Evidence map›Paper›PMID 30379284›Full record

ArticleRevista de saude publica2018

Cost-related underuse of medications in older adults: ELSI-Brazil.

Antônio Ignácio de Loyola Filho, Josélia Oliveira Araújo Firmo, Juliana Vaz de Melo Mambrini, Sérgio Viana Peixoto, Paulo Roberto Borges de Souza Junior, Fabíola Bof de Andrade, Maria Fernanda Lima-Costa, Francisco de Assis Acúrcio

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Article in Revista de saude publica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Antônio Ignácio de Loyola FilhoFundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.
Josélia Oliveira Araújo FirmoFundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.
Juliana Vaz de Melo MambriniFundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.
Sérgio Viana PeixotoFundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.
Paulo Roberto Borges de Souza JuniorFundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Fabíola Bof de AndradeFundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.
Maria Fernanda Lima-CostaFundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.
Francisco de Assis AcúrcioUniversidade Federal de Minas Gerais. Faculdade de Farmácia. Departamento de Farmácia Social. Belo Horizonte, MG, Brasil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the prevalence and factors associated with cost-related underuse of medications in a nationally representative sample of Brazilians aged 50 years and over.

methodsAmong the 9,412 participants of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), 6,014 reported using at least one medication on regular basis and were included in the analysis. Underuse of medications was by stopping taking or reducing the number of tablets or the dose of any prescribed medication for financial reasons. The theoretical framework used for the selection of the exploratory variables included predisposing factors, enabling factors, and factors of need. Associations were tested by Poisson regression.

resultsThe prevalence of underuse of medications was 10.6%. After adjustments for relevant covariables, positive and statistically significant associations (p < 0.05) with the outcome were found for females [prevalence ratio (PR) = 1.39], sufficiency of the family income for expenses (PR = 1.74 for sometimes and PR 2.42 for never), frequency with which the physician explains about the disease and treatment (PR = 1.31 for rarely or never), number of medications used (PR = 1.39 for 2-4 and 1.53 for 5 or more), fair (PR = 2.02) and poor or very poor self-rated health (PR = 2.92), and a previous medical diagnosis of depression (PR = 1.69). Negative associations were observed for the age groups of 60-79 years (PR = 0.75) and 80 years and over (PR = 0.43), socioeconomic status of the household (PR = 0.70, 0.79, and 0.60 for the second, third, and fourth quartile, respectively), and private health plan coverage (PR = 0.79). There were no associations between hypertension and self-reported diabetes and underuse of medications.

conclusionsCost-related underuse of medications is multidimensional and complex, and it covers socio-demographic characteristics, health conditions, and the use of health services. The explanation about the disease and its treatment to the patient and the expansion of the universal access to pharmaceutical care can minimize the risks of underuse.

Indexed as

Drug MonitoringAgedAged, 80 and overBrazilCross-Sectional StudiesDrug UtilizationFemaleHumansLongitudinal StudiesMaleMiddle AgedPrevalenceRisk FactorsSocioeconomic Factors

Identifiers

PMID30379284
PMCPMC6255256

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.