Polypharmacy and polymorbidity in older adults in brazil: a public health challenge

Polypharmacy and polymorbidity in older adults in brazil: a public health challenge

Title: Polypharmacy and polymorbidity in older adults in brazil: a public health challenge;
Polifarmácia e polimorbidade em idosos no Brasil: um desafio em saúde pública
Author Ramos, Luiz Roberto Autor UNIFESP Google Scholar
Leao Tavares, Noemia Urruth Google Scholar
Bertoldi, Andrea Damaso Google Scholar
Farias, Mareni Rocha Google Scholar
Oliveira, Maria Auxiliadora Google Scholar
Luiz, Vera Lucia Google Scholar
Dal Pizzol, Tatiane da Silva Google Scholar
Dourado Arrais, Paulo Sergio Google Scholar
Mengue, Sotero Serrate Google Scholar
Abstract OBJECTIVE: To analyze variations in the prevalence of chronic use of medicines by older adults in Brazil according to its possible association with the most prevalent chronic diseases and demographic and health factors, and to identify risk factors for polypharmacy. METHODS: A study based on data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), a cross-sectional, population-based survey with probability sampling in Brazilian urban areas. The independent variable was the number of chronic-use medicines taken by older adults, linked to eight chronic diseases investigated. The intervening variables were gender, age group, marital status, level of education, socioeconomic status, Brazilian region, body mass index, smoking, self-perceived health, hospitalization in the previous year and having health insurance, besides the investigated chronic diseases. A multivariable analysis identified risk factors for polypharmacy. RESULTS: Prevalence of at least one chronic-use medicines among older adults was 93.0%. Of the total number of older adults, 18.0% used at least five medications (polypharmacy). Polypharmacy was higher among the oldest individuals (20.0%), in the South region (25.0%), in those with poor self-perceived health (35.0%), in obese individuals (26.0%), in those with reported health insurance (23.0%) or hospitalization in the previous year (31.0%), and among those who reported any of the investigated diseases, particularly diabetes (36.0%) and heart diseases (43.0%). The variables remaining in the final risk model for polypharmacy were age, region, perceived health, health insurance, hospitalization in the previous year and all investigated diseases except stroke. CONCLUSIONS: Older adults with specific diseases have risk factors for polypharmacy modifiable by actions aimed at the rational use of medicines. With the current population aging and successful drug access policy, the trend is an increase in drug use by older adults, which should feature as a priority in the planning agenda of the Brazilian Unified Health System (SUS).
Keywords Population
Medication
State
Prescription
Medicines
Care
Language English
Sponsor Department of Pharmaceutical Services and Strategic Health Supplies (DAF) of the Secretariat of Science, Technology and Strategic Inputs of the Brazilian Ministry of Health [25000.111834/2]
Department of Science and Technology (DECIT) of the Secretariat of Science, Technology and Strategic Inputs of the Brazilian Ministry of Health [25000.111834/2]
Grant number SCTIE/MS: 25000.111834/2
Date 2016
Published in Revista De Saude Publica. Sao paulo, v. 50, n. 2, p. 9s, 2016.
ISSN 0034-8910 (Sherpa/Romeo, impact factor)
Publisher Hindawi Ltd
Extent 9s
Origin http://dx.doi.org/10.1590/s1518-8787.2016050006145
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000391447400006
SciELO ID S0034-89102016000300308 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/49288

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