Advertisement

Drugs & Aging

, Volume 31, Issue 12, pp 883–896 | Cite as

Prevalence of Self-Medication and Associated Factors in an Elderly Population: A Systematic Review

  • Javier Jerez-Roig
  • Lucas F. B. Medeiros
  • Victor A. B. Silva
  • Camila L. P. A. M. Bezerra
  • Leandro A. R. Cavalcante
  • Grasiela Piuvezam
  • Dyego L. B. Souza
Systematic Review

Abstract

Background

The aging of the world populat ion together with changes in the epidemiological profile of diseases have led to increases in both the consumption of medicines and health expenses. In this context, self-medication has gained importance as a rapid treatment that bypasses bureaucracy and, in some instances, delays in obtaining medical assistance.

Objective

Verification of self-medication prevalence and associated factors in the elderly, as well as identification of the main categories of non-prescription drugs utilized.

Data Sources

The following databases were utilized: Cochrane, PubMed, Scopus, LILACS, SciELO, PAHO, MedCarib and WHOLIS.

Study Eligibility Criteria

Studies on the prevalence of self-medication in community-dwelling elderly were included. Review studies were excluded, as well as MSc dissertations, PhD theses and research with convenience sampling.

Participants

Community-dwelling individuals aged 60 years or over.

Study Appraisal and Synthesis Methods

A systematic review of population-based articles published up until September 1, 2014, is presented. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) Statement was applied for critical assessment of the articles, and those with a minimum score of 60 % were selected for inclusion in the review.

Results

Thirty-six articles were selected, of which 28 were included after critical reading. The prevalence of self-medication varied between 4 and 87 %, and the majority of studies reported values between 20 and 60 %. The mean prevalence reported in the articles was 38 %, but several criteria were utilized to measure self-medication. The most commonly utilized non-prescription drugs were analgesics and antipyretics, followed by non-hormonal anti-inflammatories, cardiovascular agents, dietary complements and alternative medicine components. The variables that presented positive associations with self-medication were female sex, visits to pharmacists, depression, functional dependency, recent hospitalization, oral pain, restriction of activities and physical inactivity. The variables with negative associations were medical appointments, married status, use of health services, satisfaction with living arrangements, living in institutional settings and private health plans.

Limitations

Different definitions of self-medication were employed in the identified articles, which hindered the comparison between studies and meta-analysis. Only 15 studies analysed associated factors and a minority carried out multivariate data analysis.

Conclusion

Self-medication is frequent among the elderly, with different prevalence values found in the selected studies, probably because of heterogeneity in definitions and samples. Future studies are necessary, utilizing a standard self-medication criterion to facilitate comparison and elucidate the factors associated with this behaviour.

Keywords

Electronic Supplementary Material Table Medical Appointment Kappa Index Central Nervous System Drug Cardiovascular Agent 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors wish to thank the Virtual Library of Health Sciences of the Balearic Islands (Spain) (Biblioteca Virtual de Ciències de la Salut de les Illes Balears) for providing the articles utilized in this review.

Sources of funding

No sources of funding were used to assist in the preparation of this review.

Conflicts of interest

The authors have no potential conflicts of interest that are directly relevant to the content of this review.

Supplementary material

40266_2014_217_MOESM1_ESM.docx (48 kb)
Supplementary material 1 (DOCX 47 kb)

