(P-191) Use of Potentially Inapropriate Medicines by Elderly People in Primary Care of the Unified Health System (SUS) in Brazil

Background: Changes in senescence and common multimorbidity in the elderly people make the use of some Medicines Potentially Inappropriate (PIM) in this age group. However, few studies with national representativeness present data on the prevalence of PIM use among elderly Brazilians.

Objectives: To analyze the prevalence of PIM in the elderly people assisted by primary health care of the SUS and the associated factors.

Methods: Cross-sectional study that is part of the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM) - Services component, 2015, with a representative sample of the Brazilian population. The sample consisted of people aged 65 or over, with data collection performed in PHC services, from July / 2014 to May / 2015. For the classification of PIM, the Beers criterion 2019 was adopted and polypharmacy was defined as the concomitant use of five or more medicines. The association analyzes were performed using the test chi Pearson -square and prevalence ratio determined by Poisson regression with robust variance, using software Stata ® 13.0.

Results: The study population consisted of 1,157 elderly, with 63.4% (95% CI 59.9-66.7) being female; 58.7% (95% CI 54.1-63.2) married; and 58.8% (95% CI 50.4-66.7) with incomplete elementary education. Most of the elderly (93.86% CI95% 92.32-95.17) used at least one medicine in the 30 days prior to the interview, an average of 2.87 ± 2.12 medicines/elderly. Among the identifiable drugs (n = 3,336), 22.24% were classified by the Beers Criterion 2019 as PIM for the majority of the elderly, being aspirin (23.39%), omeprazole (18.06%) and glyburide (9.84%) most used. An association (p <0.05) was found between the use of PIM and the use of polypharmacy (PR 2.01 CI 95% 1.80-2.23); need for emergency care in the 12 months prior to the interview (PR 1.16 CI 95% 1.04-1.30); self-medication (PR 1.12 CI 95% 1.01-1.26) and diagnosis of depression (PR 1.28 CI 95% 1.15-1.43), rheumatism (PR 1.18 CI 95% 1.05-1, 32) and arterial hypertension (PR 0.81 CI 95% 0.69-0.94).

Conclusions: The use of PIM is prevalent among the elderly people treated by primary health care in Brazil and is associad the chronic diseases, polypharmacy and risks to health. These results can be used as subsidies for the development of policies that promote the rational use of medicines among elderly Brazilians.