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巴西老年人的多重用药情况:与社会人口学因素及医疗服务可及性的关联

Polypharmacy among older adults in Brazil: Association with sociodemographic factors and access to health services.

作者信息

Ramos Karina Alves, Boing Alexandra Crispim, Andrade Juliana Mara, Bof de Andrade Fabíola

机构信息

René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, MG, Brazil.

Federal University of Santa Catarina, Florianopolis, SC, Brazil.

出版信息

Dialogues Health. 2022 Nov 13;1:100078. doi: 10.1016/j.dialog.2022.100078. eCollection 2022 Dec.

Abstract

BACKGROUND

Polypharmacy is common among older adults and is of public health concern, since pharmacological therapy influences the quality of care for older individuals. Few studies have addressed its prevalence and correlates in low or middle-income countries. Objective: To evaluate the prevalence of polypharmacy in a representative sample of the Brazilian older population and its association with sociodemographic conditions and factors related to access to health services.

METHODS

Cross-sectional study with data from the last National Health Survey, conducted in 2019. The dependent variable was polypharmacy (five or more medications) and independent variables were: sociodemographic characteristics, general health conditions and access to health services indicator.

RESULTS

The prevalence of polypharmacy was 19.2%. Polypharmacy was higher among those aged 80 years and over compared to those aged 60-69 years (prevalence ratio (PR) 1.47; 95% CI: 1.30; 1.66); individuals with complete elementary education (PR 1.35; 95% CI: 1.13; 1.60) versus those who did not go to school; with 3+ chronic diseases (PR 11.14; 95% CI: 7.94; 15.63); those with limitations in basic activities of daily life (PR 1.49; 95% CI: 1.35; 1.63) and possession of private medical health insurance (PR 1.32; 95% CI 1.19; 1.46). Being in a marital relationship was inversely associated with polypharmacy (PR 0.88; 95% CI: 0.80; 0.96).

CONCLUSION

Polypharmacy affects a significant proportion of the Brazilian older population and is associated with sociodemographic factors and access to health services.

摘要

背景

多重用药在老年人中很常见,这是一个公共卫生问题,因为药物治疗会影响老年人的护理质量。很少有研究探讨其在低收入或中等收入国家的患病率及相关因素。目的:评估巴西老年人群代表性样本中多重用药的患病率及其与社会人口学状况和获得卫生服务相关因素的关联。

方法

采用2019年进行的上一次全国健康调查数据进行横断面研究。因变量为多重用药(服用五种或更多药物),自变量为:社会人口学特征、总体健康状况和获得卫生服务指标。

结果

多重用药的患病率为19.2%。80岁及以上人群的多重用药率高于60 - 69岁人群(患病率比值(PR)为1.47;95%置信区间:1.30;1.66);完成小学教育的个体(PR为1.35;95%置信区间:1.13;1.60)与未上学的个体相比;患有3种及以上慢性病的个体(PR为11.14;95%置信区间:7.94;15.63);日常生活基本活动受限的个体(PR为1.49;95%置信区间:1.35;1.63)以及拥有私人医疗保险的个体(PR为1.32;95%置信区间1.19;1.46)。处于婚姻关系与多重用药呈负相关(PR为0.88;95%置信区间:0.80;0.96)。

结论

多重用药影响了相当比例的巴西老年人群,且与社会人口学因素和获得卫生服务有关。

相似文献

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Polypharmacy among the elderly: a population-based study.老年人的多重用药:一项基于人群的研究。
Rev Bras Epidemiol. 2017 Apr-Jun;20(2):335-344. doi: 10.1590/1980-5497201700020013.

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Longevity leap: mind the healthspan gap.长寿飞跃:关注健康寿命差距。
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