Design of an educational program on food-drug interactions in the elderly with cardiovascular disease
Abstract
Introduction: Food-drug interactions may be caused by alterations in pharmacokinetic mechanisms. Most problems occur during drug absorption. The result may be a variation in bioavailability and could have clinical repercussions. Healthcare professionals should receive ongoing education to optimize treatment.
Objective: To identify possible drug-food interactions in patients with cardiovascular diseases and develop an educational program to increase the level of information.
Method: We conducted a descriptive study on the characteristics of drug and food administration in the elderly. We analyzed the medical records of 35 patients with cardiovascular disease from a Nursing Home and conducted an individual interview with patients and healthcare workers. We also analyzed the drugs and food prescribed, as well as their respective administration schedules. Finally, an educational program was designed.
Results: High blood pressure was the most frequent cardiovascular disease (77.2%), which is why antihypertensive drugs are the most frequently prescribed. In most cases, they are administered together with food (80.0%). Based on the deficiencies found, we began the design of an educational program. We created a poster and agreed to hold educational talks for the patients on general aspects of the subject. Moreover, we offered a postgraduate course for the healthcare staff on pharmacokinetics, foods that modify it, and administration schedules.
Conclusions: We were able to ascertain the co-administration of drugs and food. Both patients and healthcare personnel received an educational program based on this aspect.
Downloads
References
1. San Miguel MT, Vargas E, Martínez A. Interacciones entre medicamentos y alimentos: aspectos actuales. An R Acad Nac Farm. 2004;70(1):147-79.
2. Araujo DA. Fármaco-nutrimento: interacción insuficientemente considerada. Rev Esp Méd Quir. 2014;19(2):244-50.
3. By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-694. DOI: https://doi.org/10.1111/jgs.15767
4. Lozano C, Villegas FF. Conocimiento detección y prevención de las interacciones fármaco nutrimento en farmacia hospitalaria y farmacovigilancia. En: Araujo D, eds. Generalidades de Nutrición y Fármacos. México: COA Editorial; 2013. p. 40-9.
5. Cala L, Casas S, Dunán LK. Efecto cascada en el anciano como consecuencia de la polifarmacia. MEDISAN [Internet]. 2017 [citado 12 Feb 2020];21(3):296-303. Disponible en: http://www.medisan.sld.cu/index.php/san/article/view/1030/pdf
6. Katzung BG. Special Aspects of Geriatric Pharmacology. In: Katzung BG, eds. Basic & Clinical Pharmacology. 14 ed. San Francisco: McGraw-Hill; 2018. p. 1058-67.
7. Kenneth E, Thummel D, Isoherrane N. Diseño y optimización de regímenes posológicos: datos farmacocinéticos. En: Brunton LL, eds. Goodman & Gilman. Las Bases Farmacológicas de la Terapéutica. 13 ed. México: McGraw-Hill; 2018. p. 1891-935.
8. De Cos MA. Interacciones de fármacos y sus implicaciones clínicas. En: Flórez J, eds. Farmacología Humana. 6 ed. España: Elsevier; 2014. p. 178-92.
9. Araujo-López DA. Interacciones fármaco-nutrimento, una realidad en la práctica clínica hospitalaria. Rev Esp Méd Quir. 2015;20(2):125-34.
10. Díaz G. Interacción fármaco-nutriente. Medwave [Internet]. 2006 [citado 15 Feb 2020];6(11):e3524. Disponible en: https://doi.org/10.5867/medwave.2006.11.3524
11. Ritter JM, Flower R, Henderson G, Loke YK, MacEwan D, Rang HP. Rang and Dale’s Pharmacology. 9th ed. Londres: Elsevier; 2020. p. 117-132.
