Polypharmacy among adult and older adult users of primary care services delivered through the Unified Health System in Minas Gerais, Brazil.

Abstract

Objectives: To estimate the prevalence of polypharmacy (≥5 drugs) among adults and to analyze related factors. Methods: Cross-sectional study with 1,159 interviewees distributed across 104 cities and 253 primary healthcare services delivered through the Brazilian Unified Health System. Polypharmacy-related factors were identified using logistic regression model. Results: 949 (81.8%) interviewees were using at least one medication and were included in this analysis. The prevalence of polypharmacy among them was 13.7% (95%CI:11.7–16.0%) in the general population and 33.3%(95%CI:26.1–41.4%) in older adults(≥65 years). Polypharmacy was positively associated with age (45 to 64 years, OR=2.02; 95%CI:1.03–3.94; ≥65 years, OR=4.17; 95%CI:1.92–9.17) and the following chronic diseases: stroke (OR=4.20; 95%CI:1.53–11.55); diabetes mellitus (OR=4.03; 95%CI:2.43–6.68); heart disease (OR=3.18; 95%CI:1.92–5.29); depression (OR=2.85; 95%CI:1.80–4.53); hypertension (OR=2.13; 95%CI:1.17–3.86); and dyslipidemia (OR=1.73; 95%CI:1.07–2.80). Conclusion: This study revealed that polypharmacy is a real concern in primary health care and affects older and middle-aged adults alike. Groups of patients that are more likely to experience polypharmacy were identified. Our findings emphasize the relevance of an appropriate approach to polypharmacy driven by aging and multimorbidity.