Inappropriate use of medicines and associated factors in Brazil: an approach from a national household survey

Abstract

This article aims to describe the inappropriate use of medicines in the Brazilian urban population and to identify associated factors. We conducted a data analysis of a household survey carried out in Brazil in 2013–14. The sampling plan was done by clusters with representativeness of the urban population and large regions of the country, according to gender and age domains. For this analysis, we considered a sample of adults (≥20 years) who reported having chronic non-communicable diseases, medical indication for drug treatment and medicine use (n = 12 283). We evaluated the prevalence of inappropriate use in the domains: non-adherence, inappropriate use behaviour and inadequate care with medicines, all verified in the following groups of independent variables: demographic and socio-economic characteristics, health and pharmaceutical care, health status and use of medicines. Crude and adjusted prevalence ratios were obtained using robust Poisson regression. It was found 46.1% of people having at least one behaviour of inappropriate use of medicines. The worst results were found for the domain of inappropriate use behaviour, a situation of 36.6% of the users, which included unauthorized prescriber, inadequate source of information and indication of the medicines by non-authorized prescribers. The best result was found for the lack of medicines care, informed by only 4.6% of users who kept expired drugs at home. The inappropriate use of medicines was associated with gender (female), region of residence (Northeast), not visiting the doctor regularly or visiting more than one doctor, not having free access to medicines and using of five or more medicines. There was a high prevalence of inappropriate use, which was associated with both individual and health system characteristics pointing out the need to set priorities as for health education and public interventions.

Access to medicines through health systems in low- and middle-income countries

“…Another study considered the acceptability of medicines based on their rational selection and proper use. Luiza et al (2019) assessed the pervasiveness of inappropriate use of medicines in Brazil, including non-adherence, un-authorized prescribers, and in-appropriate storage of medicines. Nearly half of the survey respondents engaged in at least one conduct of inappropriate medicine use, with many obtaining medicine prescriptions from non-formal sources.…”

Kronik Hastalığı Olan ve Olmayan Bireylerde Akılcı İlaç Kullanımı, Sağlık Anksiyetesi ve Siberkondri

“…Araştırmacılar tarafından oluşturulan form katılımcıların yaş, cinsiyet, eğitim düzeyi, ekonomik durum ve çalışma durumu gibi sosyo-demografik özellikler ile kronik hastalık varlığı ve sağlık kurumuna başvuru sıklığı gibi sağlık özellikleri ile ilgili sorulardan oluşmaktadır (5,7,8,9,13).…”

“…Bu nedenle DSÖ gerek morbidite ve mortaliteyi azaltmak, gerekse ilaç harcamalarını kontrol altına almak için sağlık personeli ve ilaç tüketicilerinin akılcı ilaç kullanımına riayet etmesini istemektedir (6). Bu konuda yapılan çalışmalar toplumun akılcı ilaç kullanımında iyileşmeler olduğuna, ancak istenilen düzeye gelinemediğine işaret etmektedir (7)(8)(9).…”

Educação em saúde como estratégia articulada entre Farmácia Universitária e Escolas públicas do Estado do Rio de Janeiro para a promoção do uso racional de medicamentos

“…Porém, embora as diretrizes relacionadas sejam bem robustas em solo nacional, o uso irracional de medicamentos é bastante perceptível. Uma pesquisa recente investigou o uso de medicamentos na população urbana brasileira e verificou que 46,1% das pessoas apresentaram, pelo menos, um comportamento de uso inadequado de medicamentos (Luiza et al, 2019). Segundo os autores, essa alta prevalência sinaliza a crescente necessidade de estratégias de educação em saúde.…”