Abstract
The use of medicines can be an indicator of healthcare access. Our aim was to evaluate the consumption of medicine and associated factors among adults in Manaus Metropolitan Region, located in the north of Brazil. A cross-sectional population-based study was conducted with adults, ≥18 years old, selected by probabilistic sampling. The outcome was the use of medicine in the previous 15 days. Poisson regression with robust variance was used to calculate the prevalence ratio (PR) of medicine consumption, with 95% confidence interval (CI). Use of medicines was reported by 29% (95% CI: 28-31%) of the participants. People with good (PR: 0.82, 95% CI: 0.72-0.94) and fair (PR: 0.77, 95% CI: 0.65-0.90) health status were shown to use less medication than those with very good health. People with partners (PR: 1.19, 95% CI: 1.08-1.31), and people who had sought healthcare service in the fortnight (PR: 2.16, 95% CI: 1.97-2.37) showed higher medicine consumption. Medical prescription (80.1%) was the main inductor of consumption; purchasing at a drug store (46.4%), and acquiring through the Brazilian Unified Health System (39.6%) were the main ways to obtain medicines. About one-third of adults in the Metropolitan Region of Manaus used medicines regularly, mainly people with very good health, living with partners, and with recent use of a health service.
Highlights
The use and access to prescription drugs is influenced by several factors that may differ depending on the region in Brazil (Haque, 2017)
The majority of the participants (47.6%) had completed high school, reported living with a partner (52.5%), belonged to economic classification C (57.1%), were employed (78.2%), and lived in a house with three to five residents (57%); 86.9% lacked health insurance, 54.4% considered their health to be good, 59.6% had a diagnosis of at least one chronic illness, and 20.9% had resorted to healthcare services in the 15 days prior to the interview (Table I)
The probability of medicine use was 64% in people with very good health status that had used health services in the previous 15 days, and 22% in adults with very poor health that had not used health services in the same period
Summary
The use and access to prescription drugs is influenced by several factors that may differ depending on the region in Brazil (Haque, 2017). In order to cover health expenses, Brazilian citizens have to compromise the family budget; associated with other difficulties to obtain medicines, this constitutes an important barrier. Research on the use of prescription drugs includes examining the practices of prescription, distribution, and consumption of medicine. The research area offers interventions that may improve the quality of these practices, incorporating the results into the Brazilian public health context by strengthening health systems and scaling access (Wettermark, Martino, Elseviers, 2016). The Metropolitan Region of Manaus is characterized by an unequal distribution of wealth, with buying power limited to a small portion of the population. The human development index of the state of Amazonas is medium but some municipalities have poor access to basic sanitation (PNUD 2013; Andrade, Gouveia, D’Ávila et al, 2012)
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