Potentially inappropriate medication use in a city of Southeast Brazil

Mauro Cunha Xavier Pinto,Felipe Ferré,Marcos Luciano Pimenta Pinheiro

doi:10.1590/s1984-82502012000100009

Abstract

Potentially inappropriate medication use by the Diamantina (Minas Gerais State) population was investigated by analyzing medicine consumption, self-medication, polypharmacy and drug interactions of medicines prescribed among those interviewed. Level of knowledge about rational drug use and its relationship to socio-economic variables was also evaluated using a semi-structured questionnaire. This survey was based on stratified sampling of 423 individuals selected randomly. The prevalence of prescription drug consumption was 42.32% (n=179) and cardiovascular drugs were the most prescribed. Drug interactions were found in 45.81% (n=82) of prescriptions and 92.68% (n=76) of these interactions were moderate, with co-administration of cardiovascular drugs occurring in more than half of the cases. The inappropriate use of medication, according to Beers criteria, occurred in 44.73% of prescriptions to the elderly. The prevalence of self-medication was 63.34% (n=268) while 21.99% (n=91) of individuals administered medications to their children without formal prescriptions, where this practice was associated to analgesic/antipyretic consumption. The population showed a high prevalence of inappropriate use of drugs across all strata of society, representing an issue requiring effective actions to promote rational use of medicines.

Highlights

Medicines are an important therapeutic tool used for treating diseases, accounting for a significant improvement in health status of the population when used in a rational manner (Aquino, 2008; Arrais et al, 1997; Vilarino et al, 1998)
In Brazil the inappropriate use of medication is common in the context of polypharmacy, self-medication and drug interactions, and can result in the occurrence of iatrogenic diseases or poisoning (Loyola Filho et al, 2002; Hohl et al, 2001)
The most common problem found in polypharmacy prescriptions is drug interactions, responsible for some adverse drug reactions in patients (Hohl et al, 2001)

Summary

Introduction

Medicines are an important therapeutic tool used for treating diseases, accounting for a significant improvement in health status of the population when used in a rational manner (Aquino, 2008; Arrais et al, 1997; Vilarino et al, 1998). In Brazil the inappropriate use of medication is common in the context of polypharmacy, self-medication and drug interactions, and can result in the occurrence of iatrogenic diseases or poisoning (Loyola Filho et al, 2002; Hohl et al, 2001). Polypharmacy, defined as the use of two or more drugs at the same time, occurs mainly in elderly patients with comorbidities, but may take place due to lack of coordination between prescribers and self-medication concomitantly with the prescribed treatment (Loyola Filho et al, 2008; Rozenfeld et al, 2008). The most common problem found in polypharmacy prescriptions is drug interactions, responsible for some adverse drug reactions in patients (Hohl et al, 2001). In Brazil, there are few population-based studies on drug interactions while the technology to detect these interactions is generally unavailable to physicians, nurses and pharmacists, rendering the monitoring of medication-related problems in patients a challenging task

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