Drug utilization and polypharmacy among the elderly: a survey in Rio de Janeiro City, Brazil

Objectives. To describe drug utilization by Brazilian retirees with an emphasis on inappropriate use. Methods. Cross-sectional study with a simple random sample of 800 retirees of the Brazilian Institute of Social Security, 60 years of age and older, residing in Rio de Janeiro City, through face-to-face interviews. Results. Medication use in the 15 days before the study was reported by 85% of the sample, with a mean of 3.7 products per person (standard deviation = 2.9). About half the sample used one to four medications and a third used five or more. The highest number of drugs used per patient was 24. More women than men used multiple medications. There is a tendency toward positive association (P < 0.001) between drug use and variables relating to disease and health care. This trend continues in the analysis by gender. Men who reported five or more diseases were five times more likely to use multiple drugs than men with up to two (zero, one, or two) diseases (prevalence ratio 5.21, 95% confidence interval = 2.48-10.90). Women who reported five or more diseases were nearly four times more likely to use multiple drugs than women with up to two diseases (prevalence ratio 3.67, 95% confidence interval = 2.24-6.02). Of the active substances used by the sample, 10% were considered inappropriate. Conclusions. To improve drug therapy for the elderly, health practitioners can take measures to reduce unwarranted use Of medication and to optimize the benefits from important drugs. Further studies should be conducted to adjust lists of medications inappropriate for the elderly to the situation in developing countries.