Prevalence of self-medication in Brazil and associated factors

Arrais, Paulo Sérgio Dourado; Fernandes, Maria Eneida Porto; Pizzol, Tatiane da Silva Dal; Ramos, Luiz Roberto; Mengue, Sotero Serrate; Luiza, Vera Lucia; Tavares, Noemia Urruth Leão; Farias, Mareni Rocha; Oliveira, Maria Auxiliadora; Bertoldi, Andréa Dâmaso

doi:10.1590/S1518-8787.2016050006117

person Paulo Sérgio Dourado Arrais

schoolDepartamento de Farmácia. Faculdade de Farmácia, Odontologia e Enfermagem. Universidade Federal do Ceará. Fortaleza, CE, Brasil

person Maria Eneida Porto Fernandes

schoolDepartamento de Farmácia. Faculdade de Farmácia, Odontologia e Enfermagem. Universidade Federal do Ceará. Fortaleza, CE, Brasil

person Tatiane da Silva Dal Pizzol

schoolDepartamento de Produção e Controle de Medicamentos. Faculdade de Farmácia. Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brasil

person Luiz Roberto Ramos

schoolDepartamento de Medicina Preventiva. Escola Paulista de Medicina. Universidade Federal de São Paulo. São Paulo, SP, Brasil

person Sotero Serrate Mengue

schoolDepartamento de Medicina Social. Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brasil

person Vera Lucia Luiza

schoolDepartamento de Política de Medicamentos e Assistência Farmacêutica. Escola Nacional de Saúde Pública Sérgio Arouca. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil

person Noemia Urruth Leão Tavares

schoolDepartamento de Farmácia. Faculdade de Ciências da Saúde. Universidade de Brasília. Brasília, DF, Brasil

person Mareni Rocha Farias

schoolDepartamento de Ciências Farmacêuticas. Centro de Ciências da Saúde. Universidade Federal de Santa Catarina. Florianópolis, SC, Brasil

person Maria Auxiliadora Oliveira

schoolDepartamento de Política de Medicamentos e Assistência Farmacêutica. Escola Nacional de Saúde Pública Sérgio Arouca. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil

person Andréa Dâmaso Bertoldi

schoolDepartamento de Medicina Social. Faculdade de Medicina. Universidade Federal de Pelotas. Pelotas, RS, Brasil

Correspondence: Paulo Sérgio Dourado Arrais Rua Nunes Valente, 1427/802 60125-070 Fortaleza, CE, Brasil E-mail:
parrais@ufc.br

Authors’ Contribution: The following authors contributed to the study’s design, analysis and interpretation of results and critical review of the intellectual content: PSDA, MEPF, ADB, SSM. All authors participated in the writing, approved the final version of the manuscript and declared themselves responsible for all aspects of the study, thereby ensuring its accuracy and comprehensiveness.

Conflict of Interest: The authors declare no conflict of interest.

Departamento de Farmácia. Faculdade de Farmácia, Odontologia e Enfermagem. Universidade Federal do Ceará. Fortaleza, CE, Brasil

Departamento de Produção e Controle de Medicamentos. Faculdade de Farmácia. Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brasil

Departamento de Medicina Preventiva. Escola Paulista de Medicina. Universidade Federal de São Paulo. São Paulo, SP, Brasil

Departamento de Medicina Social. Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brasil

Departamento de Política de Medicamentos e Assistência Farmacêutica. Escola Nacional de Saúde Pública Sérgio Arouca. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil

Departamento de Farmácia. Faculdade de Ciências da Saúde. Universidade de Brasília. Brasília, DF, Brasil

Departamento de Ciências Farmacêuticas. Centro de Ciências da Saúde. Universidade Federal de Santa Catarina. Florianópolis, SC, Brasil

Departamento de Medicina Social. Faculdade de Medicina. Universidade Federal de Pelotas. Pelotas, RS, Brasil

Variable	Prevalence (%)^a	95%CI	p
Gender			< 0.001
Female	19.0	17.4–20.5
Male	13.1	11.7–14.6
Age group (years)			< 0.001
0-9	6.6	5.5–8.0
10-19	12.6	10.7–14.7
20-39	21.6	19.6–23.7
40-59	17.7	16.2–19.4
≥ 60	14.3	12.9–15.8
Color			< 0.001
White	15.4	14.1–16.9
Black	18.4	16.0–21.0
Yellow	25.2	19.1–32.6
Brown	17.2	15.5–19.1
Indigenous	29.8	17.6–45.7
Education (years)			< 0.001
0-8	14.7	13.4–16.0
9-11	19.0	17.1–21.0
≥ 12	19.4	16.8–22.3
Economic classification^b			0.866
A/B	16.3	14.4–18.5
C	16.3	14.8–17.8
D/E	15.8	14.1–17.7
Region			< 0.001
North	17.8	15.0–21.0
Northeast	23.8	21.6–26.2
Southeast	12.8	10.9–14.9
South	11.4	10.1–12.9
Midwest	19.2	17.3–21.3
No. chronic diseases			< 0.001
0	14.6	13.3–15.9
1	18.8	16.8–21.1
2 +	20.4	18.6–22.3
Health insurance			0.709
Yes	16.5	14.5–18.7
No	16.1	14.7–17.5
Hospitalized in the previous year			< 0.001
Yes	20.6	18.2–23.3
No	16.0	14.7–17.3
Total	16.7	15.4–18.0

