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Elisabeth Françahttp://lattes.cnpq.br/7527639560141499http://lattes.cnpq.br/3295385431275287MARIA ÂNGELA MARTINS PINHEIRO2022-11-09T15:50:51Z2022-11-09T15:50:51Z2002-04-16http://hdl.handle.net/1843/47077Este estudo teve como objetivo investigar a prevalência de consumo inadequado de medicamentos entre idosos residentes na comunidade e fatores associados a este consumo. Foram entrevistados 165 idosos residentes no bairro Eldorado, município de Montes Claros, Minas Gerais. A coleta dos dados foi realizada por meio de entrevista domiciliar de curta duração, utilizando-se questionário estruturado e testado. Os idosos foram questionados sobre o consumo de medicamentos prescritos e automedicação. Foram também coletadas informações sobre variáveis relativas à saúde do idoso, à utilização de serviços e dados sócio- demográficos selecionados. Para avaliar o consumo inadequado de medicamentos, foi utilizado critério desenvolvido por Beers et al. (1991). O uso inadequado de medicamentos foi a variável dependente do estudo. A magnitude da associação entre o uso inadequado de medicamentos e as variáveis de exposição foi estimada utilizando-se o odds ratio e o intervalo de confiança a 95%. A significância estatística das diferenças foi determinada usando-se o teste do qui-quadrado ao nível de p<0,05. Os respondestes foram os idosos em 90,3% das entrevistas. A idade variou de 60 a 94 anos, sendo que 77% foram classificados como "idosos jovens". As mulheres representavam 57,6% da amostra. Quanto ao estado civil, 58,2% eram casados, 31,5% eram viúvos e 10,3% solteiros ou separados. A renda foi de um salário mínimo em 67,3% dos indivíduos. Os idosos eram analfabetos em sua maioria. Os problemas mais frequentes mencionados foram: Hipertensão Arterial Sistêmica, diabetes, "reumatismo", "dores" inespecíficas e alterações do humor. Do total dos idosos, 90,3% consumiam pelo menos uma droga: 81,8% (n=135) consumiam medicamentos prescritos e 8,5% (n=14) utilizavam somente medicamentos sem prescrição; 51,7% (n=77) consumiam tanto drogas prescritas quanto sem prescrição. A média de fármacos consumidos por idoso foi de 3,8. Mais de um quarto dos idosos usavam quatro ou mais fármacos. Foram encontradas 33 classes terapêuticas e mais 45 medicamentos que não puderam ser classificados pelo critério de classificação utilizado por este estudo. Dos pacientes que utilizavam medicamentos prescritos, 68,9% usavam medicamentos inadequados. As drogas inadequadas mais prescritas foram os antihipertensivos e os psicoativos. Em relação à análise de associação para o uso de medicamentos inadequados, não houve significância estatística para as variáveis: idade, sexo, estado civil, atividade, escolaridade e renda. Também não se verificou associação significativa entre o uso de medicamentos inadequados e variáveis relativas à condição de saúde e utilização de serviços como: número de problemas relatados, percepção da saúde, número de consultas e internação prévia. Os idosos que usavam mais de dois medicamentos apresentaram chance 4,06 vezes maior de estarem consumindo pelo menos um medicamento inadequado (OR=4,06; IC a 95% 1,66-10,12). A poli farmácia (usar três ou mais medicamentos) esteve associada ao número de problemas de saúde referidos. Para o idoso que referiu mais de três problemas, a chance de consumir múltiplas drogas foi seis vezes maior, quando comparados com os idosos que informaram menos de três problemas (OR=6,00; IC a 95%, 1,99-19,37). A percepção negativa dos idosos sobre a sua saúde se associou significativamente com o consumo de mais de três fármacos, quando comparados com os idosos que informaram uma percepção positiva (OR=5,38; IC a 95%,2,23-13,14). Os idosos que adquiriram seus medicamentos na farmácia básica do Centro de Saúde apresentaram quase sete vezes mais chance de consumirem medicamentos inadequados (OR=6,57; IC a 95% 2,70-16,01). Os dados apresentados permitem afirmar que a prevalência do consumo de drogas inadequadas foi elevada entre os idosos residentes na comunidade estudada. Esses dados indicam a necessidade de melhorar o padrão de prescrições e disponibilizar drogas adequadas e mais seguras para os idosos.The purpose of this survey is to investigate the prevalence of inappropriate drug use and its associated factors in community dwelling elderly. We conducted in home interviews with 165 subjects aged 60 years and older, living in the community of one neighborhood of Montes Claros, Brazil (population 306.0000 approximately). Trained interviewers visited all clients at home. Subjects were asked to report all use of prescription drugs and over-thecounter medications. In addition the interviewers collected information on health and health care use, as well as data on the social demographics, education, income, number of chronic conditions, retirement, occupation and general perception on one's own health. Inappropriate medication use was evaluated using explicit criteria developed through a Delphi consensus process by BEERS et al (1991). This criteria identifies drugs that should generally be