Use of psychotropic medications in adults and elderly living in Campinas, São Paulo, Brazil: cross-sectional population-based study*

Prado, Maria Aparecida Medeiros Barros do; Francisco, Priscila Maria S. Bergamo; Barros, Marilisa Berti de Azevedo

doi:10.5123/S1679-49742017000400007

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 26 (4) • Oct-Dec 2017 • https://doi.org/10.5123/S1679-49742017000400007 copy

Use of psychotropic medications in adults and elderly living in Campinas, São Paulo, Brazil: cross-sectional population-based study^* * This article is part of Maria Aparecida Medeiros Barros do Prado’s PhD thesis entitled ‘Use of medications by the adult population in Campinas - São Paulo’, defended to the Post-graduation program in Public Health of the Medical School of the State University of São Paulo, in 2016. This study was funded by the National Council for Scientific and Technological Development (CNPq)/ Ministry of Science, Technology and Innovation (MCTI) - Process No. 409747/2006-8 - and by the Municipal Health Department of Campinas. (Partnership Unicamp/Funcamp/SMS No. 4.300).

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

OBJECTIVE:

to estimate the prevalence of use of psychotropic medicines and associated factors in adults and elderly, and to identify the main classes used.

METHODS:

cross-sectional population-based study, conducted in Campinas-SP, Brazil (January/2008-April/2009); chi-square Rao-Scott test and Poisson multiple regression were applied.

RESULTS:

the study included 2,472 individuals and the prevalence of use of at least one psychotropic medication in the three previous days was 6.8% (95%CI 5.5;8.1); in the adjusted analyses, there were positive associations between use and female sex (PR=1.48; 95%CI 1.01;2.18), worse health perception (PR=2.10; 95%CI 1.13;3.89), common mental disorder (PR=1.66; 95%CI 1.09;2.51) and emotional problems (PR=8.04; 95%CI 4.87;13.02); black/brown-skinned individuals presented significantly lower use (PR=0.58; 95%CI 0.39;0.88); antidepressants (52.6%), anxiolytics (28.1%) and antipsychotics (17.0%) were the most used.

CONCLUSION:

inequalities regarding sex and ethnicity/skin color were observed; the findings contribute to the evaluation of the rational use of these drugs.

Keywords:
Drug Utilization; Psychotropic Drugs; Pharmacoepidemiology; Cross-Sectional Studies; Health Surveys

