Automedicación y autoprescripción / Self-medication and self-prescription

Resumen La automedicación y la autoprescripción son acciones de los pacientes; la primera como elemento del autocuidado que involucra medicamentos de venta libre y la segunda como una violación a la ley de salud, pues comprende medicamentos que solo pueden expenderse con receta. Todos los inconvenientes que se han atribuido a la automedicación en realidad lo son de la autoprescripción.

Abstract Self-medication and self-prescription are actions undertaken by patients; the former, as an element of self-care that involves over-the-counter drugs, and the latter, as a violation of the Statute of Health, since it includes drugs that can only be dispensed with a medical prescription. All the drawbacks that have been attributed to self-medication are actually associated with self-prescription.

Why deprescribing instead of not prescribing? / Por que desprescrever em vez de não prescrever?

Prescribing medications involves complex cognitive processes, and mistakes in prescription can cause serious adverse events. Deprescribing is one of the last opportunities to prevent patient harm from the use of drugs that should be avoided, especially among older patients. This viewpoint article aims to discuss the prescription process and some essential concepts, such as polypharmacy, prescription of potentially inappropriate medications, and, particularly, the relevance of deprescribing and its relationship with the appropriate prescription of medications in older people.

A prescrição de medicamentos envolve processos cognitivos complexos e erros na prescrição podem causar eventos adversos graves. A desprescrição é uma das últimas oportunidades de prevenir danos ao paciente decorrentes do uso de medicamentos que devem ser evitados, principalmente entre pacientes mais velhos. Este artigo teve como objetivo discutir o processo de prescrição e alguns conceitos essenciais, como a polifarmácia, a prescrição de medicamentos potencialmente inadequados e, particularmente, a relevância da desprescrição e sua relação com a prescrição adequada de medicamentos em idosos.

Understanding Opioid Use After Total Hip Arthroplasty: A Comprehensive Analysis of a Mandatory Prescription Drug Monitoring Program.

INTRODUCTION: Opioids remain the most prescribed medication after total hip arthroplasty (THA) despite the potential for abuse and adverse effects. Given the high rates of opioid abuse and potential adverse effects, the reporting of controlled substances is now mandatory in many statewide databases. This study aimed to use a mandatory statewide database to analyze opioid prescription patterns in postoperative THA patients and identify independent risk factors for those patients who need a second prescription and/or require prolonged use (>6 months). METHODS: We retrospectively reviewed a consecutive series of 619 primary THAs. Demographic and comorbidity information were collected for all patients. Narcotic prescription data (converted to morphine milligram equivalents) as well as prescription data for sedatives, benzodiazepines, and stimulants were collected from the State's Controlled Substance Monitoring websites 6 months before and 9 months after the index procedure. Bivariate and multivariate analyses were done for second prescription and continued use. RESULTS: Of the 619 patients who underwent THA, 34.9% (216/619) used preoperative opioids, 36.2% (224/619) filled a second opioid prescription, and 10.5% (65/619) had continued use past 6 months. Patients with preoperative opioids were at an approximately 4-fold increased odds of requiring a second script and 12 times odds of continued opioid use. In the multivariate analysis, independent risk factors for requiring a second prescription, in descending order of magnitude, included the use of any sedative or sleep aid prescription and preoperative narcotic use. Independent risk factors for continued narcotic use longer than 6 months after THA included preoperative narcotic use and increased length of stay. DISCUSSION: Several risk factors and their relative weight have been identified for continued narcotic consumption after THA. It is important for surgeons to consider these predisposing factors preoperatively during the informed consent process and for managing postoperative pain expectations.

Interactions of clinical relevance associated with concurrent administration of prescription drug and food or medicinal plants: a systematic review protocol.

BACKGROUND: An inadequate combination of prescription drugs with food or medicinal plants could cause adverse effects in patients or produce negative therapeutic results. Therefore, this generic systematic review protocol aims to identify and synthesize the literature on clinical characteristics and safety issues of these types of pharmacological interactions occurring in children, adolescents, adults, pregnant/lactating women, and older adults. METHODS/DESIGN: This generic protocol follows the stated guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. A literature search will be performed in PubMed, Scopus, and Virtual Health Library (VHL) electronic databases from 1960 till present for studies reporting clinical characteristics and safety issues associated with pharmacological interactions occurring between prescription drugs and food or medicinal plants in participants from birth-age to ≥ 65-year-old, including pregnant/lactating women. Lateral searching will be carried out in PubMed via related citation. Two reviewers will carry out an independent evaluation of eligible studies as well as the corresponding data extraction of the selected ones. Subsequently, the methodological quality evaluation of the selected articles will be completed using the corresponding Joanna Briggs Institute Checklists. Moreover, the quality of evidence will be graded according to the criteria of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group. Quantitative research in humans comprising clinical trials and clinical, comparative and, observational studies will be included. The main outcomes of this protocol involve reported potential food-drug and herb-drug interactions, associated safety issues, and adverse reactions along with the generic name of the prescribed drug and the scientific name of the food and medicinal plants involved in these types of pharmacological interactions. Finally, findings extracted from the selected studies will be summarized in a narrative synthesis. DISCUSSION: This generic systematic review protocol seeks to synthesize and critically evaluate current knowledge besides to identify any comprehension gaps in the concurrent administration of prescription drugs with food and herbs. By achieving a better understanding of this topic, this information will allow healthcare professionals to develop useful strategies to recognize, manage, and prevent these types of pharmacological interactions at different age stages, including pregnant/lactating women. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018117308.

Self-medication and self-prescription.

Self-medication and self-prescription are actions undertaken by patients; the former, as an element of self-care that involves over-the-counter drugs, and the latter, as a violation of the Statute of Health, since it includes drugs that can only be dispensed with a medical prescription. All the drawbacks that have been attributed to self-medication are actually associated with self-prescription.La automedicación y la autoprescripción son acciones de los pacientes; la primera como elemento del autocuidado que involucra medicamentos de venta libre y la segunda como una violación a la ley de salud, pues comprende medicamentos que solo pueden expenderse con receta. Todos los inconvenientes que se han atribuido a la automedicación en realidad lo son de la autoprescripción.

Interações medicamentosas potenciais em adultos e idosos na atenção primária / Potential drug interactions in adults and the elderly in primary health care

Resumo O objetivo do presente estudo foi caracterizar as interações medicamentosas potenciais (IMP) e avaliar os fatores associados à sua ocorrência em adultos e idosos assistidos pelo Programa Médico de Família de Niterói, Rio de Janeiro. Trata-se de um subestudo do ESTUDO DIGITALIS, que incluiu indivíduos cadastrados no Programa Médico de Família de Niterói (45-99 anos). Foram analisados 341 indivíduos com prescrição de dois ou mais medicamentos. A classificação das IMP seguiu o MICROMEDEX®. Houve 113 interações diferentes. Do total de indivíduos, 63,6% apresentaram pelo menos uma IMP. As variáveis com maior chance de IMP foram: menor escolaridade; renda inferior a R$800,00; ausência de plano de saúde; diagnóstico de hipertensão, diabetes, infarto agudo do miocárdio; e uso de 5 ou mais medicamentos prescritos. Após ajuste, as variáveis diagnóstico anterior de hipertensão e diabetes e uso de 5 ou mais medicamentos prescritos permaneceram significativas estatisticamente. É importante uma gestão cautelosa do tratamento na atenção básica com monitoramento das IMP, especialmente em pacientes mais susceptíveis.

