Prevalência da polifarmácia e fatores associados em pacientes atendidos em um ambulatório indígena

Abstract

Objectives: This study aimed to estimate the prevalence of polypharmacy—defined as the simultaneous use of five or more medications—and the factors associated with it among patients treated at an Indigenous outpatient clinic in Passo Fundo, RS, as well as to characterize the sample and identify the main pharmacological classes used by polypharmacy patients. Methods: This is a cross-sectional study, with a sample consisting of patients treated from August 2021 to June 2024 at an Indigenous outpatient clinic, including individuals of both sexes aged 20 years or older. Data were obtained from electronic medical records and included sociodemographic, lifestyle, and health-related variables. Absolute and relative frequencies of these variables were calculated for sample description. In addition, the drugs used by patients with polypharmacy were classified according to their pharmacological action for frequency calculation. The prevalence of polypharmacy was estimated with a 95% confidence interval (95% CI). The relationship between polypharmacy (outcome) and exposure (independent) variables was assessed using the chi-square or Fisher’s exact test, adopting a 5% type I error. Results: In the sample (n = 570), a polypharmacy prevalence of 4% (95% CI: 3–6) was observed, with a statistically significant difference in relation to age (15.8% among patients aged 60 years or older; p < 0.001), and to the diagnoses of systemic arterial hypertension (11.7%; p < 0.001), diabetes mellitus (20.3%; p < 0.001), dyslipidemia (17.2%; p < 0.001), depression (16%; p < 0.001), and multimorbidity (19.5%; p < 0.001). Conclusions: Polypharmacy is a reality among Indigenous populations and is closely related to advancing age. Furthermore, health variables such as chronic diseases (hypertension, diabetes mellitus, dyslipidemia, and depression) and multimorbidity were associated with the outcome. The medications most frequently used by polypharmacy patients were those acting on the cardiovascular and endocrine systems, reflecting the most prevalent diseases in the studied population. Therefore, strategies aimed at promoting the rational use of medicines should be developed to address polypharmacy in Indigenous populations.