric disorders were anxiolytics and hypnotics (n = 15), followed by antipsychotics (n = 13), mood stabilizers (n = 10), antihistamines (n = 6), selective inhibitors of serotonin reuptake - SSRI (n = 2) and the specific noradrenergic and serotoninergic antidepressants - NaSSa (n = 2), in addition to selective noradrenaline reuptake inhibitors - ISRN (n = 1). The most prominent psychiatric disorders were different types of schizophrenia, bipolar affective disorder, severe depressive state and affective mood disorder. Concomitantly, the most incident non-psychiatric pathologies were hypertension (n = 4), diabetes (n = 3), gastritis (n = 2) and, finally, gastrointestinal disorders (n = 1), thrombotic disorders (n = 1), fungal infection (n = 1), productive cough (n = 1), hypercholesterolemia (n = 1). Four major interactions were found (Mirtazapine vs Desvenlafaxine; Clonazepam vs Olanzapine; Haloperidol vs Promethazine; Lithium carbonate vs Hydrochlorothiazide) and 6 moderate interactions, secondarily. The prevalence of psychiatric complications in males is something idiosyncratic, something that is particular to each individual, and may differ in other cases in a variable way. According to the results obtained, a considerable range of medications can be seen, being predominantly used for schizophrenia, bipolar disorders and depression combined with hypertensive, diabetic, gastrointestinal conditions, among others. Given this, it is possible to infer the high evidence of schizophrenic and bipolar disorders, and other non-psychotic complications among geriatric patients, however, it can generate drug interactions of a greater to moderate degree, being important caution in the combination of some therapies, considering the possibility change of medication or schedule, according to the risk-benefit analysis of the therapy.