Abstract The objective of the present study was to characterize the potential drug interactions (PDI), estimating the factors associated to their occurrence in adults and the elderly assisted by the Programa Médico de Família de Niterói, Rio de Janeiro. This is a sub-study of STUDY DIGITALIS, which included individuals enrolled in the Niteroi Family Medical Program (45-99 years). In this study, 341 individuals with a prescription of two or more drugs were analyzed. The classification of PDI followed MICROMEDEX. There were 113 different interactions. Of the total number of individuals, 63.6% had at least one PDI. The variables with higher probability of PDI were: lower level of schooling; income less than R$800.00; absence of health plan; previous diagnosis of hypertension and diabetes; use of 5 or more medications prescribed. After adjustment, the variables previous diagnosis of hypertension and diabetes and use of 5 or more prescription drugs remained statistically significant. Careful management of primary care treatment with monitoring is important in patients with PDI, especially in patients who are more susceptible.

[Potential drug interactions in adults and the elderly in primary health care]. / Interações medicamentosas potenciais em adultos e idosos na atenção primária.

The objective of the present study was to characterize the potential drug interactions (PDI), estimating the factors associated to their occurrence in adults and the elderly assisted by the Programa Médico de Família de Niterói, Rio de Janeiro. This is a sub-study of STUDY DIGITALIS, which included individuals enrolled in the Niteroi Family Medical Program (45-99 years). In this study, 341 individuals with a prescription of two or more drugs were analyzed. The classification of PDI followed MICROMEDEX. There were 113 different interactions. Of the total number of individuals, 63.6% had at least one PDI. The variables with higher probability of PDI were: lower level of schooling; income less than R$800.00; absence of health plan; previous diagnosis of hypertension and diabetes; use of 5 or more medications prescribed. After adjustment, the variables previous diagnosis of hypertension and diabetes and use of 5 or more prescription drugs remained statistically significant. Careful management of primary care treatment with monitoring is important in patients with PDI, especially in patients who are more susceptible.

O objetivo do presente estudo foi caracterizar as interações medicamentosas potenciais (IMP) e avaliar os fatores associados à sua ocorrência em adultos e idosos assistidos pelo Programa Médico de Família de Niterói, Rio de Janeiro. Trata-se de um subestudo do ESTUDO DIGITALIS, que incluiu indivíduos cadastrados no Programa Médico de Família de Niterói (45-99 anos). Foram analisados 341 indivíduos com prescrição de dois ou mais medicamentos. A classificação das IMP seguiu o MICROMEDEX®. Houve 113 interações diferentes. Do total de indivíduos, 63,6% apresentaram pelo menos uma IMP. As variáveis com maior chance de IMP foram: menor escolaridade; renda inferior a R$800,00; ausência de plano de saúde; diagnóstico de hipertensão, diabetes, infarto agudo do miocárdio; e uso de 5 ou mais medicamentos prescritos. Após ajuste, as variáveis diagnóstico anterior de hipertensão e diabetes e uso de 5 ou mais medicamentos prescritos permaneceram significativas estatisticamente. É importante uma gestão cautelosa do tratamento na atenção básica com monitoramento das IMP, especialmente em pacientes mais susceptíveis.

Lista básica de medicamentos / Basic Drug List

El objetivo de este catálogo es contar con una Lista Básica de Medicamentos actualizada, que facilite la disponibilidad de medicamentos eficaces, seguros y accesibles en el sistema público de salud. La idea de este catálogo nace con el fin de fortalecer el acceso y uso racional de medicamentos de calidad, eficaces, seguros y costo-efectivos en los diferentes niveles de atención. Sirve como marco de referencia para la utilización y gestión del medicamento. Incluye un excelente glosario de términos farmacéuticos

Profile of medicines used via oral and gastrointestinal catheter in a Walk-in Service.