References

  1. 1.
    de Oliveira MA, Francisco PM, Costa KS, Barros MB. Self-medication in the elderly population of Campinas, São Paulo State, Brazil: prevalence and associated factors. Cad Saude Publica. 2012;28:335–45.PubMedCrossRefGoogle Scholar
  2. 2.
    Goh LY, Vitry AI, Semple SJ, Esterman A, Luszcz MA. Self-medication with over-the-counter drugs and complementary medications in South Australia’s elderly population. BMC Complement Altern Med. 2009;9:42.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Woo J, Ho SC, Yuen YK, Lau J. Drug use in an elderly Chinese population: prevalence and associated factors. Gerontology. 1995;41:98–108.PubMedCrossRefGoogle Scholar
  4. 4.
    Loyola Filho AI, Uchoa E, Guerra HL, Firmo JO, Lima-Costa MF. Prevalence and factors associated with self-medication: the Bambui Health Survey. Rev Saude Publica. 2002;36:55–62.Google Scholar
  5. 5.
    Schmid B, Bernal R, Silva NN. Self-medication in low-income adults in Southeastern Brazil. Rev Saude Publica. 2010;44:1039–45.PubMedCrossRefGoogle Scholar
  6. 6.
    Miralles MA, Kimberlin CL. Perceived access to care and medication use among ambulatory elderly in Rio de Janeiro, Brazil. Soc Sci Med. 1998;46:345–55.PubMedCrossRefGoogle Scholar
  7. 7.
    World Health Organization. The uses of epidemiology in the study of the elderly. Geneva: WHO; 1984.Google Scholar
  8. 8.
    Turner A, Hochschild A, Burnett J, Zulfiqar A, Dyer CB. High prevalence of medication non-adherence in a sample of community-dwelling older adults with adult protective services-validated self-neglect. Drugs Aging. 2012;29:741–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Ünsal A, Demir G. The prevalence of chronic disease and drug use in the elderly in central Kirsehir. Turkish J Geriatr. 2010;13:244–51.Google Scholar
  10. 10.
    World Health Organization (WHO). The role of the pharmacist in self-care and self-medication. Report of the 4th WHO Consultive Group on the Role of the Pharmacist. Geneva: World Health Organization; 1998.Google Scholar
  11. 11.
    Simons LA, Tett S, Simons J, Lauchlan R, McCallum J, Friedlander Y, et al. Multiple medication use in the elderly. Use of prescription and non-prescription drugs in an Australian community setting. Med J Aust. 1992;157:242–6.PubMedGoogle Scholar
  12. 12.
    Qato DM, Alexander GC, Conti RM, Johnson M, Schumm P, Lindau ST. Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States. JAMA. 2008;300:2867–78.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. BMJ. 2007;335:806–8.CrossRefGoogle Scholar
  14. 14.
    Balbuena FR, Aranda AB, Figueras A. Self-medication in older urban Mexicans: an observational, descriptive, cross-sectional study. Drugs Aging. 2009;26:51–60.PubMedCrossRefGoogle Scholar
  15. 15.
    Loyola Filho AI, Uchoa E, Firmo JO, Lima-Costa MF. A population-based study on use of medications by elderly Brazilians: the Bambui Health and Aging Study (BHAS). Cad Saude Publica. 2005;21:545–53.PubMedCrossRefGoogle Scholar
  16. 16.
    Coelho Filho JM, Marcopito LF, Castelo A. Medication use patterns among elderly people in urban area in Northeastern Brazil. Rev Saude Publica. 2004;38:557–64.PubMedCrossRefGoogle Scholar
  17. 17.
    Hanlon JT, Fillenbaum GG, Burchett B, Wall WE Jr, Service C, Blazer DG. Drug-use patterns among black and nonblack community-dwelling elderly. Ann Pharmacother. 1992;26:679–85.PubMedGoogle Scholar
  18. 18.
    Carrasco-Garrido P, Hernandez-Barrera V, de Lopez Andres A, Jimenez-Trujillo I, Jimenez-Garcia R. Sex-differences on self-medication in Spain. Pharmacoepidemiol Drug Saf. 2010;19:1293–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Nielsen MW, Hansen EH, Rasmussen NK. Prescription and non-prescription medicine use in Denmark: association with socio-economic position. Eur J Clin Pharmacol. 2003;59:677–84.PubMedCrossRefGoogle Scholar
  20. 20.
    Barros e Sá M, Barros JAC, OliveiraSá MPB. Self-medication in the elderly of the city of Salgueiro, State of Pernambuco. Rev Bras Epidemiol. 2007;10:75–85.Google Scholar
  21. 21.
    Stuck AE, Beers MH, Steiner A, Aronow HU, Rubenstein LZ, Beck JC. Inappropriate medication use in community-residing older persons. Arch Intern Med. 1994;154:2195–200.PubMedCrossRefGoogle Scholar
  22. 22.
    Stoehr GP, Ganguli M, Seaberg EC, Echement DA, Belle S. Over-the-counter medication use in an older rural community: the MoVIES Project. J Am Geriatr Soc. 1997;45:158–65.PubMedGoogle Scholar
  23. 23.
    Arcury TA, Bell RA, Anderson AM, Chen H, Savoca MR, Kohrman T, et al. Oral health self-care behaviors of rural older adults. J Public Health Dent. 2009;69:182–9.PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Poole C, Jones D, Veitch B. Relationships between prescription and non-prescription drug use in an elderly population. Arch Gerontol Geriatr. 1999;28:259–71.PubMedCrossRefGoogle Scholar
