Rozenfeld Suely, Fonseca Maria J M, Acurcio Francisco A
National School of Public Health/Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil.
Rev Panam Salud Publica. 2008 Jan;23(1):34-43. doi: 10.1590/s1020-49892008000100005.
To describe drug utilization by Brazilian retirees with an emphasis on inappropriate use.
Cross-sectional study with a simple random sample of 800 retirees of the Brazilian Institute of Social Security, 60 years of age and older, residing in Rio de Janeiro City, through face-to-face interviews.
Medication use in the 15 days before the study was reported by 85% of the sample, with a mean of 3.7 products per person (standard deviation=2.9). About half the sample used one to four medications and a third used five or more. The highest number of drugs used per patient was 24. More women than men used multiple medications. There is a tendency toward positive association (P<0.001) between drug use and variables relating to disease and health care. This trend continues in the analysis by gender. Men who reported five or more diseases were five times more likely to use multiple drugs than men with up to two (zero, one, or two) diseases (prevalence ratio 5.21, 95% confidence interval=2.48-10.90). Women who reported five or more diseases were nearly four times more likely to use multiple drugs than women with up to two diseases (prevalence ratio 3.67, 95% confidence interval=2.24-6.02). Of the active substances used by the sample, 10% were considered inappropriate.
To improve drug therapy for the elderly, health practitioners can take measures to reduce unwarranted use of medication and to optimize the benefits from important drugs. Further studies should be conducted to adjust lists of medications inappropriate for the elderly to the situation in developing countries.
描述巴西退休人员的药物使用情况，重点关注不当用药情况。
采用横断面研究，通过面对面访谈，对巴西社会保障研究所800名60岁及以上居住在里约热内卢市的退休人员进行简单随机抽样。
85%的样本报告在研究前15天内使用过药物，人均使用3.7种药物（标准差=2.9）。约一半的样本使用1至4种药物，三分之一使用5种或更多药物。每位患者使用药物的最高数量为24种。使用多种药物的女性多于男性。药物使用与疾病和医疗保健相关变量之间存在正相关趋势（P<0.001）。按性别分析时这种趋势依然存在。报告患有5种或更多疾病的男性使用多种药物的可能性是患有至多2种（0种、1种或2种）疾病男性的5倍（患病率比值5.21，95%置信区间=2.48-10.90）。报告患有5种或更多疾病的女性使用多种药物的可能性几乎是患有至多2种疾病女性的4倍（患病率比值3.67，95%置信区间=2.24-6.02）。样本使用的活性物质中，10%被认为是不当的。
为改善老年人的药物治疗，医疗从业者可采取措施减少不必要的药物使用，并优化重要药物的益处。应开展进一步研究，根据发展中国家的情况调整不适用于老年人的药物清单。
