Cost-related underuse of medications in older adults: ELSI-Brazil

Detalhes bibliográficos
Autor(a) principal: Loyola Filho,Antônio Ignácio de
Data de Publicação: 2018
Outros Autores: 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
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.
id USP-23_026a5869f02da3293bbdb010e424b3ee
oai_identifier_str oai:scielo:S0034-89102018000300505
network_acronym_str USP-23
network_name_str Revista de Saúde Pública
repository_id_str
spelling 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