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BACKGROUND: Physician and patient-related characteristics can influence prescription of medications to older patients within primary healthcare. Use of Brazilian criteria may indicate the real prevalence of prescription of potentially inappropriate medications to this population. OBJECTIVES: To evaluate prescription of potentially inappropriate medications to older patients within primary care and identify patient-related and prescribing physician-related factors. DESIGN AND SETTING: This cross-sectional study was conducted in 22 public primary care facilities in Brazil, among older people (≥ 60 years) who were waiting for medical consultations. METHODS: Interviews were conducted before and after the medical consultations. If the patient received a medical prescription at the consultation, all the drugs prescribed and the physician's medical council registration number were recorded. Prevalence ratios were estimated to ascertain the magnitude of prescription of potentially inappropriate medications, along with patient and physician-related factors associated with such prescription. RESULTS: In total, 417 older patients were included; 45.3% had received ≥ 1 potentially inappropriate medication, and 86.8% out of 53 physicians involved had prescribed ≥ 1 potentially inappropriate medication. The strongest patient-related factor associated with higher prevalence of prescription of potentially inappropriate medications was polypharmacy. Among physician-related factors, the number of patients attended, number of prescriptions and length of medical practice < 10 years were positively associated with prescription of potentially inappropriate medications. CONCLUSIONS: High prevalence of prescription of potentially inappropriate medications was observed. Physician-related characteristics can influence prescription of medications to older people within primary healthcare. This suggests that there is a need for interventions among all physicians, especially younger physicians.

Rationale, aims, and objectives Misunderstanding medication dosage regimen instructions can lead to unintentional misuse of a prescribed medicine, non‐adherence to providers' instructions, and other treatment‐related issues. We aimed to evaluate the frequency of and factors associated with older patients' misunderstanding of medication dosage regimen instructions after consultation with a general practitioner. Method This cross‐sectional study was conducted in 22 primary‐care facilities in Brazil. Data were collected from September 2016 to December 2017 using a multidimensional questionnaire. Patients who were 60 years old or older who visited primary care units were included in the study (n = 416). Results Of the older patients interviewed, 38.2% had a misunderstanding of medication dosage regimen instructions; being female was a protective factor against the misunderstanding of medication dosage regimen instructions (prevalence ratio [PR] = 0.63; 95% confidence interval [CI] = 0.45‐0.89). In relation to other factors with an important association, misunderstanding medication dosage regimen instructions was 71% higher among illiterate participants (PR = 1.71; 95% CI = 1.25‐2.35), 39% higher among people who considered their memory to be poor (PR = 1.39; 95% CI = 1.01‐1.91), 49% higher in those who did not have a job at the time of the interview (PR = 1.49; 95% CI = 1.01‐2.19), and 50% higher in patients who had been prescribed five or more medications (PR = 1.50; 95% CI = 1.02‐2.20). Conclusions The results showed that older people's misunderstandings of medication dosage regimen instructions after consultation with a general practitioner was greater than expected due to a range of factors, especially polypharmacy, poor literacy, poor memory, and having a job at the time of the interview. Health services and professionals should implement strategies to increase the quality of the guidance given to elderly individuals and to ensure their adherence to the regimen instructions of their medications.

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O surgimento do vírus SARS-CoV-2 associado à sua rápida transmissão fez com que governantes de todo o mundo adotassem medidas prioritárias a fim de mitigá-lo. Apesar da importância da estruturação adequada do ambiente hospitalar para o combate à pandemia, também é necessário uma abordagem comunitária que promova a vigilância em saúde, atuação específica das equipes de Atenção Primária à Saúde. Sendo assim, pretende-se contextualizar o cenário atual e pontuar os desafios e possibilidades da Atenção Primária à Saúde frente à pandemia da COVID-19. Nos últimos anos, o SUS sofreu com um subfinanciamento crônico que foi agravado com redução e congelamento dos gastos. A Atenção Primária à Saúde no cenário da pandemia do coronavírus tem a potencialidade de se articular intersetorialmente para apoiar sua população em suas diversas vulnerabilidades. Apesar dos desafios enfrentados pela Atenção Primária à Saúde, a pandemia reafirma sua importância para o sistema de saúde e sinaliza a necessidade do seu fortalecimento, readequação e qualificação a fim de garantir a universalidade, integralidade e equidade do cuidado.