Epidemiology of medication use among the elderly in an urban area of Northeastern Brazil

Neves, Sabrina Joany Felizardo; Marques, Ana Paula de Oliveira; Leal, Márcia Carrera Campos; Diniz, Alcides da Silva; Medeiros, Tibério Silva; Arruda, Ilma Kruze Grande de

doi:10.1590/S0034-8910.2013047003768

OBJECTIVE

To analyze medication use and associated factors among the elderly.

METHODS

A population-based cross-sectional study was carried out with a sample of 400 elderly people aged over 60 living in the urban area covered by the Family Health Strategy program in Recife, Northeastern Brazil in 2009. Individuals were selected by systematic random sampling and household data were collected. Demographic, socio-economic, lifestyle factors including nutrition practices and health variables were evaluated. Medication use was the independent variable. Univariate and multivariate statistical analysis were performed.

RESULTS

: The prevalence of medication use was 85.5%. Polypharmacy (> 5 drugs) occurred in 11% of cases. Of the 951 drugs reported, 98.2% were prescribed by doctors and 21.6% were considered unsafe for the elderly. The most commonly prescribed groups were: cardiovascular drugs (42.9%), central nervous system agents (20.2%) and drugs with an effect on the digestive tract and metabolism (17.3%). The use of polypharmacy was associated with education (p = 0.008), self-reported health (p = 0.012), self-reported chronic disease (p = 0.000) and the number of doctor appointments per year (0.000).

CONCLUSIONS

The results of this study indicate a high proportion of medication use among the elderly, including of those considered unsuitable, and inequality among groups of elderly individuals regarding the use ofmedication, when education, number of doctor appointments and self-reported health are considered.

Aged; Drug Utilization; Polypharmacy; Socioeconomic Factors; Urban Health

[1] Correspondence : Sabrina Joany Felizardo Neves Rua Deputado José Lages, 1230 apto. 1001 - Ponta Verde 54035-330 Maceió, AL, Brasil E-mail: joanysabrina@gmail.com

Variable	Elderly

	n	%

Sex
Female	302	75.5
Male	98	24.5
Age group (years)
60 to 69	205	51.3
70 to 79	134	33.5
80 and over	61	15.4
Schooling (years of study)
Illiterate	146	36.6
1 to 4	87	21.9
5 to 9	62	15.5
10 or more	104	26.1
Marital status
Living with a partner	147	36.8
Not living with a partner	252	63.2
Individuals per residence
Up to 3	228	57.0
4 or more	142	43.0
Income (MW)
< 1	60	15.1
1 to 2	310	78.1
> 2	27	6.8
Health
Excellent. very good and good	24	6.0
Regular or very bad	376	94.0
Reported illness
None	48	12.0
One chronic illness	137	34.2
Two or more chronic illnesses	215	53.8
Physical activity
No	98	24.5
Yes	302	75.5
Nutritional status (BMI)
< 22 kg/m ²	50	13.7
22 to 27 kg/m ²	140	38.5
> 27 kg/m ²	174	47.8
Doctor’s appointments per year
Up to 4	257	64.3
5 or more	143	35.8

Group and subgroup	n	%

Cardiovascular drugs	408	42.9
Diuretics	124	13.0
Drugs active in the renin angiotensin system	107	11.2
Calcium channel blockers	37	3.9
β-blockers	19	2.0
Cardiac therapy	14	1.5
Hipolipermiantes	4	0.4
Other	103	10.9
Medicines for central nervous	192	20.2
Analgesics	80	8.4
Psycholeptics	26	2.7
Psychoanaleptics	20	2.1
Antiparkinsonian	6	0.6
Antiepileptic	4	0.4
Other	6	0.6
Medicines for the alimentary tract and metabolism	165	17.3
Antidiabetic	65	6.8
Mineral supplements	18	1.9
Antacids, anti-ulcer and antiflatulents	14	1.5
Vitamins	5	0.5
Other	3	0.3
Other	186	19.6

Medication	n	%

Hydrochlorothiazide 25 mg pill	153	16.1
Captopril 25 mg pill	102	10.8
ASA 100 mg pill	66	6.9
Metformin 850 mg pill	42	4.4
Propranolol 40 mg pill	42	4.4
Glibenclamide 5 mg pill	36	3.8
Simvastatin 40 mg pill	30	3.1
Diazepam 10 mg pill	21	2.2
Atenolol 50 mg pill	15	1.6
Furosemide 40 mg pill	12	1.3
Other	432	45.4
Total	951	100.0

Variable	Polypharmacy				p ^a

	Yes		No
	n	%	n	%

Sex					0.302
Female	8	8.2	90	91.8
Male	36	11.9	266	88.1
Age group (years)					0.097
60 to 69	29	14.15	176	85.9
70 to 79	9	6.7	125	93.3
80 and over	6	9.8	55	90.2
Schooling (years of study)					0.008
Illiterate	20	19.2	84	80.8
1 to 4	7	11.3	55	88.7
5 to 9	9	10.3	78	89.7
10 or more	8	5.5	138	94.5
Marital status					0.688
Living with a partner	15	10.2	132	89.8
Not living with a partner	29	11.5	223	88.5
Individuals per residence					0.535
Up to 3	27	11.8	201	88.2
4 or more	17	9.9	155	90.1
Income (MW)					0.416
< 1	3	9.4	29	90.6
1 to 2	1	3.7	26	96.3
> 2	40	11.8	300	88.2
Health					0.012
Excellent, very good and good	6	5.0	114	95.0
Regular or very bad	38	13.6	242	86.4
Reported illness					0.000
None	–	–	48	100.0
One chronic illness	5	3.7	129	96.3
Two or more chronic illnesses	39	17.9	179	82.1
Physical activity					0.183
No	30	9.8	275	90.2
Yes	14	14.7	81	85.3
Nutritional status (BMI)					0.663
< 22 kg/m2	19	9.9	173	90.1
22 to 27 kg/m2	16	13.1	106	86.9
> 27 kg/m2	6	12.2	43	87.8
Doctor’s appointments per year					0.000
Up to 4	16	6.2	241	93.8
5 or more	28	19.6	115	80.4