Polypharmacy in adults and elderly registered in the Family Health Strategy: association with sociodemographic, lifestyle, social support network and health factors

• Autor(a) principal: Andrade, Nathália de Oliveira
• Data de Publicação: 2020
• Outros Autores: Alves, Aline Martins, Luchesi, Bruna Moretti, Martins, Tatiana Carvalho Reis
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Brasileira de Medicina de Família e Comunidade (Online)
• Texto Completo: https://www.rbmfc.org.br/rbmfc/article/view/2462
• topic: Polypharmacy; Primary Health Care; Family Health Strategy; Aging.; Polifarmacia; Atención Primaria de Salud; Estrategia de Salud Familiar; Envejecimiento.; Polimedicação; Atenção Primária à Saúde; Estratégia Saúde da Família; Envelhecimento.

Introduction: In the global context, there is a change in the profile of morbidity and mortality due to demographic and epidemiological transitions, related to increase in the number of elderly people and chronic non-communicable diseases. In this scenario, polypharmacy has become frequent and, therefore, its damages are visualized. The use of multiple medications increases the risk of potentially inappropriate prescriptions, which promotes pharmacological interactions, adverse drug events and hospitalizations. There is also a burden on the health system and health care. Objective: To identify factors associated with polypharmacy in adults and older adults. Methods: This is a cross-sectional and quantitative study, carried out in 2018 and 2019, with n=147 adults (45-59 years old) and n=153 elderlies (≥60y), registered in the Family Health Strategy (ESF) in in Três Lagoas/MS/Brazil. Sociodemographic characterization, lifestyle, social support network and health information data were collected. The number of drugs of continuous use taken per day was questioned, and the use of five or more medications was considered polypharmacy. Binomial logistic regression was conducted to identify factors associated with polypharmacy. Results: The prevalence of polypharmacy was 10.2% (95% CI = [6.3% -16.2%]) for adults and 17.0% (95% CI = [11.9% -23.7%]) for the elderly. Increased age (OR = 1.32; 95% CI = 1.10-1.59) and no partner (OR = 6.52; 95% CI = 1.59-26) were associated with polypharmacy for the adult group. For the elderly group, the associated factors were having suffered at least one fall in the last year (OR = 3.33; 95% CI = 1.13-9.85), being a smoker (OR = 5.04; 95% CI = 1.30-19.62), assess health as regular (OR = 4.10; 95% CI = 1.16-14.54) or poor/very bad (OR = 6.59; 95% CI = 1.31-33.08). Alcohol consumption was inversely associated with polypharmacy (OR = 0.15; 95% CI = 0.02-0.98) in the elderly. Conclusions: In view of the potential risks offered by polypharmacy, it is essential to distinguish groups in conditions of greater vulnerability to the use of multiple medications and more careful monitoring, in order to ensure greater safety in the prescription of drugs in primary care and the improvement of attention.