Abstract
Introduction (with objective): Introduction: Population aging is associated with one of the most relevant demographic transformations of the 21st century. As in Brazil, population aging is also occurring in developed countries, such as the United States, where the elderly population (65 years or older) will reach 83.7 million by 2050, almost double the 43.1 million in 2012. This demographic scenario is associated with the epidemiological transition, characterized by an increase in chronic non-communicable diseases, which demand more complex therapeutic regimens, with a higher prevalence of polypharmacy, risk of adverse reactions, drug interactions (DI), and use of potentially inappropriate medications (PIM) by older adults. Objective: To analyze the number of medications used by elderly Americans, their comorbidities, and the occurrence of polypharmacy, DI, and PIM. Material and Method: Method: This is a retrospective study with patients first seen at a Senior Care Center in Huntsville, Alabama (USA). The project was approved by the Research Ethics Committee of the University of Alabama in Huntsville. In December 2025, the electronic medical records of eligible elderly individuals were reviewed to obtain sociodemographic, clinical, and pharmacotherapeutic information relevant to the research. Polypharmacy was defined as the use of five or more medications; medication-associated drugs (MIs) were classified according to drugs.com, and medication-inhibiting drugs (MPIs) according to the Beers Criteria (2023). The analysis was conducted using descriptive statistics. Results: Data from 150 patients were evaluated, with a mean age of 79 years (66–95), 59.3% women, 86% white, presenting 48 distinct comorbidities; of these, 63.3% were polypharmacy patients. Among the 20 most frequent comorbidities, 17 (85%) were more prevalent among patients on polypharmacy (hypertension, high cholesterol, gastroesophageal reflux, depression, anxiety, diabetes, osteoarthritis, dementia, hypothyroidism, cancer, heart disease, atrial fibrillation, irritable bowel syndrome, COPD/Emphysema, diverticulitis, peripheral neuropathy, and rheumatoid arthritis). 1,068 medication errors (MIs) were identified (9.27% major, 74.35% moderate, and 16.38% minor) and 326 medication-inhibiting medications (MPIs) (82.7% of prescriptions). The most prevalent major MIs were: salicylic acid and apixaban (4 cases), citalopram and proton pump inhibitors (PPIs) (3 cases), and clopidogrel and PPIs (3 cases). Among the most prevalent moderate drug interactions, the following stand out: atorvastatin and PPIs (16 cases), PPIs and levothyroxine (16 cases), acetylsalicylic acid and amlodipine (8 cases), acetylsalicylic acid and losartan (8 cases), and amlodipine and atorvastatin (8 cases). The most frequent potentially inappropriate medications (PIMs) were: acetylsalicylic acid (38 cases), omeprazole (20 cases), pantoprazole (16 cases), escitalopram (15 times), and donepezil (13 times). Conclusions: The results show a high prevalence of polypharmacy among elderly Americans, accompanied by a significant number of drug interactions and the use of potentially inappropriate medications. The higher concentration of comorbidities among patients on polypharmacy reinforces the association between multimorbidities and greater pharmacotherapeutic complexity. In this context, the importance of the pharmacist's role in the systematic review of pharmacotherapy stands out, promoting deprescribing and patient-centered care.