Variables	Sample		Prevalence of use of psychotropic substances		P value ^c	Crude_PR ^d (95%CI)^e	Adjusted_PR ^f (95%CI)^e
Variables	n^a	%^b	n^a	%^b	P value ^c	Crude_PR ^d (95%CI)^e	Adjusted_PR ^f (95%CI)^e
Sex					<0.001
Male	1,063	47.7	50	3.6		1.00	1.00
Female	1,409	52.3	174	9.6		2.64 (1.74;4.00)	2.51 (1.66;3.79)
Age group (in years)					<0.001
20-59	957	83.9	59	6.0		1.00	1.00
≥60	1,515	16.1	165	10.8		1.80 (1.35;2.40)	1.71 (1.30;2.60)
Marital status					0.305
With spouse	1,438	61.0	107	6.3		1.00	1.00
Without spouse	1,034	39.0	117	7.6		1.20 (0.84;1.72)	1.11 (0.76;1.63)
Ethnicity/skin color					0.023
White/Asian	1,881	74.6	192	7.6		1.00	1.00
Black/brown	584	25.4	32	4.5		0.59 (0.37;0.94)	0.65 (0.40;1.03)
Education level (in years of schooling)							0.020
0-3	607	10.9	59	10.5		1.00	1.00
4-8	934	33.7	87	7.8		0.74 (0.45;1.22)	1.07 (0.62;1.84)
≥9	932	55.4	78	5.4		0.51 (0.32;0.82)	0.97 (0.56;1.65)
Monthly income per capita (in minimum wages)					0.286
≤1	1,018	40.5	89	5.7		1.00	1.00
>1 to ≤3	995	39.7	87	7.9		1.37 (0.95;1.96)	1.41 (0.97;2.05)
>3	459	19.8	48	6.7		1.17 (0.70;1.95)	1.20 (0.73;1.98)
Occupational activity					<0.001
Yes	1,006	64.5	41	3.8		1.00	1,00
No	1,465	35.5	183	12.1		3.14 (2.08;4.74)	2.15 (1.24;3.74)
Abusive alcohol use					0.132
No	2,319	91.4	217	7.1		1.00	1,00
Yes	148	8.6	6	3.3		0.46 (0.16;1.33)	0.74 (0.24;2.27)
Smoking					0.201
Non-smoker	1,682	67.9	162	6.5		1.00	1,00
Smoker	369	19.2	23	5.7		0.88 (0.48;1.61)	1.05 (0.57;1.91)
Former-smoker	418	12.9	38	9.9		1.53 (0.95; 2.44)	1.53 (0.94;2.49)
Practice of physical activity during free time							0.150
No	1,678	66.7	159	7.4		1.00	1,00
Yes	793	33.3	65	5.5		0.74 (0.50;1.12)	0.86 (0.58; 1.30)
Body mass index (BMI)					0.963
Low weight	288	6.0	27	7.3		1.00	1,00
Eutrophy	1,136	48.8	93	6.7		0.93 (0.47;1.83)	1.42 (0.73;2.75)
Excess weight	942	45.2	88	6.6		0.91 (0.44;1.86)	1.28 (0.62;2.64)
Sleeping hours (per day)					0.036
<6	439	16.0	51	9.7		1.00	1,00
≥7	2,016	84.0	171	6.2		0.64 (0.42;0.97)	0.72 (0.47;1.09)
Self-perception of health					<0.001
Excellent/very good	760	39.8	37	3.4		1.00	1,00
Good	1,460	52.7	127	6.1		1.81 (1.03;3.18)	1.55 (0.87;2.77)
Bad/very bad	252	7.5	60	29.6		8.80 (4.84;16.03)	6.79 (3.51;13.11)
Common mental disorder					<0.001
Negative	2,148	90.2	130	3.9		1.00	1,00
Positive	322	9.8	94	33.0		8.40 (5.89;11.97)	6.65 (4.42;9.99)
Number of chronic diseases							<0.001
None	883	56.3	40	4.2		1.00	1,00
One	580	24.0	43	4.7		1.12 (0.64;1.97)	0.98 (0.55;1.74)
Two or more	977	19.7	137	16.2		3.87 (2.45;6.13)	2.66 (1.58;4.48)
Emotional problems					<0.001
No	1,945	80.7	68	1.9		1.00	1,00
Yes	527	19.3	156	27.0		13.95 (8.78;22.17)	11.92 (7.28;19.50)
Insomnia					<0.001
No	1,978	83.9	131	4.4		1.00	1,00
Yes	494	16.1	93	18.9		4.25 (2.92;6.20)	3.25 (2.17;4.89)
Demand for health service					<0.001
No	1,916	80.6	147	5.0		1.00	1,00
Yes	556	19.4	77	14.3		2.88 (1.97;4.22)	2.45 (1.67;3.59)
Hospitalization within the previous year							0.042
No	2,168	90.2	179	6.4		1.00	1,00
Yes	304	9.8	45	10.3		1.61 (1.02;2.54)	1.37 (0.87;2.16)
Private health care insurance							0.667
No	1,347	55.3	103	6.5		1.00	1,00
Yes	1,123	44.7	121	7.1		1.08 (0.74;1.58)	1.02 (0.70;1.48)

Variables	Adjusted_PR ^a (95%CI)^b	P value ^c	Design effect
Sex
Male	1.00
Female	1.49 (1.02;2.20)	0.041	1.51
Age group (in years)
20-59	1.00
≥60	1.36 (1.04;1.77)	0.026	0.68
Ethnicity/skin color
White/Asian	1.00
Black/brown	0.57 (0.38;0.85)	0.007	1.22
Self-perception of health
Excellent/very good	1.00
Good	1.17 (0.71;1.93)	0.533	1.57
Bad/very bad	2.15 (1.15;4.01)	0.017	1.74
Common mental disorder
Negative	1.00
Positive	1.74 (1.15;2.65)	0.010	1.46
Emotional problems
No	1.00
Yes	8.08 (4.99;13.09)	<0.001	1.37

Drug classes	ATC	%
Antidepressants	N06A	52.6
Serotonin reuptake selective inhibitors	N06AB	29.8
Monoamine reuptake nonselective inhibitors	N06AA	18.0
Other antidepressants	N06AX	4.8
Anxiolytics	N05B	28.1
Antipsychotics	N05A	17.2
Hypnotics and sedatives	N05C	2.1

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence: Maria Aparecida Medeiros Barros do Prado - Universidade Estadual de Campinas, Departamento de Saúde Coletiva, Caixa Postal 6111, Campinas-SP, Brasil. CEP: 13083-970 E-mail: cvprado@uol.com.br