Objectives : To estimate the prevalence of polypharmacy among older adults (≥65 years); to verify its association with sociodemographic variables, nutritional status and health conditions; to describe the prevalence of polypharmacy according to the presence of specific chronic diseases, and to report the method of acquiring drugs. Method : A cross-sectional study was performed with older adults (n=2,217) from seven Brazilian municipal regions. The prevalence of polypharmacy and its 95% confidence intervals were estimated. Associations were verified using Pearson’s Chi-squared test with a significance level of 5%, and the independent associations between the selected variables and polypharmacy were verified by multiple hierarchical Poisson regression. Results : The prevalence of polypharmacy was 18.4% (CI95%:16.8-20.0), and was significantly lower among non-white individuals, those who did not have a health plan, and those who assessed their health as very good/good (p<0.05). Obesity: (PR=1.36; CI95%:1.06-1.75), increased waist circumference (PR=1.54; CI95%:1.08-2.20) and presence of two (PR=2.24; CI95%:1.52-3.31) or three or more (PR=4.22; CI95%:2.96-6.02) chronic diseases were positively associated with polypharmacy. Polypharmacy was observed in about 30.0% of older adults with heart disease, diabetes mellitus and/or strokes/CVA/ischemia. The frequency of older adults who acquired drugs in Basic Health Units was 20.3% and those who obtained them via their own/family resources was 13.5%. Conclusion : Among older adults, the identification of segments with a higher prevalence of polypharmacy enables a better structuring of the provision of treatment during their care pathway, allowing special attention to be paid to problems related to the use of drugs.
RESUMO O estudo teve por objetivo estimar a prevalência da realização de Práticas Integrativas e Complementares (PIC) e sua relação com doenças crônicas em idosos brasileiros. Estudo transversal de base populacional realizado com dados da Pesquisa Nacional de Saúde (PNS/2013; n=23.815). Estimaram-se a prevalência de realização de PIC e as frequências relativas das práticas referidas. Realizaram-se comparações entre proporções pelo teste de Rao-Scott com nível de significância de 5% e estimaram-se razões de prevalência para o uso das práticas integrativas e complementares, segundo doenças crônicas. O uso das PIC foi referido por 5,4% (IC95%:4,9-6,0) dos idosos. Entre estes, 62,6% relataram uso de plantas medicinais/fitoterapia; 22,2%, acupuntura; e 11,2%, homeopatia. Somente 6,7% realizaram o tratamento no SUS. Observou-se maior realização das práticas pelas mulheres e para todos os tratamentos considerados (p<0,001); naqueles com colesterol alto, artrite ou reumatismo, problema de coluna e depressão (p<0,05). Os resultados dimensionam o uso das PIC com dados de abrangência nacional, apontando para sua utilização no tratamento das diversas condições de saúde que acometem principalmente os idosos.
Objective: to characterize the sociodemographic profile of elderly persons with arthritis/rheumatism in relation to gender, as well as to estimate the prevalence and factors associated with functional disability for the performance of instrumental activities of daily living (IADL). Method: a cross-sectional population-based study with a sample of 1,136 elderly persons (≥65 years old) from seven Brazilian municipal regions was carried out. Functional capacity was assessed by the self-reports of the elderly in terms of the performance of IADL, using the Lawton Scale. Differences between the genders, according to sociodemographic variables, were verified by the chi-squared test (p<0.05). The prevalence of inability to perform IADL was calculated and the independent associations were verified through multiple logistic regression. Results: the mean age was 72.4 years, 79.1% of the sample were women, and 45.9% of the elderly with arthritis/rheumatism were dependent for the performance of IADL. Differences were observed between the genders in relation to age, marital status, income and household arrangements (p<0.05). A higher prevalence of disability was observed among older elderly persons, those with no schooling and lower incomes, who lived in multigenerational households and who were frail. In the evaluation of the performance of specific activities, elderly persons with arthritis/rheumatism had greater difficulty taking medication (OR: 1,90; CI 95%: 1.19 - 3.06), after adjusting for gender and age. Conclusion: associations were found between functional disability and sociodemographic variables and frailty. Independence in daily activities such as those evaluated in this study is one of the primary conditions for the well-being of the elderly, even in conditions of frailty or chronic diseases.
O objetivo é revisar os artigos científicos publicados nos últimos cinco anos sobre idosos longevos (≥80 anos) e identificar o perfil dessas publicações. Foi realizada uma revisão da literatura, utilizando-se a Biblioteca Virtual em Saúde. A busca resultou na seleção de 36 artigos nacionais e internacionais. Observou-se que a maioria dos estudos era do tipo transversal, realizados em países da Europa e com maior participação de idosos do sexo feminino. Câncer e doenças cardíacas foram os temas mais abordados.
Objetivo: identificar na literatura científica, entre os anos de 2016 e 2018, estudos sobre a polifarmácia em idosos residentes na comunidade. Métodos: revisão integrativa, realizada nas bases de dados PUBMED, BVS/BIREME, SCOPUS, WEB OF SCIENSE, EMBASE, Cochrane Library e CINAHL. Resultados: dezesseis artigos foram selecionados para esta revisão. Quanto ao do uso de medicamentos por idosos residentes na comunidade, os estudos apresentaram a prevalência de uso, características e fatores associados à polifarmácia nos idosos; conhecimento adequado dos medicamentos prescritos; e uso dos medicamentos potencialmente inapropriados. Conclusão: a identificação do uso de medicamentos nos idosos aponta para a necessidade de melhor comunicação entre profissionais e pacientes, incentivar o autocuidado, minimizar o risco de complicações, prevenir iatrogenias e hospitalizações, assim como, reduzir a mortalidade em idosos por uso impróprio de medicamentos.
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