Abstract

ObjectiveWe aimed to investigate the consumption and lack of access to medicines in the adult population of Manaus, Amazonas.MethodsA population-based study was conducted in Manaus in 2019. Individuals aged ≥18 years were selected by probabilistic sampling performed in three stages. Study outcomes included the consumption of medicines in the previous fortnight and the lack of access to treatments in those who used any medicine. We calculated the prevalence ratios (PR) for the outcomes with 95% confidence intervals (CI) by Poisson regression with robust variance, considering the complex sampling design.ResultsOut of the 2,321 participants, 53.2% (95%CI 50.7-55.7%) consumed medicines, of which 14.4% (95% CI 11.9–16.8%) could not obtain appropriate treatments. Analgesics were the most used medicines (557/2,702; 21.4%), whereas antibiotics were the most inaccessible treatments (18/228; 7.9%). Lack of financial resources was the main reason for not accessing treatments (104/228; 45.6%). Consumption was significantly associated with older age (≥60 years: PR = 1.27; 95%CI 1.09–1.49), lower social class (D/E: PR = 0.84; 95%CI 0.72–0.99), lower educational level (p = 0.039), poor health status (PR = 1.30; 95%CI 1.11–1.52), use of health care services (PR = 1.37; 95%CI 1.26–1.49), and chronic diseases (PR = 1.36; 95%CI 1.22–1.52). Lack of access was higher in people with poor health status (PR = 2.46; 95%CI 1.50–4.04) and chronic diseases (PR = 1.84; 95%CI 1.16–2.92).ConclusionHalf of Manaus’ population used medicines, which was higher in socially privileged and sicker individuals. Among those, 14 in every 100 could not access drug therapies, which was more frequent in people with poor health and with chronic diseases.

Highlights

  • The use and access to medicines are important indicators of population health due to their role in promoting health maintenance and reducing global morbidity and mortality (Ofori-Asenso, 2016)

  • The free availability of medicines and access to health care services from SUS are imperative for these individuals (Andrade et al, 2018), but previous studies indicate that the Brazilian pharmaceutical policy is not ensuring access to essential medicines to the entire population (Bertoldi et al, 2012)

  • The consumption of medicines was more frequent among women (51.4%), individuals aged 25 to 34 years (30.9%), nonwhite/Asian people (84.7%), those belonging to middle-class (54.6%), individuals who completed high school (60.6%), people with good health status (57.8%) and no health insurance (84.1%), those who did not use health care services in the previous 15 days (62.2%), and people with chronic diseases (67.5%)

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Summary

Methods

A population-based study was conducted in Manaus in 2019. Individuals aged ≥18 years were selected by probabilistic sampling performed in three stages. Study outcomes included the consumption of medicines in the previous fortnight and the lack of access to treatments in those who used any medicine. We calculated the prevalence ratios (PR) for the outcomes with 95% confidence intervals (CI) by Poisson regression with robust variance, considering the complex sampling design

Results
Conclusion
INTRODUCTION
Study Design
Participants and Sample Size
DISCUSSION
ETHICS STATEMENT
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