Polypharmacy:

Abstract

OBJECTIVE To characterize the polypharmacy in primary health care patients and to identify its associated factors.METHODS This is a cross-sectional, exploratory, and evaluative study, part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). The variable of interest was polypharmacy, defined as the use of five or more medicines. We sought to identify the association of sociodemographic variables and indicators of health conditions to polypharmacy. For group comparison, the Pearson’s Chi-square test was used. The association between polypharmacy and explanatory variables was evaluated by logistic regression model (p < 0.05). The quality of the adjustment was verified by Hosmer-Lemeshow test.RESULTS The prevalence of polypharmacy among medicine users was 9.4% (95%CI 7.8–12.0) in the general population and 18.1% (95%CI 13.6–22.8) in older adults above 65 years old. We found statistically significant association between polypharmacy and age above 45 years, lower self-perception of health, presence of chronic diseases, having health insurance, care in emergency services, and region of the Country. South users presented the highest chances to polypharmacy. The most used medicines were those of the cardiovascular system, being compatible with the national epidemiological profile.CONCLUSIONS Polypharmacy is a reality in the population met within the primary care of Brazilian Unified Health System and may be related to excessive or inappropriate use of medicines. The main challenge to qualify health care is to ensure that prescription of multiple medicines be appropriate and safe.

Polypharmacy in a semirural community in Chile: Results from Maule Cohort

“…MAUCO participants on polypharmacy were less educated and had more frequent bad self‐reported health, independent of the age group. This is consistent with the results obtained by Castioni et al in Swedish adults and Nascimento et al in Brazil . Participants with polypharmacy had significantly higher prevalence of diseases (diabetes, hypertension, dyslipidemia, cardiovascular disease, depression, hypothyroidism, and osteomuscular diseases), which is also consistent with previous observations …”

“…In MAUCO, polypharmacy was significantly more common in women than men, and significantly more common among those aged 60 years or older. This is consistent with the results observed in previous research and the results from the last ChNHS . MAUCO participants on polypharmacy were less educated and had more frequent bad self‐reported health, independent of the age group.…”

“…In this study, we investigated prevalence and risks factors for polypharmacy and for increased medication utilization in MAUCO. The estimated prevalence of medication use in MAUCO was similar to estimates obtained in Greece by (41.6%), Ireland (20.3%‐46.7%), and Scotland (46.7%), but lower than in Brazil (74%) . We found that the pattern of the most commonly used medications was consistent with the prevalence of chronic diseases found in this sample, particularly hypertension, diabetes, dyslipidemia, and depression.…”

“…Number of medications was coded as the number of active ingredients reported by each participant. Polypharmacy was defined as the concomitant use of five or more active ingredients, including herbal supplements and multivitamins …”

“…Pappa et al studied a population in Greece, finding that 45.6% of the population meeting criteria for polypharmacy was younger than 65 years old . More recently, an analysis of the Brazilian Unified Health System found that the prevalence of polypharmacy among medication users was 9.4% for the younger to middle aged adults (18‐64 years old) and 18.1% among older adults . Although polypharmacy clearly is not restricted to older adults, it is not yet well understood in younger populations.…”