Variable	Self-medication prevalence
	North		Northeast		Southeast		South		Midwest
	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI
Gender
Female	19.2	15.9–23.0	27.5	25.1–30.0	15.3	13.0–18.0	13.1	11.6–14.8	22.9	20.3–25.6
Male	16.3	13.4–19.6	19.6	16.9–22.6	9.9	7.8–12.4	9.5	8.1–11.2	15.5	13.1–18.4
Age group (years)
0-9	10.9	8.1–14.5	11.9	9.2–15.2	2.5	1.4–4.3	3.6	2.3–5.6	8.7	6.5–11.5
10-19	15.5	10.8–21.7	19.6	15.6–24.3	9.3	6.7–12.8	5.6	3.7–8.2	17.0	12.6–22.7
20-39	23.1	19.5–27.0	31.2	27.5–35.2	17.4	14.4–20.9	15.1	12.8–17.8	24.3	20.9–28.0
40-59	18.9	15.4–22.9	25.6	23.1–28.3	14.8	12.3–17.7	14.8	12.0–15.8	20.0	17.7–22.5
≥ 50	14.3	11.9–17.1	21.4	18.8–24.2	11.3	9.3–13.7	11.9	10.0–14.1	19.6	16.9–22.6
Education (years)
0-8	17.3	14.3–20.7	21.8	19.6–24.3	11.0	9.2–13.0	10.5	9.1–12.1	18.0	15.8–20.5
9-11	19.9	16.1–24.3	29.4	23.7–31.4	16.0	13.2–19.4	13.1	11.0–15.6	20.5	17.9–23.3
≥ 12 years	16.1	10.9–23.2	32.9	28.1–38.2	16.1	12.1–21.0	13.5	10.4–17.4	22.7	18.2–28.0
Economic classification^b
A/B	17.7	13.1–23.5	26.6	20.8–32.6	15.0	12.1–18.6	12.2	10.3–14.4	20.5	17.2–24.3
C	18.8	15.6–22.5	24.5	21.9–27.4	12.6	10.5–15.0	11.3	9.7–13.1	19.0	17.0–21.2
D/E	15.7	12.5–19.6	22.2	19.7–24.9	10.1	7.7–13.1	10.1	7.5–13.7	18.0	14.5–22.0

Variable	Crude PR	95%CI	p	Adjusted PR	95%CI	p
Gender			< 0.001			< 0.001
Male	1			1
Female	1.44	1.31–1.59		1.33	1.21–1.47
Age group (years)			< 0.001			< 0.001
0-9	1			1
10-19	1.89	1.54–2.33		2.03	1.66–2.47
20-39	3.25	2.72–3.89		3.46	2.94–4.08
40-59	2.68	2.22–3.21		2.68	2.26–3.17
≥ 60	2.15	1.78–2.59		1.95	1.63–2.34
Color			< 0.001			0.045
White	1			1
Black	1.19	1.04–1.37		0.93	0.81–1.07
Yellow	1.63	1.25–2.13		1.11	0.88–1.40
Brown	1.11	1.00–1.23		0.90	0.82–1.00
Indigenous	1.93	1.18–3.16		1.37	0.89–2.12
Education (years)			< 0.001
0-8	1
9-11	1.37	1.17–1.43
≥ 12	1.37	1.15–1.52
Economic classification*			0.858
D/E	1
A/B	1.03	0.90–1.20
C	1.03	0.93–1.13
Region			< 0.001			0.001
North	1.56	1.27–1.92		1.76	1.44–2.16
Northeast	2.10	1.79–2.44		2.33	2.00–2.72
Southeast	1.12	0.92–1.36		1.18	0.97–1.42
South	1			1
Midwest	1.18	1.44–1.98		1.74	1.49–2.04
No. chronic diseases			< 0.001			< 0.001
0	1			1
1	1.33	1.20–1.48		1.17	1.06–1.29
≥ 2	1.33	1.20–1.47		1.33	1.18–1.50
Health insurance			0.708
No	1
Yes	1.03	0.90–1.18
Hospitalized in the previous year			< 0.001
No	1
Yes	1.29	1.14–1.47

Therapeutic subgroup	%	95%CI
Analgesics	33.4	31.4–35.4
Muscle relaxers	14.8	12.5–15.3
Anti-inflammatories and antirheumatics	11.7	10.4–13.2
Cough and cold remedies	5.9	5.0–6.9
Supplements (general nutrients)	3.9	3.3–4.6
Drugs for acid-imbalance-related disorders	3.8	3.3–4.6
Sex hormones and genital system modulators	3.1	2.5–3.7
Drugs for functional gastrointestinal disorders	2.8	2.3–3.3
Plants	2.7	2.2–3.4
Vitamins	2.4	1.8–3.1
Antibacterials for systemic use	2.3	1.9–2.8
Other	14.3	13.1–15.6
Total	100

Drug	%	95%CI	NPD^b	PD^c
Dipyrone	15.4	13.9–17.1	X
Caffeine + orphenadrine + dipyrone	12.1	10.8–13.6	X
Paracetamol	11.4	10.2–12.8	X
Caffeine + carisoprodol + diclofenac + paracetamol	3.6	3.0–4.4		X
Diclofenac	3.5	2.7–4.5		X
Caffeine + dipyrone + isometheptene	3.3	2.5–4.2	X
Ethinylestradiol + levonorgestrel	2.5	2.0–3.0		X
Ibuprofen	2.3	1.8–3.0	X
Phenylephrine + chlorpheniramine + paracetamol	2.2	1.6–2.9	X
Omeprazole	1.8	1.4–2.4		X
Caffeine + chlorpheniramine + dipyrone	1.8	1.4–2.5	X
Nimesulide	1.6	1.2–2.1		X

[TFN1] ^a Percentages adjusted for sample weights and post-stratified according to age and gender.

[TFN2] ^b The Economic Classification variable is according to the 2013 Brazilian Economic Classification Criterion of the Brazilian Association of Research Companies (www.abep.org).

Prevalence of self-medication in Brazil and associated factors

ABSTRACT