Prescription Drug Use, Diagnoses, and Healthcare Utilization among the Elderly

Abstract

This study shows an extensive multiple drug use among elderly people living at home. Whether this multiple drug use per se is harmful to the patients or not could not be evaluated in this study. Further focused investigations are needed to assess the effect of multiple drug use in an elderly population.

Influência da renda na associação entre disfunção cognitiva e polifarmácia: Projeto Bambuí

“…8,25 On the other hand, the prevalence of major polypharmacy was lower than what has been observed in European countries, 8,9,25 while it was greater than what has been observed in Hong Kong 27 and in the metropolitan region of Belo Horizonte. 16 Differences regarding sociodemographic characteristics, cultural traits, morbidity patterns and healthcare service usage patterns may underlie the variations in medication consumption between different populations.…”

“…The Bambui study included prescribed and non-prescribed drugs and the question on medication consumption covered the last 90 days. This may partially explain the greater prevalence observed there, in comparison with studies that solely considered prescribed medications 8,25 or that used shorter time windows, such as one week 27 or a fortnight. 16 In the present study, the variables indicating health conditions and healthcare service usage, and some sociodemographic characteristics, were considered to be a priori confounding variables in relation to investigating the association between polypharmacy and cognitive impairment.…”

“…16 Both the variables indicating health conditions and those for healthcare service usage presented strong and independent associations with the number of * Classifi cation in accordance with the Anatomical Therapeutic Chemical Index (ATC) ** Based on the score obtained from the Mini-Mental State Examination, adjusted for schooling level *** % of users of the class of medications **** OR 95% CI, estimated by logistic regression and adjusted for sex and age ***** Level 1 of the ATC classifi cation ****** Angiotensin-converting enzyme ******* Except for anticonvulsants medications consumed, thus corroborating a pattern that has been found to be consistent across different populations. 7,8,16 The magnitude and independence of these associations prove the importance of these variables for explaining the use of medications. This consequently attests to the pertinence of including them in the study for adjustment purposes.…”

“…22 Multiple use of medications is more frequent among elderly people, 1 because of the high prevalence of chronic diseases during this phase of life. 2 In developed countries, population-based pharmacoepidemiological studies have shown that, among elderly people, the number of chronic diseases, 7,8,25 healthcare service usage, 7,8 being female 14 and being at a more advanced age 8,14 are related to multiple use of medications. In Brazil, a study carried out among elderly people living in the metropolitan region of Belo Horizonte 16 showed that there were signifi cant independent associations between the consumption of three or more medications and female sex, older age group (80 years or over), having at least one chronic disease and having three or more medical consultations over the last 12 months.…”

“…7,8,14 The basis for this defi nition is solely quantitative and it does not take into account the clinical pertinence of the use of these medications (for example, the presence of multiple diseases) or the adequacy of the proposed therapeutic regimen. 21 In addition to comorbidity, the factors implicated in the genesis of polypharmacy include the number of doctors consulted, absence of questions during consultations concerning the medications in use and self-medication.…”