FRAIL AND POLYMEDICATED ELDERLY IN THE CONTEXT OF PRIMARY HEALTH CARE

Abstract

The rise in life expectancy and patients with multiple morbidities in Primary Health Care entails the phenomenon of polypharmacy in the elderly population. Polypharmacy is described as the daily use of 5 or more different medications. It is associated with inadequate drug administration, risk of drug interactions, and potentially deleterious effects on the normal function of the elder, increasing their state of fragility. Fragility is a state of high physical, cognitive, psychological, and social vulnerability that results in dependency, reduced quality of life, and increased demand for health care. Polypharmacy and fragility are strongly connected conditions, both likely to be modified, which importance deserves to stand out due to the risks of inappropriate and excessive use of drugs and the susceptibility of the elders to iatrogenesis. Thus, this bibliographic and qualitative review study based on references collected from LILACS and PubMed through the Health Sciences Descriptors “Primary Health Care” AND “Polypharmacy” AND “Frail Elderly” aims to discuss the vulnerabilities of the frail and polymedicated elderly in the context of Primary Health Care. One notes the importance of early recognition of the fragility state risks to the elder to prevent adverse impacts since this group presents as the most vulnerable to iatrogenesis, and quaternary prevention actions, such as deprescribing, appear to be of great relevance. Primary Health Care services are the ideal scenario for these actions, yet, models of care are still overly focused on diseases, so they may not be enough to manage the fragility of the elderly population.