Gender differences and psychotropic polypharmacy in psychiatric patients in Brazil: a cross-sectional analysis of the PESSOAS Project

Costa, Juliana de Oliveira; Ceccato, Maria das Graças Braga; Melo, Ana Paula Souto; Acúrcio, Francisco de Assis; Guimarães, Mark Drew Crosland

doi:10.1590/0102-311x00168915

Cited by 15 publications

(18 citation statements)

References 33 publications

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“…Our findings suggested that a higher prevalence of polypharmacy and excessive polypharmacy exists among females, which is consistent with previous studies (Bjerrum et al, 1998;Venturini et al, 2011;Costa et al, 2017;Midao et al, 2018). The possible explanation might be as follows: First, females have a life expectancy advantage over males and they have to live with chronic diseases for a longer period of time (Kontis et al, 2017).…”

Section: Discussionsupporting

confidence: 91%

An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study

Zhang

Sundquist

et al. 2020

Front. Pharmacol.

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Polypharmacy is becoming a global health problem. The aims of this study were to evaluate the temporal trends in the prevalence of polypharmacy in Sweden and to explore polypharmacy disparities by age, gender, education, and immigration status. Methods: Polypharmacy and excessive polypharmacy were evaluated using data extracted from the Swedish Prescribed Drug Register between 2006 and 2014. Polypharmacy was defined as being exposed to five or more drugs and excessive polypharmacy was defined as being exposed to 10 or more drugs during 1 month respectively. Average annual percent change (AAPC) was calculated using Joinpoint Statistical Software. Results: The prevalence of polypharmacy increased from 16.9% in 2006 to 19.0% in 2014 with an AAPC of 1.3; the prevalence of excess polypharmacy increased from 3.8% in 2006 to 5.1% in 2014 with an AAPC of 3.4. The prevalence of polypharmacy and excessive polypharmacy increased dramatically with age and peaked up to 79.6% and 36.4% in individuals aged 90 and above respectively. Females and individuals with lower education level were associated with a higher rate of polypharmacy and excessive polypharmacy. Immigrants from Middle-Eastern countries had the highest rate of polypharmacy and excessive polypharmacy, whereas individuals from Western Europe countries had the lowest rate. Conclusion: The prevalence of polypharmacy has increased gradually in Sweden during the past decade. Individuals with older age, female sex, or lower education have a higher rate of polypharmacy and excessive polypharmacy. Immigrants from Middle-Eastern countries showed a higher rate of polypharmacy.

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Section: Discussionsupporting

confidence: 91%

An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study

Zhang

Sundquist

et al. 2020

Front. Pharmacol.

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“…Such high prevalences of APP has been also consistently found in numerous independent studies in different geographic regions such as Korea, China, Brazil, Canada, America, and Japan. [18][19][20][21][22][23] There has been no clear determination of how many number of APs are commonly used in APP, which is found to create a variable range of AP numbers. According to the extensive meta-analysis, 17 17.8% were taking two APs and 0.2% were taking ≥3 antipsychotics.…”

Section: Prevalence Of Appmentioning

confidence: 99%

Antipsychotic Polypharmacy in Treatment of Schizophrenia; Should or Should Not?

Pae

2020

Chonnam Med J

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Antipsychotics have been utilized as the standard treatment for schizophrenia regardless of illness phase where antipsychotic monotherapy (APM) is routinely recommended as the gold standard rather than antipsychotic polypharmacy (APP). However, approximately 20 to 40% of patients with schizophrenia do not respond to APM based on randomized controlled clinical trials and large practical clinical trials indicating that the subgroup of patients with schizophrenia would need differential treatment approaches beyond traditional treatment strategies such as APM. Numerous studies have supported the use of APP in particular for patients with certain clinical situations including: failure to show efficacy or tolerability from treatment with APM, need for different treatment for targeting specific symptom domains, severe illness, failure to treatment with clozapine, skepticism about following treatment guidelines, or cross titration periods. Furthermore, recent large cohort studies and practical clinical trials have proposed more benefits of APP rather than APM in terms of rehospitalization, mortality, and specific symptoms. APP has recently become more widely utilized and recognized as one of the next treatment strategies to clinicians for patients with schizophrenia. Some experts have already proposed the revision of treatment guidelines incorporating APP as evidence-based treatment option for certain patients with schizophrenia. Taken together, APP now deserves an evidence-based and acceptable treatment strategy, not an empirical or preferential treatment approach for treatment of schizophrenia in contemporary clinical practice.

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“…Ademais, dada a realidade encontrada, a incorporação de grupos terapêuticos temáticos, de educação permanente com os profissionais de saúde, de matriciamento dos casos complexos com os serviços de saúde mental e de visitas domiciliares para levantamento dos usuários na rotina de serviços da UBS podem fomentar estratégias de promoção do uso responsável de psicofármacos (26,27) .…”

Section: Discussionunclassified

“…Uma vez que a atual política de saúde mental brasileira apresenta a APS como porta de entrada e coordenadora do cuidado dos usuários em sofrimento psíquico, os resultados encontrados no presente estudo suscitam a necessidade de se reelaborar as estratégias dessas políticas. Sob a ótica das populações de maior risco e/ou vulnerabilidade ao (ab)uso de psicofármacos, pode-se reformular diretrizes que discutam a influência do gênero, da terceira idade e da baixa escolaridade e renda no consumo irracional dos psicofármacos (21,23,26) .…”

Section: Discussionunclassified

Uso de psicofármacos na atenção primária à saúde

Filho

Azevedo

Pinto

et al. 2018

Rev Bras Promoc Saúde

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Objetivo: Caracterizar a população em uso de psicofármacos da Estratégia Saúde da Família na Atenção Primária à Saúde. Métodos: Pesquisa transversal realizada com 203 usuários de psicofármacos em uma Unidade Básica de Saúde em Caicó, Rio Grande do Norte, Brasil, em 2017. Coletaram-se dados sociodemográficos e sobre o uso do(s) psicofármaco(s) através de um questionário, posteriormente analisados por meio do IBM SPSS Statistics, versão 20.0. Resultados: Encontrou-se média de psicofármacos prescritos de 1,52 ±0,746, tempo médio de uso de 6,52 ±7,350 anos, prevalência do sexo feminino (n=163; 80,3%), casados ou em união estável (n=90; 44,3%) e com baixa escolaridade (n=99; 48,8%). A maior proporção relatou ter moradia própria (n=132; 65%), ser de cor negra/parda (n=118; 58,1%), trabalhador do lar (n=58; 28,6%) e com renda individual de até um salário mínimo (n=101; 49,8%). Além disso, 35,5% (n=72) viviam com hipertensão arterial sistêmica como principal doença crônica. Houve prevalência da classe dos ansiolíticos (34%), do acesso caracterizado pela compra do medicamento (62%), e do psiquiatra como o principal prescritor das drogas psicotrópicas (49%). Conclusão: O uso de psicofármacos no serviço de saúde foi prevalente em mulheres pretas e/ou pardas, com baixa renda e escolaridade, que desempenham atividades laborais em casa, e com adoecimento crônico. Os ansiolíticos estão entre as drogas de maior consumo e o psiquiatra é o principal prescritor. Há dificuldades no acesso e na descontinuação desses medicamentos.

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Gender differences and psychotropic polypharmacy in psychiatric patients in Brazil: a cross-sectional analysis of the PESSOAS Project

Cited by 15 publications

References 33 publications

An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study

An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study

Antipsychotic Polypharmacy in Treatment of Schizophrenia; Should or Should Not?

Uso de psicofármacos na atenção primária à saúde

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