avoided in elderly use in nursing homes subjects regardless of clinical circumstances. It uses, basically, three concepts: prescription medicines that should be entirely avoided in the elderly, excessive dosage, and excessive duration of treatment. The units of analysis on all computations were the individual subject and the drug consumption. At first there was a distribution of frequency on the different variables analyzed in order to evaluate the general characteristics of the subjects. The use of inappropriate drugs was the independent variable. To identify the associated factors of using inappropriate drugs, the subjects were compared in two groups of appropriate and inappropriate users of drugs in relation to one specific factor at a time. To verify the odds between the associated factors and the use of inappropriate drugs was utilized the odds ratio on a 95% interval (confidence limit). The statistic significance of the differences was detected using the chi-square on a level of p < 0,05. The survey was answered by 90,3% solely and 9,7% had a companion to help. The age of the elderly varied from 60 to 94 with an average of 69 years of age. The age class between 60 and 74 years counted 77%. There were 57,ó% women. There were 58,2% married, 31,5% widowed and 10,3% single or separated. There were 67,3% that had an income of one minimum salary. Most of the elderly were illiterate with 65,5% and 34,5% informed that they knew how to read and write. The elders mentioned their problems in order of most frequent as being: high blood pressure, diabetes, "rheumatism", generic pain and changes in humor. According to the standard of medicine consumption, out of the 165 elders, only 9,7% did not use any medication and 90,3% consumed at least one prescribed medication (81,8%) or over-the-counter drugs (8,5%). The average medicine use is 3,8 drugs per patient. Over a quarter of the subjects used four or more medications (polypharmacy). There were 33 therapeutical classes and 45 pharmaceutical substances which could not be classified because they didn't follow model list of essential drugs (1999). On the class of the patients who used prescribed medicines, 68,9 % of them were inadequate. The inadequate drugs prescribed were the antihypertensives and sedative-hypnotics. There weren't any statistic association between the inadequate prescribed drugs and some variables (age, gender, marital status, school education, income, self perception of health and memory, number of office visits, hospital admissions). On the other hand, the elderly people who use more than 3 medicines are 4,26 times more likely to be taking at least one inadequate drug (OR=4,26; 1,41 -13,82). The polypharmacy (4 or more medications) is also associated with the self referred illnesses. The elder who self referred more than 3 illnesses is 4 times more likely to be taking more than 3 medicines (OR=3,87; 1,68-9.04) and 6 times more likely if he referred 4 illnesses (OR=6,00; 1,99-19,37). This results demonstrated an important progressive association. The older people who dispense medicine on the public pharmacy unit is 7 times more likely to be getting some inappropriate drug than the ones who buy it on the private pharmacy (OR=6,57; 2,70-16,01). The polypharmacy is associated with the negative self health perception too. The ones who have a negative self perception are 3,34 times more likely to use more than 3 medicines (OR=3,34; 1,49-7,61). This study provides representative data of medication usage among older people in Montes Claros - Brazil. The prevalence of inappropriate prescribed drug use was very high. That might demonstrate that the physicians lack knowledge about the differences of pharmacokinetics and pharmacodynamics applied to the elderly people. Another hypothesis is that the public health system doesn't offer appropriate drugs for the older people. As there aren't the appropriate drugs on the public pharmacy, the tendency is that the medical doctor will prescribe the medicines available, even when they aren't the safest.porUniversidade Federal de Minas GeraisPrograma de Pós-Graduação em Saúde PúblicaUFMGBrasilMEDICINA - FACULDADE DE MEDICINAIdosoUso de MedicamentosAtenção Primária à SaúdeGeriatriaIdosoUso de MedicamentosAtenção Primária à SaúdeGeriatriaConsumo inadequado de medicamentos entre idosos em Montes Claros, Minas Geraisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINALDissertação Maria Ângela nov2013.pdfDissertação Maria Ângela nov2013.pdfapplication/pdf2928301https://repositorio.ufmg.br/bitstream/1843/47077/1/Disserta%c3%a7%c3%a3o%20Maria%20%20%c3%82ngela%20nov2013.pdfc4d7d8e1545a645e6a0a05bf7be286edMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-82118https://repositorio.ufmg.br/bitstream/1843/47077/2/license.txtcda590c95a0b51b4d15f60c9642ca272MD521843/470772022-11-09 12:50:51.774oai:repositorio.ufmg.br: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ório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2022-11-09T15:50:51Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
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