Abstract Body

Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of worldwide morbidity and mortality, being associated with high prevalence of mental disorders. Therefore, we analysed men with self-reported COPD regarding socio-demographic data and several dimensions of mental health.

Methods: We analysed data from a population-based survey with a representative sample of Portuguese men aged ≥40 years (n=5,707), in 2014. We performed an age- and education-adjusted comparison of the prevalence of depression diagnosis, use of mental health consultations and different dimensions of mental health disease according to self-reported COPD diagnosis. We estimated weighted prevalences with 95% confidence intervals (95%CI) and adjusted prevalence ratios (PR) using Poisson regression. This study was approved by ethics committee.

Results: The nationwide prevalence of COPD in men was 6.4% (95%CI: 5.5-7.2), increasing with age, with a prevalence of 13.7% (95%CI: 10.8-16.6) for ≥75-year-old men. Men with COPD had an adjusted higher prevalence of depression diagnosis [PR=2.07 (1.45-2.98)]. They also reported more commonly life insatisfaction [PR=1.57 (1.23-2.00)], perceiving health-status as bad [PR=1.76 (1.44-2.16)], indifference for daily activities [PR=1.68 (1.39-2.03)], depressed mood [PR=1.67 (1.40-1.98)], sleep disturbances [PR=1.40 (1.20-1.62)], fatigue [PR=1.63 (1.44-1.84)], feeling of worthlessness or guilt [PR=2.13 (1.71-2.66)] and difficulty in concentrating [PR=1.62 (1.23-2.19)].

Conclusion: These findings provide evidence that COPD is associated with mental health, namely depression, being a major component of the burden of this disease among men. The clinicians should be aware of this association in order to have a high level of suspicion to mental health disturbances when assessing men with COPD.

Abstract Body

Background

The aging process is associated with an increase in comorbidities and a consequent increase in the number of medications prescribed to provide symptomatic relief and to prevent disease-related sequelae. Whereas undertreatment might harm the potential benefits of a medication, overtreatment can put a patient at increased iatrogenic risk.

Polypharmacy is defined as the regular use of five or more medications and might result in adverse drug interactions, high pill burden and heavy medication costs. Patient-related factors such as multiple medical conditions managed by different subspecialist physicians, chronic mental health conditions and residing in a long-term care facility are very challenging for the General Practicioner (GP).

Deprescribing is the patient-centered process of reducing medications after considering the treatment expected outcomes, benefits and risks. Primary care providers often face complex decisions about how to manage patient’s prescriptions at the end of life. Some preventive medications can become obsolete as the health benefits they could provide may not be relevant or even noticed.

Aim and learning objectives

This workshop aims to provide tools to GP’s in identifying and deprescribing potentially inappropriate medications in frail patients or in patients with a limited life expectancy.

Methods and timetable

In this one-hour workshop, we shall review the most recent evidence regarding this subject in a viewer-friendly environment, leading the attendees to a more participated learning process about deprescribing in the elderly.

Conclusions

Deprescribing and overtreatment are very common in primary care. Knowledge about deprescribing guidelines and practicing this process should be a priority in the care of the elderly.