  25. 25.
    Marin MJ, Cecilio LC, Perez AE, Santella F, Silva CB, Goncalves Filho JR, et al. Use of medicines by the elderly in a Family Health Program unit in Brazil. Cad Saude Publica. 2008;24:1545–55.PubMedCrossRefGoogle Scholar
  26. 26.
    Pinto M, Ferré F, Pinheiro M. Potentially inappropriate medication use in a city of Southeast Brazil. Braz J Pharm Sci. 2012;48:79–86.CrossRefGoogle Scholar
  27. 27.
    Stoller EP. Prescribed and over-the-counter medicine use by the ambulatory elderly. Med Care. 1988;26:1149–57.PubMedCrossRefGoogle Scholar
  28. 28.
    Barat I, Andreasen F, Damsgaard EM. The consumption of drugs by 75-year-old individuals living in their own homes. Eur J Clin Pharmacol. 2000;56:501–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Krska J, Jones L, McKinney J, Wilson C. Medicine safety: experiences and perceptions of the general public in Liverpool. Pharmacoepidemiol Drug Saf. 2011;20:1098–103.PubMedCrossRefGoogle Scholar
  30. 30.
    Bortolon PC, de Medeiros EF, Naves JO, Karnikowski MG, Nobrega OT. Analysis of the self-medication pattern among Brazilian elderly women. Cien Saude Colet. 2008;13:1219–26.PubMedCrossRefGoogle Scholar
  31. 31.
    Cohen I, Rogers P, Burke V, Beilin LJ. Predictors of medication use, compliance and symptoms of hypotension in a community-based sample of elderly men and women. J Clin Pharm Ther. 1998;23:423–32.PubMedCrossRefGoogle Scholar
  32. 32.
    Flores VB, Benvegnu LA. Use of medicines by the elderly in Santa Rosa, Rio Grande do Sul State, Brazil. Cad Saude Publica. 2008;24:1439–46.PubMedCrossRefGoogle Scholar
  33. 33.
    Helling DK, Lemke JH, Semla TP, Wallace RB, Lipson DP, Cornoni-Huntley J. Medication use characteristics in the elderly: the Iowa 65+ Rural Health Study. J Am Geriatr Soc. 1987;35:4–12.PubMedGoogle Scholar
  34. 34.
    Hale WE, May FE, Marks RG, Stewart RB. Drug use in an ambulatory elderly population: a five-year update. Drug Intell Clin Pharm. 1987;21:530–5.PubMedGoogle Scholar
  35. 35.
    Moore JF, Johnson JE. Over-the-counter drug use by the rural elderly. Geriatr Nurs. 1993;14:190–1.PubMedCrossRefGoogle Scholar
  36. 36.
    Neves SJ, Marques AP, Leal MC, Diniz Ada S, Medeiros TS, Arruda IK. Epidemiology of medication use among the elderly in an urban area of Northeastern Brazil. Rev Saude Publica. 2013;47:759–68.PubMedCrossRefGoogle Scholar
  37. 37.
    Gazibara T, Nurkovic S, Kisic-Tepavcevic D, Kurtagic I, Kovacevic N, Gazibara T, et al. Pharmacotherapy and over-the-counter drug use among elderly in Belgrade, Serbia. Geriatr Nurs. 2013;34:486–90.PubMedCrossRefGoogle Scholar
  38. 38.
    Santos TR, Lima DM, Nakatani AY, Pereira LV, Leal GS, Amaral RG. Medicine use by the elderly in Goiania, Midwestern Brazil. Rev Saude Publica. 2013;47:94–103.PubMedCrossRefGoogle Scholar
  39. 39.
    Halapy H, Kertland H. Ascertaining problems with medication histories. Can J Hosp Pharm. 2012;65:360–7.PubMedCentralPubMedGoogle Scholar
  40. 40.
    Puig-Junoy J. Impact of European pharmaceutical price regulation on generic price competition: a review. Pharmacoeconomics. 2010;28:649–63.PubMedCrossRefGoogle Scholar
  41. 41.
    Kanavos P. Do generics offer significant savings to the UK National Health Service? Curr Med Res Opin. 2007;23:105–16.PubMedCrossRefGoogle Scholar
  42. 42.
    Saverno K, Gothe H, Schuessel K, Biskupiak J, Schulz M, Siebert U, et al. Consideration of international generic distribution policies on patient outcomes in the United States and Germany. Pharmazie. 2014;69:238–40.PubMedGoogle Scholar
  43. 43.
    Nobrega OT, Marques AR, Araujo AC, Karnikowski MG, Naves JO, Silver LD. Retail prices of essential drugs in Brazil: an international comparison. Rev Panam Salud Publica. 2007;22:118–23.CrossRefGoogle Scholar
  44. 44.
    Flores LM, Mengue SS. Drug use by the elderly in Southern Brazil. Rev Saude Publica. 2005;39:924–9.PubMedCrossRefGoogle Scholar
  45. 45.
    Telles Filho PCP, Almeida AGP, Pinheiro MLP. Self-medication in the elderly: a public health problem. Rev enferm UERJ Rio de Janeiro. 2013;21:197–201.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Javier Jerez-Roig
    • 1
    • 2
  • Lucas F. B. Medeiros
    • 3
  • Victor A. B. Silva
    • 3
  • Camila L. P. A. M. Bezerra
    • 3
  • Leandro A. R. Cavalcante
    • 3
  • Grasiela Piuvezam
    • 4
  • Dyego L. B. Souza
    • 4
  1. 1.Graduate Program in Collective HealthFederal University of Rio Grande do NorteNatalBrazil
  2. 2.Hospital Can MissesIbizaSpain
  3. 3.Federal University of Rio Grande do NorteOnofre Lopes University HospitalNatalBrazil
  4. 4.Graduate Program in Collective HealthFederal University of Rio Grande do NorteNatalBrazil

Personalised recommendations