OBJECTIVE: To identify the profile of drugs prescribed via oral and gastrointestinal catheter in a Walk-in Service of a University Hospital. METHOD: Quantitative cross-sectional study in which data were collected from the medical records of hospitalized patients using medication via oral or gastrointestinal catheter at least once a day between April and October 2015. The analysis was performed through descriptive statistics. RESULTS: Out of 568 prescriptions (total), there were 143 different medications. The pharmaceutical form with the greatest number of prescriptions was solid (95.8%), of which 46.1% were simple tablets. The oral route had the highest number of administrations (97.3%). The most prescribed drug class was of anti-infectives (25.9%), but the Omeprazole drug was the most prescribed in the study (40%). CONCLUSION: There are indications that enable rethinking the care practice and establishing criteria and norms for contributing to the safety and efficacy of services provided in healthcare, especially regarding the preparation and administration of medications via gastrointestinal catheter.

Nonbioequivalent prescription drug interchangeability, concerns on patient safety and drug market dynamics in Brazil.

Since the enforcement of Generics Act (1999), three types of pharmaceutically equivalent products are marketed in Brazil: innovative reference (REF), "similar" (S) and generic (G) drugs. The S (brand name) and G (generic name) borrow from REF (brand name) clinical data on safety and efficacy and dosage regimen. G (but not S) is bioequivalent to and interchangeable with REF. Starting in 2003, Brazilian Sanitary Surveillance Agency (Anvisa) has required data on relative bioavailability tests (with REF) to approve (or renew registration of) S drugs. In 2014, Anvisa extended interchangeability notion to similar drugs with a "comparable" bioavailability, i.e., an "equivalent" similar drug (EQ). Drugs for chronic diseases and "critical dose medicines" are listed among the EQ drugs approved. Interchangeability of nonbioequivalent medicines raises deep concerns regarding therapeutic failures and adverse events. Concerns are even more worrisome if patients switch from one drug to another during an ongoing treatment for illnesses such as epilepsy, congestive heart failure, hypertension, diabetes and/or substitutable drugs have a narrow therapeutic index.

Nonbioequivalent prescription drug interchangeability, concerns on patient safety and drug market dynamics in Brazil / Intercambialidade de medicamentos não-bioequivalentes, segurança do paciente e dinâmica do mercado farmacêutico no Brasil

Abstract Since the enforcement of Generics Act (1999), three types of pharmaceutically equivalent products are marketed in Brazil: innovative reference (REF), "similar" (S) and generic (G) drugs. The S (brand name) and G (generic name) borrow from REF (brand name) clinical data on safety and efficacy and dosage regimen. G (but not S) is bioequivalent to and interchangeable with REF. Starting in 2003, Brazilian Sanitary Surveillance Agency (Anvisa) has required data on relative bioavailability tests (with REF) to approve (or renew registration of) S drugs. In 2014, Anvisa extended interchangeability notion to similar drugs with a "comparable" bioavailability, i.e., an "equivalent" similar drug (EQ). Drugs for chronic diseases and "critical dose medicines" are listed among the EQ drugs approved. Interchangeability of nonbioequivalent medicines raises deep concerns regarding therapeutic failures and adverse events. Concerns are even more worrisome if patients switch from one drug to another during an ongoing treatment for illnesses such as epilepsy, congestive heart failure, hypertension, diabetes and/or substitutable drugs have a narrow therapeutic index.

Resumo A partir da vigência da lei dos genéricos (1999), três tipos de produtos farmaceuticamente equivalentes são comercializados no Brasil: o medicamento inovador de refência (REF), o produto "similar" (S), e o genérico (G). O similar (nome de fantasia) e o genérico (nome genérico) tomam de empréstimo do REF (nome de fantasia) os dados clínicos de segurança e eficácia e a posologia. G (mas não S) é bioequivalente ao, e intercambiável com REF. Desde 2003, a Agência Nacional de Vigilância Sanitária (Anvisa) exige dados de testes de biodisponibilidade relativa para registrar (ou renovar o registro de) medicamentos S. Em 2014, a Anvisa estendeu o conceito de intercambialidade aos medicamentos similares com biodisponibilidade "comparável", i.e., um medicamento similar "equivalente" (EQ). Medicamentos para doenças crônicas e "fármacos de dose crítica" estão listados entre os produtos EQ aprovados. A intercambialidade de medicamentos não-bioequivalentes suscita grande preocupação quanto a falhas terapêuticas e eventos adversos. Os receios são ainda maiores se os pacientes trocam um medicamento por outro durante o tratamento de doenças como epilepsia, insuficiência cardíaca, hipertensão, diabetes e/ou os produtos farmacêuticos substituídos tem um índice terapêutico estreito.

