El relevante papel de los cuidadores de pacientes usuarios de analgésicos opioides

  1. V. Hernández-García 1
  2. D. Alberto-Armas 1
  3. A. Hardisson-de-la-Torre 2
  4. C. Rubio-Armendáriz 2
  1. 1 Ciencias Médicas y Farmacéuticas, Desarrollo y Calidad de Vida. Área de Toxicología. Universidad de La Laguna.
  2. 2 Área de Toxicología de la Universidad de La Laguna
Zeitschrift:
Farmacéuticos comunitarios

ISSN: 1885-8619

Datum der Publikation: 2024

Ausgabe: 16

Nummer: 4

Art: Artikel

DOI: 10.33620/FC.2173-9218.(2024).23 DIALNET GOOGLE SCHOLAR lock_openOpen Access editor

Andere Publikationen in: Farmacéuticos comunitarios

Zusammenfassung

Aging is a global reality that is accompanied by an increase in polypharmacy. In this vital stage, caregivers emerge as relevant actors since their intervention impacts on the safety of the medication use process and on the quality of life of the patient they assist. As the knowledge about the treatments that caregivers supervise for the patient under their care conditions the health outcomes of the medications, the main objective of this study is to characterize the caregivers of patients who use opioid analgesics and to identify factors that increase the risk of the appearance of Medication Related Problems (DRP). The results reveal that the caregiver profile affects the health outcomes of this therapeutic group in both the prevalence and type of DRP. Of the 63 patients using opioid analgesics under pharmacotherapeutic follow-up during this study, 17 (27%) had caregivers. The caregiver in this study was predominantly female (61.1%). Considering DRP and kinship, a higher prevalence of DRP was observed when the caregivers were children or external personnel. Analyzing the pharmacotherapy of these caregivers, 4.8% have started antidepressant treatment, 3.2% hypnotic treatment after becoming caregivers of these patients. The Zarit Test reveals that 29.4% of the caregivers of these patients manifest overload. We conclude that Pharmaceutical Care should consider the opportunity and relevance of designing and implementing intervention and education protocols focused on caregivers.

