Multimorbidade e Prevenção Quaternária (P4)
DOI:
https://doi.org/10.5712/rbmfc10(35)1069Palavras-chave:
Saúde do Idoso, Comorbidade, Interações de Medicamentos, Medicalização, Prevenção QuaternáriaResumo
A multimorbidade se tornou a norma para a maioria dos pacientes atendidos nos serviços de atenção primária à saúde, e enquanto a proporção de pessoas com multimorbidade é maior em idades mais avançadas, o número absoluto de pessoas com multimorbidade é maior em pessoas com menosde 65 anos. O modelo de tratamento de doença única, com base no especialista focal, pressupõe que cada doença-índice seja a doença dominante dentro de um sistema complexo e que as outras comorbidades se mantenham constantes, enquanto o seu manejo é centrado em uma única condição. Assim, aplicando-se as diretrizes de doenças-únicas para uma pessoa com cinco comorbidades crônicas, não importando quais sejam elas, resulta em uma polifarmácia, potencialmente nociva. Esta abordagem tem conduzido a atual “epidemia” da morbidade e mortalidade por reações adversas a medicamentos, que já ultrapassa as doenças-alvo como causas de morte. Neste artigo, destacam-se quatro características da prevenção quaternária, que gestores de saúde deveriam levar em conta ao considerarem a qualidade dos cuidados em saúde
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