12. Ramírez Pérez AR, Ramírez Pérez JF, Borrell Zayas JC. Polifarmacia e interacciones medicamentosas potenciales en el adulto mayor, una polémica en la prescripción. Rev Cuba Farm [Internet]. 2019 [citado 15 Feb 2020];52(2):e335. Disponible en: http://www.revfarmacia.sld.cu/index.php/far/article/view/335/217
13. Castro-Rodríguez JA, Orozco-Hernández JP, Marín-Medina DS. Polifarmacia y prescripción de medicamentos potencialmente no apropiados en ancianos. Rev Méd Risaralda. 2015;21(2):52-7.
14. Lipska KJ, Krumholz H, Soones T, Lee SJ. Polypharmacy in the aging patient: A review of glycemic control in older adults with type 2 diabetes. JAMA. 2016;315(10):1034-45. DOI: https://doi.org/10.1001/jama.2016.0299
15. Castañeda R, Chacaliaza LR, Espinoza G, Mauricio S. Interacción alimento-medicamento en la indicación terapéutica del paciente quirúrgico del Hospital EsSalud. 2013. Lima-Perú [Internet]. Universidad Peruana de Ciencias Aplicadas. 2013 [citado 21 Feb 2020]. Disponible en: http://hdl.handle.net/10757/322127
16. Hernández Ugalde F, Álvarez Escobar MC, Martínez Leyva G, Junco Sánchez VL, Valdés Gasmury I, Hidalgo Ruiz M. Polifarmacia en el anciano. Retos y soluciones. Rev Med Electrón [Internet]. 2018 [citado 21 Feb 2020];40(6). Disponible en: http://www.revmedicaelectronica.sld.cu/index.php/rme/article/view/2640/pdf_542
17. Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016;387(10022):957-67. DOI: https://doi.org/10.1016/s0140-6736(15)01225-8
18. Teixeira A, Arrigo M, Tolppanen H, Gayat E, Laribi S, Metra M, et al. Management of acute heart failure in elderly patients. Arch Cardiovasc Dis. 2016;109(6-7):422-30. DOI: https://doi.org/10.1016/j.acvd.2016.02.002
19. Roush GC, Sica DA. Diuretics for Hypertension: A review and update. Am J Hypertens. 2016;29(10):1130-7. DOI: https://doi.org/10.1093/ajh/hpw030
20. Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, et al. Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest. 2016;149(2):315-52. DOI: https://doi.org/10.1016/j.chest.2015.11.026
21. Pérez Caballero MD, León Álvarez JL, Dueñas Herrera A, Alfonzo Guerra JP, Navarro Despaigne DA, de la Noval García R, et al. Guía cubana de diagnóstico, evaluación y tratamiento de la hipertensión arterial. Rev Cuban Med [Internet]. 2017 [citado 3 Mar 2020];56(4):242-321. Disponible en: http://scielo.sld.cu/pdf/med/v56n4/med01417.pdf
22. Jiménez Fernández L, Siverio Mota D, Chala Tandrón JM, Brito Ferrer Y, Armada Esmores Z. Factores relacionados con la no adherencia al tratamiento farmacológico en hipertensos del Policlínico XX Aniversario. Diseño de un programa educativo. CorSalud [Internet]. 2017 [citado 15 Mar 2020];9(1):10-8. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/211/458
23. Naranjo Rojas A, Arango Arango AC, Sánchez Élago HL, Jaramillo NC, Mora YA, Cruz Mosquera FE. Efectos de un programa educativo para cuidadores de pacientes con afecciones respiratorias en el domicilio. Rev Cuban Med Gen Integr [Internet]. 2019 [citado 15 Mar 2020];35(4). Disponible en: http://revmgi.sld.cu/index.php/mgi/article/view/922/306
24. Menor Rodríguez MJ, Aguilar Cordero MJ, Mur Villar N, Santana Mur C. Efectividad de las intervenciones educativas para la atención de la salud. Revisión sistemática. Medisur [Internet]. 2017 [citado 16 Mar 2020];15(1):71-84. Disponible en: http://www.medisur.sld.cu/index.php/medisur/article/view/3424/2263
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
