Prevalence of Outpatient Use of Medicines by the Elderly Population in Portugal: A Cross-Sectional Study
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19254 |
Resumo: | Introduction: Like in other countries, the age pyramid in Portugal has been changing considerably, with a substantial increase in the size of the older population and a significant reduction in the number of young people. With aging, co-occurrence of several conditions becomes frequent, often leading to the use of multiple medications (polypharmacy). Polypharmacy in the older population is particularly relevant considering the physiological changes of the ageing process, which increase the risk of drug interactions, poor adherence to treatment, and adverse drug reactions, especially in the oldest-old population (85 years or older). As the size of the older population is likely to increase significantly, it is important to characterize the pattern of medicines’ use by the elderly while also identifying cases of polypharmacy in order to obtain evidence that can be used to develop specific measures to tackle the high prevalence of use and its associated risks. To this end, the aim of this study was to characterize medication use by older individuals in Portugal. Methods: Cross-sectional study with data from the National Health System’s Control and Monitoring Center on reimbursed medicines that were prescribed and dispensed to individuals aged 65 years or older in 2019 in all community pharmacies of the Portuguese mainland. We performed a demographic and geographic analysis of the data by international nonproprietary name and therapeutic group. The number of reimbursed packages and the number of reimbursed packages per capita were the metrics used (data from Instituto Nacional de Estatística).Results: A higher consumption of medicines was observed in women, increasing with age, except in the oldest olds, in which the sex difference tended to shrink. Use per capita showed an opposite trend, with the oldest-old men surpassing the oldest-old women (mean reimbursed packages: 55.5 in men versus 55.1 in women). In women, consumption was led by cardiovascular medicines (31%), followed by central nervous system medications (30%) and antidiabetics (13%); in men, 37% of TOP 10 consumption was due to cardiovascular medications, antidiabetics (16%) and drugs for benign prostatic hypertrophy (14%).Conclusion: In the elderly, there were sex differences in the pattern of medicines’ use, and there were also significant age-related differences in 2019. To the best of our knowledge, our study is the first nationwide analysis of reimbursed medicines’ consumption data in the elderly, which is essential to characterize the use of medicines in this age group in Portugal. |
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Prevalence of Outpatient Use of Medicines by the Elderly Population in Portugal: A Cross-Sectional StudyPrevalência da Dispensa de Medicamentos em Ambulatório na População Idosa em Portugal: Um Estudo TransversalAgedDrug PrescriptionsOutpatientsPortugalDoentes em AmbulatórioIdosoPortugalPrescrição de MedicamentosIntroduction: Like in other countries, the age pyramid in Portugal has been changing considerably, with a substantial increase in the size of the older population and a significant reduction in the number of young people. With aging, co-occurrence of several conditions becomes frequent, often leading to the use of multiple medications (polypharmacy). Polypharmacy in the older population is particularly relevant considering the physiological changes of the ageing process, which increase the risk of drug interactions, poor adherence to treatment, and adverse drug reactions, especially in the oldest-old population (85 years or older). As the size of the older population is likely to increase significantly, it is important to characterize the pattern of medicines’ use by the elderly while also identifying cases of polypharmacy in order to obtain evidence that can be used to develop specific measures to tackle the high prevalence of use and its associated risks. To this end, the aim of this study was to characterize medication use by older individuals in Portugal. Methods: Cross-sectional study with data from the National Health System’s Control and Monitoring Center on reimbursed medicines that were prescribed and dispensed to individuals aged 65 years or older in 2019 in all community pharmacies of the Portuguese mainland. We performed a demographic and geographic analysis of the data by international nonproprietary name and therapeutic group. The number of reimbursed packages and the number of reimbursed packages per capita were the metrics used (data from Instituto Nacional de Estatística).Results: A higher consumption of medicines was observed in women, increasing with age, except in the oldest olds, in which the sex difference tended to