Factors associated with potentially inappropriate medication use by the elderly in the Brazilian primary care setting.
BACKGROUND
The exposure of elderly patients to potentially inappropriate medication (PIM) is associated with the increased use of health care services.


OBJECTIVE
To evaluate both the prevalence of and the factors associated with the use of PIM by elderly patients who are being treated in primary healthcare facilities.


METHODS
Family Health Programme centres in northeastern Brazil.


METHODS
A prospective survey of the medications used by elderly patients was performed. A total of 142 participants were randomly selected via systematic sampling. Beers criteria were applied to assess the use of PIM among the investigated sample. All of the medications included in these criteria were assessed for their availability in Brazil. The prevalence of inappropriate medications was chosen as an occurrence measure and was compared among the exposure groups using the prevalence ratio (PR) as a measure of association.


METHODS
Prevalence and various factors associated with the use of PIM. Results The prevalence of PIM usage was 34.5 %. The factors that exhibited associations included the following: illiteracy (PR = 1.51; 95 % CI = 1.02-2.24); black skin colour (PR = 1.80; 95 % CI = 1.40-2.32); the use of ≥4 drugs per day (PR = 2.36; 95 % CI = 1.79-3.11); the use of medications prescribed by a doctor (PR = 2.52; 95 % CI = 1.12-5.69), and the use of medications supplied by the Brazilian government (PR = 1.42; 95 % CI = 1.10-1.81). The most frequently prescribed PIM included short-acting nifedipine (34.5 %) and methyldopa (9.1 %).


CONCLUSIONS
The data collected in this study indicated a high prevalence of the use of PIM. The factors that contributed the most to this prevalence included medical prescriptions, polypharmacy, medications supplied by the Brazilian National Health System, and black skin colour (specifically, being of African descent).
Campus Anísio Teixeira, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Rua Rio de Contas, 58, Quadra 17, Lote 58, Bairro Candeias, Vitória da Conquista, Bahia, CEP: 45029-094, Brazil. mgalvao@ufba.br
Márcio Galvão
MG
Oliveira
Welma Wildes
WW
Amorim
Sandra Rêgo
SR
de Jesus
Victor Alves
VA
Rodrigues
Luiz Carlos
LC
Passos
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors