Polifarmácia entre idosos do Município de São Paulo - Estudo SABE

Abstract

Polypharmacy for the elderly and associated factors were assessed. A cross-sectional study was conducted using data from the SABE Study (Health, Well-being and Aging), 2006. 1,115 individuals representing 422,377 elderly aged 65 or more, living in São Paulo City, were interviewed. Polypharmacy was defined as the use of five or more medications. A multivariate regression logistics was used. Polypharmacy prevalence was 36%. Female (OR = 1.7; IC 95%: 1.0; 2.9), age over 75 years (OR = 1.9; CI 95%: 1.3; 2.7), higher income (OR = 1.8; CI 95%: 1.2; 2.8), working (OR = 1.8; CI 95%: 1.1; 2.9), regular self assessed health (OR = 1.6; CI 95%: 1.1; 2.3) or poor (OR = 2.6; CI 95%: 1.4; 4.9), hypertension (OR = 2.0; CI 95%: 1.4; 2.9), diabetes (OR = 4.1; CI 95%: 2.2; 7.5), rheumatic diseases (OR = 2.3; CI 95%: 1.5; 3.6) and cardiac problems (OR = 2.9; CI 95%: 1.9; 4.5) were associated positively with polypharmacy. Using only the public health system (OR = 0.5, 95% CI: 0.3; 0.7) was inversely associated with polypharmacy. Medicines for the cardiovascular system and for the alimentary tract and metabolism were the most used. The knowledge of factors associated with polypharmacy, such as those identified in this study, may be useful to alert health professionals about the importance of identifying and monitoring the elderly groups most vulnerable to polypharmacy.

Analysis of medication use by elderly persons with supplemental health insurance plans

“…This variation can occur due to methodological differences (populations studied, recall period) and even to the interpretation of the concept of polypharmacy. However, it is known that the use of six or more drugs raises the risk of serious drug interactions by as much as 100% 29 .…”

“…However, it should be considered that the PIM list for the elderly, according to the 2015 Beers Criteria 9 , continues to disregard the heterogeneity of the elderly population and the availability of pharmaceutical specialties in the markets of each country 29,32 , as it is designed for use in the USA. The new version, however, puts greater emphasis on clinical judgment in decision-making regarding the pharmacotherapy of the elderly.…”

Prevalence of and factors associated with polypharmacy among elderly persons resident in the community

“…The increased use of medications by the elderly leads to polypharmacy, defined as the regular use of five or more drugs 2 . Concomitant use of multiple medications can lead to undesirable health outcomes such as an increase in adverse reactions and drug interactions, lower adherence to drug therapy, decreased functional capacity, and cognitive decline.…”

Medication use by the elderly: analysis of prescribing, dispensing, and use in a medium-sized city in the state of São Paulo

“…The use of medication is a frequent occurrence among the elderly, and while it contributes to prolonging and improving life, it can also generate serious health problems, especially when it is inadequate, either due to the prescription, dispensation or taking of the drugs 1 . The indiscriminate use of medicines has a clinical and economic impact, and is considered a key indicator of patient safety 2 .…”