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Original Articles • Rev. Saúde Pública 50 (suppl 2) • 12 Dec 2016 • https://doi.org/10.1590/S1518-8787.2016050006117 copy

Prevalence of self-medication in Brazil and associated factors

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To analyze the prevalence and associated factors regarding the use of medicines by self-medication in Brazil.

METHODS

This cross-sectional population-based study was conducted using data from the PNAUM (National Survey on Access, Use and Promotion of Rational Use of Medicines), collected between September 2013 and February 2014 by interviews at the homes of the respondents. All people who reported using any medicines not prescribed by a doctor or dentist were classified as self-medication practitioners. Crude and adjusted prevalence ratios (Poisson regression) and their respective 95% confidence intervals were calculated in order to investigate the factors associated with the use of self-medication by medicines. The independent variables were: sociodemographic characteristics, health conditions and access to and use of health services. In addition, the most commonly consumed medicines by self-medication were individually identified.

RESULTS

The self-medication prevalence in Brazil was 16.1% (95%CI 15.0–17.5), with it being highest in the Northeast region (23.8%; 95%CI 21.6–26.2). Following the adjusted analysis, self-medication was observed to be associated with females, inhabitants from the North, Northeast and Midwest regions and individuals that have had one, or two or more chronic diseases. Analgesics and muscle relaxants were the therapeutic groups most used for self-medication, with dipyrone being the most consumed medicines. In general, most of the medicines used for self-medication were classified as non-prescriptive (65.5%).

CONCLUSIONS

Self-medication is common practice in Brazil and mainly involves the use of non-prescription medicines; therefore, the users of such should be made aware of the possible risks.

Self Medication; Drug Utilization; Socioeconomic Factors; Pharmacoepidemiology; Health Surveys

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

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