Bibliographische Referenzen

  • Ouellet N, Bergeron AS, Gagnon E, Cossette B, Labrecque CA, Sirois C. Prescribing and deprescribing in very old age: perceptions of very old adults, caregivers and health professionals. Age Ageing. 2022 Nov 1;51(11): afac244. Disponible en: https://doi.org/10.1093/ageing/afac244 .
  • Chock YL, Wee YL, Gan SL, Teoh KW, Ng KY, Lee SWH. How Willing Are Patients or Their Caregivers to Deprescribe: A Systematic Review and Meta-analysis. J Gen Intern Med. 2021 Dec;36(12):3830-3840. doi: 10.1007/s11606-021-06965-5. Epub 2021 Jun 25. PMID: 34173200; PMCID: PMC8642501. Disponible en: https://doi.org/10.1007/s11606-021-06965-5
  • Nicholson K, Liu W, Fitzpatrick D, Hardacre KA, Roberts S, Salerno J, Stranges S, Fortin M, Mangin D. Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review. Lancet Healthy Longer. 2024 Apr;5(4): e287-e296. do: 10.1016/S2666-7568(24)00007-2. Epub 2024 Mar 4. PMID: 38452787. Disponible en: https://doi.org/10.1016/S2666-7568(24)00007-2
  • Fried TR, O’Leary J, Towle V, Goldstein MK, Trentalange M, Martin DK. Health outcomes associated with polypharmacy in community-dwelling older adults: a systematic review. J Am Geriatr Soc. 2014 Dec;62(12):2261-72. doi: 10.1111/jgs.13153. PMID: 25516023; PMCID: PMC4270076. Disponible en: https://doi.org/10.1111/jgs.13153
  • Wastesson JW, Morin L, Tan ECK, Johnell K. An update on the clinical consequences of polypharmacy in older adults: a narrative review. Expert Opin Drug Saf. 2018 Dec;17(12):1185-1196. doi: 10.1080/14740338.2018.1546841. Epub 2018 Dec 12. PMID: 30540223. Disponible en: https://doi.org/10.1080/14740338.2018.1546841
  • Davies LE, Spiers G, Kingston A, Todd A, Adamson J, Hanratty B. Adverse Outcomes of Polypharmacy in Older People: Systematic Review of Reviews. J Am Med Dir Assoc. 2020 Feb;21(2):181-187. doi: 10.1016/j.jamda.2019.10.022. Epub 2020 Jan 8. PMID: 31926797. Disponible en: https://doi.org/10.1016/j.jamda.2019.10.022
  • McMillan SS, King MA, Sav A, Wheeler AJ, Kelly F. Support for Australian carers from community pharmacy: Insight into carer perspectives of a novel service. Health Soc Care Community. 2019 Mar;27(2):320-329. doi: 10.1111/hsc.12649. Epub 2018 Sep 6. PMID: 30187990. Disponible en: https://doi.org/10.1111/hsc.12649
  • Del-Pino-Casado R, Priego-Cubero E, López-Martínez C, Orgeta V. Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysis. PLoS One. 2021 Mar 1;16(3): e0247143. doi: 10.1371/journal.pone.0247143. PMID: 33647035; PMCID: PMC7920375. Disponible en: https://doi.org/10.1371/journal.pone.0247143
  • Nichols LO, Martindale-Adams J, Burns R, Graney MJ, Zuber J. Translation of a dementia caregiver support program in a health care system--REACH VA. Arch Intern Med. 2011 Feb 28;171(4):353-9. doi: 10.1001/archinternmed.2010.548. PMID: 21357811. Disponible en: https://doi.org/10.1001/archinternmed.2010.548
  • Look, K. A., & Stone, J. A. (2018). Medication management activities performed by informal caregivers of older adults. Research in social & administrative pharmacy: RSAP, 14(5),418–426. Disponible en: https://doi.org/10.1016/j.sapharm.2017.05.005.
  • Erlen JA, Sereika SM, Sun R, Tamres LK, Tang F, Lingler JH. Outcomes of a Problem-Solving Medication Management Intervention for Informal Caregivers. West J Nurs Res. 2019 Nov;41(11):1642-1657. doi: 10.1177/0193945919825844. Epub 2019 Feb 7. PMID: 30729881; PMCID: PMC6685764. Disponible en: https://doi.org/10.1177/0193945919825844
  • Family Caregiver Alliance. Caregiver assessment: principles, guidelines, and strategies for change. Report from a national consensus development conference.2006. Consultado Junio 2024. Disponible en: https://www.caregiver.org/uploads/legacy/pdfs/v1_consensus.pdf
  • Sepe-Monti M, Vanacore N, Bartorelli L, Tognetti A, Giubilei F, Caregiver Study Group Savvy the Savvy Caregiver Program: A Probe Multicenter Randomized Controlled Pilot Trial in Caregivers of Patients Affected by Alzheimer’s Disease. J Alzheimers Dis. 2016 Oct 04;54(3):1235–1246. doi: 10.3233/JAD-160235. Disponible en: https://doi.org/10.3233/JAD-160235
  • Alves SP, Bueno D. O perfil dos cuidadores de pacientes pediátricos com fibrose cística [The profile of caregivers to pediatric patients with cystic fibrosis]. Cien Saude Colet. 2018 May;23(5):1451-1457. Portuguese. doi: 10.1590/1413-81232018235.18222016. PMID: 29768600. Disponible en: https://doi.org/10.1590/1413-81232018235.18222016.
  • Bjørge H, Kvaal K, Ulstein I. The effect of psychosocial support on caregivers’ perceived criticism and emotional over-involvement of persons with dementia: an assessor-blinded randomized controlled trial. BMC Health Serv Res. 2019 Oct 24;19(1):744. doi: 10.1186/s12913-019-4551-x. PMID: 31651321; PMCID: PMC6813966. Disponible en: https://doi.org/10.1186/s12913-019-4551-x.
  • Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980 Dec;20(6):649-55. doi: 10.1093/geront/20.6.649. PMID: 7203086. Disponible en: https://doi.org/10.1093/geront/20.6.649
  • Kazemi A, Azimian J, Mafi M, Allen KA, Motalebi SA. Caregiver burden and coping strategies in caregivers of older patients with stroke. BMC Psychol. 2021 Apr 1;9(1):51. doi: 10.1186/s40359-021-00556-z. PMID: 33794995; PMCID: PMC8017750. https://doi.org/10.1186/s40359-021-00556-z
  • Sherifali D, Ali MU, Ploeg J, Markle-Reid M, Valaitis R, Bartholomew A, Fitzpatrick-Lewis D, McAiney C. Impact of Internet-Based Interventions on Caregiver Mental Health: Systematic Review and Meta-Analysis. J Med Internet Res. 2018 Jul 3;20(7): e10668. doi: 10.2196/10668. PMID: 29970358; PMCID: PMC6053616. https://doi.org/10.2196/10668
  • DHHS. U.S. Department of Health and Human Services. Healthy People 2010: general-data-issues. Disponible en https://www.cdc.gov/nchs/data/hpdata2010/hp2010_final_review.pdf Acceso Junio 2024
  • Isac C, Lee P, Arulappan J. Older adults with chronic illness - Caregiver burden in the Asian context: A systematic review. Patient Educ Couns. 2021 Dec;104(12):2912-2921. doi: 10.1016/j.pec.2021.04.021. Epub 2021 Apr 29. PMID: 33958255. https://doi.org/10.1016/j.pec.2021.04.021
  • Wilson AMMM, Almeida GSM, Santos BCFD, Nakahara-Melo M, Conceição APD, Cruz DALMD. Factors associated with caregivers’ contribution to self-care in heart failure. Rev Lat Am Enfermagem. 2022;30: e3632. doi: 10.1590/1518-8345.5838.3632. PMID: 35976358; PMCID: PMC9364777. https://doi.org/10.1590/1518-8345.5838.3632
  • Pande S, Hiller JE, Nkansah N, et al. The effect of pharmacist-provided non-dispensing services on patient outcomes, health service utilisation and costs in low- and middle-income countries. Cochrane Database Syst Rev 2013;2:CD01039810.1002/14651858.CD010398. https://doi.org/10.1002/14651858.CD010398
  • Signal LN, Walton MD, Ni Mhurchu C, Maddison R, Bowers SG, Carter KN, Gorton D, Heta C, Lanumata TS, McKerchar CW, O’Dea D, Pearce J. Tackling ‘wicked’ health promotion problems: a New Zealand case study. Health Promot Int. 2013 Mar;28(1):84-94. doi: 10.1093/heapro/das006. Epub 2012 Mar 14. PMID: 22419621. https://doi.org/10.1093/heapro/das006
  • Foro de Atención Farmacéutica, panel de expertos. Documento de Consenso. Enero de 2008. Ed. Consejo General de Colegios Oficiales de Farmacéuticos, Madrid. ISBN 978-84-691-1243-4. https://www.farmaceuticos.com/wp-content/uploads/2019/12/Foro_AF_Diferencias_SD.pdf
  • Low HMM, See ZY, Lai YF. Understanding and expectation towards pharmaceutical care among patients, caregivers and pharmacy service providers: a qualitative study. Eur J Hosp Pharm. 2020 Jan;27(1):25-30. doi: 10.1136/ejhpharm-2017-001415. Epub 2018 Aug 10. PMID: 32064085; PMCID: PMC6992973. https://doi.org/10.1136/ejhpharm-2017-001415
  • Skoy E, Eukel H, Werremeyer A, Strand M, Frenzel O, Steig J. Implementation of a statewide program within community pharmacies to prevent opioid misuse and accidental overdose. J Am Pharm Assoc (2003). 2020 Jan-Feb;60(1):117-121. doi: 10.1016/j.japh.2019.09.003. Epub 2019 Oct 31. PMID: 31677933. https://doi.org/10.1016/j.japh.2019.09.003
  • Foro de Atención Farmacéutica-Farmacia Comunitaria (Foro AF-FC), panel de expertos. Guía práctica para los Servicios Profesionales Farmacéuticos Asistenciales en la Farmacia Comunitaria. Madrid: Consejo General de Colegios Oficiales de Farmacéuticos; 2024. https://www.sefac.org/system/files/2021-02/AF_GUIA_SPFA_FORO_2021_ONLINE_PGs.pdf
  • Krikorian A, Vélez M, Gonzalez C, & Vargas J. The experience of suffering in main care takers of patients with cancer-pain and non-cancer pain. Avances En Enfermería. 2010; 28: 13–20. https://www.researchgate.net/publication/262439351_The_experience_of_suffering_in_main_care_takers_of_patients_with_cancer-pain_and_non-cancer_pain
  • Swartz K, Collins LG. Caregiver Care. Am Fam Physician. 2019 Jun 1;99(11):699-706. PMID: 31150177. https://pubmed.ncbi.nlm.nih.gov/31150177
  • Yu W, Chen J, Hu J, Hu J. Relationship between Mental Health and Burden among Primary Caregivers of Outpatients with Schizophrenia. Fam Process. 2019 Jun;58(2):370-383. doi: 10.1111/famp.12340. Epub 2018 Jan 24. PMID: 29363737. https://doi.org/10.1111/famp.12340
  • Díaz Vallejo JA, Osorio Bermúdez JD, Londoño Garzón E, Delgado Castillo GA. A commentary on “Poor patient health is associated with higher caregiver burden for older adults with advanced cancer”. J Geriatr Oncol. 2022 Apr;13(3):388. https://doi.org/10.1016/j.jgo.2021.10.012 . Epub 2021 Oct 29. PMID: 34756695.
  • WHO. Medication Safety in Polypharmacy. Geneva: World Health Organization. 2019 (WHO/UHC/SDS/2019.11). Disponible en: https://www.who.int/publications/i/item/WHO-UHC-SDS-2019.11
Fuente de los datos: Dialnet