shrink. Use per capita showed an opposite trend, with the oldest-old men surpassing the oldest-old women (mean reimbursed packages: 55.5 in men versus 55.1 in women). In women, consumption was led by cardiovascular medicines (31%), followed by central nervous system medications (30%) and antidiabetics (13%); in men, 37% of TOP 10 consumption was due to cardiovascular medications, antidiabetics (16%) and drugs for benign prostatic hypertrophy (14%).Conclusion: In the elderly, there were sex differences in the pattern of medicines’ use, and there were also significant age-related differences in 2019. To the best of our knowledge, our study is the first nationwide analysis of reimbursed medicines’ consumption data in the elderly, which is essential to characterize the use of medicines in this age group in Portugal.Introdução: À semelhança de outros países, a pirâmide etária em Portugal tem sofrido alterações profundas, com um expressivo aumento na dimensão da população idosa. A multimorbilidade que surge com o envelhecimento leva, frequentemente, à utilização concomitante de vários medicamentos. A polimedicação é particularmente importante no idoso devido às alterações fisiológicas associadas ao processo de envelhecimento, que aumentam o risco de interações medicamentosas, de fraca adesão à terapêutica e de reações adversas à medicação, em particular nos indivíduos muito idosos (85 ou mais anos). Dado que a dimensão da população idosa poderá aumentar significativamente, importa caracterizar o padrão de consumo de medicamentos pelos idosos, identificando também os casos de polifarmácia, de forma a gerar-se evidência que permita o desenvolvimento de medidas específicas de combate à elevada prevalência de utilização e riscos associados. Assim, o objetivo desta análise preliminar foi determinar a prevalência e caracterizar o padrão de utilização de medicamentos pelos idosos em Portugal, desagregando por faixa etária, sexo e localização geográfica. Métodos: Estudo transversal com dados relativos aos medicamentos comparticipados e dispensados nas farmácias comunitárias de Portugal Continental em 2019, aos utentes com mais de 65 anos. Efetuou-se análise descritiva demográfica e geográfica, por denominação comum internacional e grupo terapêutico. A utilização foi estudada através do número de embalagens comparticipadas dispensadas e número de embalagens comparticipadas dispensadas per capita (dados do Instituto Nacional de Estatística).Resultados: Observou-se uma dispensa superior nas mulheres, a qual foi aumentando com a idade, à exceção dos idosos 85+, nos quais a diferença tendeu a diminuir. No que diz respeito ao número de embalagens comparticipadas dispensadas per capita, a tendência foi inversa, com os homens muito idosos a ultrapassarem as mulheres 85+ (média de embalagens: 55,5 nos homens versus 55,1 nas mulheres). Nas mulheres, os medicamentos mais consumidos foram os do foro cardiovascular (31%), seguidos dos prescritos para o sistema nervoso central (30%) e antidiabéticos (13%). Nos homens, o ranking foi liderado também pelos medicamentos para o aparelho cardiovascular (37%); contudo, em segundo lugar surgem os antidiabéticos (16%), seguidos dos medicamentos para a hiperplasia benigna da próstata (14%).Conclusão: Existiram diferenças de sexo e idade relevantes no padrão de dispensa de medicamentos comparticipados nos idosos portugueses em 2019. Esta é a primeira análise publicada de âmbito nacional à dispensa de medicamentos em idosos, sendo essencial para caracterizar o perfil de utilização de medicamentos pelos seniores em Portugal.Ordem dos Médicos2023-07-07info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19254Acta Médica Portuguesa; Vol. 36 No. 12 (2023): December; 792-801Acta Médica Portuguesa; Vol. 36 N.º 12 (2023): Dezembro; 792-8011646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19254https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19254/15270Direitos de Autor (c) 2023 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessCarmona Araújo, AnaFernandes, ElisabeteFranco Ruivo, InêsMachado, Maria do CéuFaria Vaz, AntónioFurtado, Cláudia2023-12-17T03:00:30Zoai:ojs.www.actamedicaportuguesa.com:article/19254Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:02:52.521299Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Prevalence of Outpatient Use of Medicines by the Elderly Population in Portugal: A Cross-Sectional Study Prevalência da Dispensa de Medicamentos em Ambulatório na População Idosa em Portugal: Um Estudo Transversal |
title |
Prevalence of Outpatient Use of Medicines by the Elderly Population in Portugal: A Cross-Sectional Study |
spellingShingle |
Prevalence of Outpatient Use of Medicines by the Elderly Population in Portugal: A Cross-Sectional Study Carmona Araújo, Ana Aged Drug Prescriptions Outpatients Portugal Doentes em Ambulatório Idoso Portugal Prescrição de Medicamentos |
