Cost-related underuse of medications in older adults: ELSI-Brazil
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102018000300505 |
Resumo: | ABSTRACT OBJECTIVE To assess the prevalence and factors associated with cost-related underuse of medications in a nationally representative sample of Brazilians aged 50 years and over. METHODS Among the 9,412 participants of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), 6,014 reported using at least one medication on regular basis and were included in the analysis. Underuse of medications was by stopping taking or reducing the number of tablets or the dose of any prescribed medication for financial reasons. The theoretical framework used for the selection of the exploratory variables included predisposing factors, enabling factors, and factors of need. Associations were tested by Poisson regression. RESULTS The prevalence of underuse of medications was 10.6%. After adjustments for relevant covariables, positive and statistically significant associations (p < 0.05) with the outcome were found for females [prevalence ratio (PR) = 1.39], sufficiency of the family income for expenses (PR = 1.74 for sometimes and PR 2.42 for never), frequency with which the physician explains about the disease and treatment (PR = 1.31 for rarely or never), number of medications used (PR = 1.39 for 2–4 and 1.53 for 5 or more), fair (PR = 2.02) and poor or very poor self-rated health (PR = 2.92), and a previous medical diagnosis of depression (PR = 1.69). Negative associations were observed for the age groups of 60–79 years (PR = 0.75) and 80 years and over (PR = 0.43), socioeconomic status of the household (PR = 0.70, 0.79, and 0.60 for the second, third, and fourth quartile, respectively), and private health plan coverage (PR = 0.79). There were no associations between hypertension and self-reported diabetes and underuse of medications. CONCLUSIONS Cost-related underuse of medications is multidimensional and complex, and it covers socio-demographic characteristics, health conditions, and the use of health services. The explanation about the disease and its treatment to the patient and the expansion of the universal access to pharmaceutical care can minimize the risks of underuse. |
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Cost-related underuse of medications in older adults: ELSI-BrazilUnderuse of MedicationsPrescription DrugsHealth of the Older AdultsCross-Sectional StudyPharmacoepidemiologyABSTRACT OBJECTIVE To assess the prevalence and factors associated with cost-related underuse of medications in a nationally representative sample of Brazilians aged 50 years and over. METHODS Among the 9,412 participants of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), 6,014 reported using at least one medication on regular basis and were included in the analysis. Underuse of medications was by stopping taking or reducing the number of tablets or the dose of any prescribed medication for financial reasons. The theoretical framework used for the selection of the exploratory variables included predisposing factors, enabling factors, and factors of need. Associations were tested by Poisson regression. RESULTS The prevalence of underuse of medications was 10.6%. After adjustments for relevant covariables, positive and statistically significant associations (p < 0.05) with the outcome were found for females [prevalence ratio (PR) = 1.39], sufficiency of the family income for expenses (PR = 1.74 for sometimes and PR 2.42 for never), frequency with which the physician explains about the disease and treatment (PR = 1.31 for rarely or never), number of medications used (PR = 1.39 for 2–4 and 1.53 for 5 or more), fair (PR = 2.02) and poor or very poor self-rated health (PR = 2.92), and a previous medical diagnosis of depression (PR = 1.69). Negative associations were observed for the age groups of 60–79 years (PR = 0.75) and 80 years and over (PR = 0.43), socioeconomic status of the household (PR = 0.70, 0.79, and 0.60 for the second, third, and fourth quartile, respectively), and private health plan coverage (PR = 0.79). There were no associations between hypertension and self-reported diabetes and underuse of medications. CONCLUSIONS Cost-related underuse of medications is multidimensional and complex, and it covers socio-demographic characteristics, health conditions, and the use of health services. The explanation about the disease and its treatment to the patient and the expansion of the universal access to pharmaceutical care can minimize the risks of underuse.Faculdade de Saúde Pública da Universidade de São Paulo2018-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102018000300505Revista de Saúde Pública v.52 suppl.2 2018reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USP10.11606/s1518-8787.2018052000622info:eu-repo/semantics/openAccessLoyola Filho,Antônio Ignácio deFirmo,Josélia Oliveira AraújoMambrini,Juliana Vaz de MeloPeixoto,Sérgio VianaSouza Junior,Paulo Roberto Borges deAndrade,Fabíola Bof deLima-Costa,Maria FernandaAcúrcio,Francisco de Assiseng2018-10-23T00:00:00Zoai:scielo:S0034-89102018000300505Revistahttp://www.scielo.br/scielo.php?script=sci_serial&pid=0034-8910&lng=pt&nrm=isoONGhttps://old.scielo.br/oai/scielo-oai.phprevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2018-10-23T00:00Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Cost-related underuse of medications in older adults: ELSI-Brazil |
