Silva Isabella Ribeiro, Gonçalves Luana Giatti, Chor Dora, Fonseca Maria de Jesus Mendes da, Mengue Sotero Serrate, Acurcio Francisco de Assis, Pereira Mariana Linhares, Barreto Sandhi Maria, Figueiredo Roberta Carvalho de
Universidade Federal de São João del-Rei, Divinópolis, MG, Brazil.
Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Rev Bras Epidemiol. 2020;23:e200077. doi: 10.1590/1980-549720200077. Epub 2020 Jul 6.
To estimate the prevalence of polypharmacy, describe the pharmacotherapeutic classes used, and investigate whether polypharmacy is associated with demographic and socioeconomic indicators, regardless of the number of diseases, among participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010).
In this analysis, 14,523 adults and elderly (35-74 years) participated. Polypharmacy was characterized as regular use of five or more medicines. The demographic and socioeconomic indicators analyzed were: gender, age, education level, per capita family income, and access to private health insurance. The independent association between demographic and economic indicators and polypharmacy was estimated by binary logistic regression.
The prevalence of polypharmacy was 11.7%. The most used drugs were those with action on the cardiovascular system. After adjustments, including by number of diseases, the chances of being on polypharmacy treatment were significantly higher among women, older participants and those with greatest number of diseases. Individuals without health insurance had lower chance to be under polypharmacy, as well as those with lower income.
The occurrence of polypharmacy among ELSA-Brasil baseline participants was mainly due to drugs for the treatment of chronic diseases. The relation between polypharmacy and the female gender, as well as its association with old age, are in consonance with the results obtained in other studies. Despite the absence of an association between polypharmacy and education level, the income and health insurance results reinforce the existence of social inequalities regarding drug use.
在巴西成人健康纵向研究（ELSA - Brasil）基线期（2008 - 2010年）的参与者中，评估多重用药的患病率，描述所使用的药物治疗类别，并调查多重用药是否与人口统计学和社会经济指标相关，而不考虑疾病数量。
在本次分析中，14523名成年人及老年人（35 - 74岁）参与其中。多重用药被定义为规律使用五种或更多药物。所分析的人口统计学和社会经济指标包括：性别、年龄、教育水平、家庭人均收入以及是否拥有私人医疗保险。通过二元逻辑回归估计人口统计学和经济指标与多重用药之间的独立关联。
多重用药的患病率为11.7%。使用最多的药物是作用于心血管系统的药物。在进行调整后，包括按疾病数量进行调整，女性、年龄较大的参与者以及疾病数量最多的参与者接受多重用药治疗的几率显著更高。没有医疗保险的个体以及收入较低的个体接受多重用药治疗的几率较低。
ELSA - Brasil基线期参与者中多重用药的发生主要归因于治疗慢性病的药物。多重用药与女性性别之间的关系以及与老年的关联，与其他研究所得结果一致。尽管多重用药与教育水平之间不存在关联，但收入和医疗保险方面的结果强化了在药物使用方面社会不平等的存在。