title_short |
Prevalence of Outpatient Use of Medicines by the Elderly Population in Portugal: A Cross-Sectional Study |
title_full |
Prevalence of Outpatient Use of Medicines by the Elderly Population in Portugal: A Cross-Sectional Study |
title_fullStr |
Prevalence of Outpatient Use of Medicines by the Elderly Population in Portugal: A Cross-Sectional Study |
title_full_unstemmed |
Prevalence of Outpatient Use of Medicines by the Elderly Population in Portugal: A Cross-Sectional Study |
title_sort |
Prevalence of Outpatient Use of Medicines by the Elderly Population in Portugal: A Cross-Sectional Study |
author |
Carmona Araújo, Ana |
author_facet |
Carmona Araújo, Ana Fernandes, Elisabete Franco Ruivo, Inês Machado, Maria do Céu Faria Vaz, António Furtado, Cláudia |
author_role |
author |
author2 |
Fernandes, Elisabete Franco Ruivo, Inês Machado, Maria do Céu Faria Vaz, António Furtado, Cláudia |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Carmona Araújo, Ana Fernandes, Elisabete Franco Ruivo, Inês Machado, Maria do Céu Faria Vaz, António Furtado, Cláudia |
dc.subject.por.fl_str_mv |
Aged Drug Prescriptions Outpatients Portugal Doentes em Ambulatório Idoso Portugal Prescrição de Medicamentos |
topic |
Aged Drug Prescriptions Outpatients Portugal Doentes em Ambulatório Idoso Portugal Prescrição de Medicamentos |
description |
Introduction: Like in other countries, the age pyramid in Portugal has been changing considerably, with a substantial increase in the size of the older population and a significant reduction in the number of young people. With aging, co-occurrence of several conditions becomes frequent, often leading to the use of multiple medications (polypharmacy). Polypharmacy in the older population is particularly relevant considering the physiological changes of the ageing process, which increase the risk of drug interactions, poor adherence to treatment, and adverse drug reactions, especially in the oldest-old population (85 years or older). As the size of the older population is likely to increase significantly, it is important to characterize the pattern of medicines’ use by the elderly while also identifying cases of polypharmacy in order to obtain evidence that can be used to develop specific measures to tackle the high prevalence of use and its associated risks. To this end, the aim of this study was to characterize medication use by older individuals in Portugal. Methods: Cross-sectional study with data from the National Health System’s Control and Monitoring Center on reimbursed medicines that were prescribed and dispensed to individuals aged 65 years or older in 2019 in all community pharmacies of the Portuguese mainland. We performed a demographic and geographic analysis of the data by international nonproprietary name and therapeutic group. The number of reimbursed packages and the number of reimbursed packages per capita were the metrics used (data from Instituto Nacional de Estatística).Results: A higher consumption of medicines was observed in women, increasing with age, except in the oldest olds, in which the sex difference tended to shrink. Use per capita showed an opposite trend, with the oldest-old men surpassing the oldest-old women (mean reimbursed packages: 55.5 in men versus 55.1 in women). In women, consumption was led by cardiovascular medicines (31%), followed by central nervous system medications (30%) and antidiabetics (13%); in men, 37% of TOP 10 consumption was due to cardiovascular medications, antidiabetics (16%) and drugs for benign prostatic hypertrophy (14%).Conclusion: In the elderly, there were sex differences in the pattern of medicines’ use, and there were also significant age-related differences in 2019. To the best of our knowledge, our study is the first nationwide analysis of reimbursed medicines’ consumption data in the elderly, which is essential to characterize the use of medicines in this age group in Portugal. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-07-07 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19254 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19254 |
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por |
language |
por |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19254 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19254/15270 |
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Direitos de Autor (c) 2023 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2023 Acta Médica Portuguesa |
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openAccess |
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application/pdf |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 36 No. 12 (2023): December; 792-801 Acta Médica Portuguesa; Vol. 36 N.º 12 (2023): Dezembro; 792-801 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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