title |
Cost-related underuse of medications in older adults: ELSI-Brazil |
spellingShingle |
Cost-related underuse of medications in older adults: ELSI-Brazil Loyola Filho,Antônio Ignácio de Underuse of Medications Prescription Drugs Health of the Older Adults Cross-Sectional Study Pharmacoepidemiology |
title_short |
Cost-related underuse of medications in older adults: ELSI-Brazil |
title_full |
Cost-related underuse of medications in older adults: ELSI-Brazil |
title_fullStr |
Cost-related underuse of medications in older adults: ELSI-Brazil |
title_full_unstemmed |
Cost-related underuse of medications in older adults: ELSI-Brazil |
title_sort |
Cost-related underuse of medications in older adults: ELSI-Brazil |
author |
Loyola Filho,Antônio Ignácio de |
author_facet |
Loyola Filho,Antônio Ignácio de Firmo,Josélia Oliveira Araújo Mambrini,Juliana Vaz de Melo Peixoto,Sérgio Viana Souza Junior,Paulo Roberto Borges de Andrade,Fabíola Bof de Lima-Costa,Maria Fernanda Acúrcio,Francisco de Assis |
author_role |
author |
author2 |
Firmo,Josélia Oliveira Araújo Mambrini,Juliana Vaz de Melo Peixoto,Sérgio Viana Souza Junior,Paulo Roberto Borges de Andrade,Fabíola Bof de Lima-Costa,Maria Fernanda Acúrcio,Francisco de Assis |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Loyola Filho,Antônio Ignácio de Firmo,Josélia Oliveira Araújo Mambrini,Juliana Vaz de Melo Peixoto,Sérgio Viana Souza Junior,Paulo Roberto Borges de Andrade,Fabíola Bof de Lima-Costa,Maria Fernanda Acúrcio,Francisco de Assis |
dc.subject.por.fl_str_mv |
Underuse of Medications Prescription Drugs Health of the Older Adults Cross-Sectional Study Pharmacoepidemiology |
topic |
Underuse of Medications Prescription Drugs Health of the Older Adults Cross-Sectional Study Pharmacoepidemiology |
description |
ABSTRACT OBJECTIVE To assess the prevalence and factors associated with cost-related underuse of medications in a nationally representative sample of Brazilians aged 50 years and over. METHODS Among the 9,412 participants of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), 6,014 reported using at least one medication on regular basis and were included in the analysis. Underuse of medications was by stopping taking or reducing the number of tablets or the dose of any prescribed medication for financial reasons. The theoretical framework used for the selection of the exploratory variables included predisposing factors, enabling factors, and factors of need. Associations were tested by Poisson regression. RESULTS The prevalence of underuse of medications was 10.6%. After adjustments for relevant covariables, positive and statistically significant associations (p < 0.05) with the outcome were found for females [prevalence ratio (PR) = 1.39], sufficiency of the family income for expenses (PR = 1.74 for sometimes and PR 2.42 for never), frequency with which the physician explains about the disease and treatment (PR = 1.31 for rarely or never), number of medications used (PR = 1.39 for 2–4 and 1.53 for 5 or more), fair (PR = 2.02) and poor or very poor self-rated health (PR = 2.92), and a previous medical diagnosis of depression (PR = 1.69). Negative associations were observed for the age groups of 60–79 years (PR = 0.75) and 80 years and over (PR = 0.43), socioeconomic status of the household (PR = 0.70, 0.79, and 0.60 for the second, third, and fourth quartile, respectively), and private health plan coverage (PR = 0.79). There were no associations between hypertension and self-reported diabetes and underuse of medications. CONCLUSIONS Cost-related underuse of medications is multidimensional and complex, and it covers socio-demographic characteristics, health conditions, and the use of health services. The explanation about the disease and its treatment to the patient and the expansion of the universal access to pharmaceutical care can minimize the risks of underuse. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102018000300505 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102018000300505 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.11606/s1518-8787.2018052000622 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
publisher.none.fl_str_mv |
Faculdade de Saúde Pública da Universidade de São Paulo |
dc.source.none.fl_str_mv |
Revista de Saúde Pública v.52 suppl.2 2018 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1748936505118687232 |