Prevalence of Self-Medication and Associated Factors in an Elderly Population: A Systematic Review
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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.
Verification of self-medication prevalence and associated factors in the elderly, as well as identification of the main categories of non-prescription drugs utilized.
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.
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.
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.
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.
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.
KeywordsElectronic Supplementary Material Table Medical Appointment Kappa Index Central Nervous System Drug Cardiovascular Agent
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.
- 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
- 7.World Health Organization. The uses of epidemiology in the study of the elderly. Geneva: WHO; 1984.Google Scholar
- 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.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
- 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
- 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