Prevalência e fatores associados à polifarmácia entre idosos atendidos na atenção primária à saúde de Marau/RS

Abstract

Objective: To describe the prevalence of polypharmacy, verify its distribution according to sociodemographic, behavioral and health characteristics and identify the frequency of drug class. Methodology: Cross-sectional essay, carried out with elderly people (≥60 years), followed up in Primary Health Care (PHC) in the city of Marau, RS. Data were collected online from electronic medical records and the study was approved by the UFFS Ethics Committee for Research with Human Beings (opinion No. 4,769,903). The non-probabilistic sample consisted of those who had at least one medical and/or nursing consultation in 2019. The analysis included relative and absolute frequencies, prevalence of polypharmacy (CI95), variation of its distribution according to its independent variables (chi-square 5%) and description of the frequency of drug classes used. Results: In the sample of 1,728 elderly people, there was a predominance of women (60.1%), aged between 60-69 years (53.2%), incomplete elementary school (83.3%) and who did not have a paid job (91%). Regarding health characteristics, 61.7% of the sample was overweight, 66.5% had systemic arterial hypertension and 44.3% had multimorbidity. The prevalence of polypharmacy was 52% (CI95 50-55), being higher in women (55.6%; p<0.001), age ≥80 years (62.5%; p<0.001), incomplete elementary school (57 .7%; p=0.001) and who did not work (57.2%; p=0.031). Regarding behavioral characteristics, polypharmacy was more prevalent in elderly people who used medicinal plants (60%; p=0.003), integrative and complementary practices (61.7%; p=0.001) and who did not use alcoholic beverages (52.7 %; p=0.04). In addition, there was statistical significance of the outcome with all chronic non-communicable diseases (NCDs), especially overweight (60.6%; p<0.001), systemic arterial hypertension (62.4%; p<0.001), dyslipidemia (63.9%; p<0.001), diabetes mellitus (74%; p<0.001), heart disease (75.8%; p<0.001), kidney disease (70%; p=0.005); stroke (75%; p<0.001), acute myocardial infarction (87.8%; p<0.001) and multimorbidity (71.4%; p<0.001). Regarding the drug classes used by polymedicated elderly, there was a higher prevalence of antihypertensive drugs (91.4%), statins (70.2%), non-steroidal anti-inflammatory drugs (NSAIDs) (50.7%), antidepressants (43.4%) and proton pump inhibitors (48%). Conclusion: The data obtained in the present study showed a high rate of polypharmacy in elderly people treated at PHC. Special attention should be given to this population, as polypharmacy was related to the presence of multimorbidity, causing greater risks of drug interactions and adverse effects. In addition, the frequency of medication used by polymedicated elderly was observed, which presented, worryingly, inappropriate medication for the elderly according to the Beers criteria. The impact caused by polypharmacy in the elderly should be focused, since this population is more susceptible to side effects, which may interfere with quality of life and the effectiveness of treatment.