Prescription medication by physiotherapists: a Brazilian view of the United Kingdom, Canada, Australia and New Zealand.

Many health systems (HS) have adopted novel models of care which have included non-medical prescription (NMP) by physiotherapists. The aim of this study was to verify in the literature the existence of this practice and its possible benefits. A literature review was carried out through search on Science Direct, PubMed, SciELO, Lilacs and Google Scholar, and in the World Confederation for Physical Therapy and Chartered Society of Physiotherapy websites. In recent decades the United Kingdom adopted the NMP for health professionals, followed by Canada. In Australia and New Zealand physiotherapists have acted in the prescription and administration of medications under medical orders, which is the first step into independent prescription. Brazilian physiotherapists cannot prescribe any medication, despite of high demands from patients in the Brazilian HS, shortage of physicians in many regions and bureaucracy in accessing health services. The adoption of NMP by physiotherapists may play an important role in the HS, and it seems to be an inevitable achievement in the next years in Australia and New Zealand. The main benefits include decreasing bureaucracy for assistance, population demands for medication as well as major professional refinement.

Prescription medication by physiotherapists: a Brazilian view of the United Kingdom, Canada, Australia and New Zealand / Prescrição de medicamentos por fisioterapeutas: um olhar brasileiro sobre o Reino Unido, Canadá, Austrália e Nova Zelândia

Abstract Many health systems (HS) have adopted novel models of care which have included non-medical prescription (NMP) by physiotherapists. The aim of this study was to verify in the literature the existence of this practice and its possible benefits. A literature review was carried out through search on Science Direct, PubMed, SciELO, Lilacs and Google Scholar, and in the World Confederation for Physical Therapy and Chartered Society of Physiotherapy websites. In recent decades the United Kingdom adopted the NMP for health professionals, followed by Canada. In Australia and New Zealand physiotherapists have acted in the prescription and administration of medications under medical orders, which is the first step into independent prescription. Brazilian physiotherapists cannot prescribe any medication, despite of high demands from patients in the Brazilian HS, shortage of physicians in many regions and bureaucracy in accessing health services. The adoption of NMP by physiotherapists may play an important role in the HS, and it seems to be an inevitable achievement in the next years in Australia and New Zealand. The main benefits include decreasing bureaucracy for assistance, population demands for medication as well as major professional refinement.

Resumo Alguns sistemas de saúde (SS) têm adotado modelos inovadores de assistência que incluem a prescrição não médica (PNM) por fisioterapeutas. Este estudo objetivou verificar na literatura a existência dessa prática e seus possíveis benefícios. Foi realizada revisão da literatura, com buscas na Science Direct, PubMed, SciELO, Lilacs e Google Scholar, e nos sites da World Confederation for Physical Therapy e da Charthered Society of Physiotherapy, entre 2014 e 2015. O Reino Unido adotou a PNM por fisioterapeutas em décadas recentes, exemplo seguido pelo Canadá. Na Austrália e Nova Zelândia, fisioterapeutas têm atuado na prescrição e administração de medicamentos, sob ordens médicas, sendo este o primeiro passo para a prescrição independente. Fisioterapeutas brasileiros não podem prescrever medicamentos, apesar das altas demandas de pacientes, carência de médicos em muitas regiões e burocracia no acesso aos serviços de saúde. A prática da PNM por fisioterapeutas pode preencher um importante papel nos SS, e parece ser uma inevitável realização na Austrália e Nova Zelândia nos próximos anos. Os principais benefícios são a diminuição da burocracia no acesso a medicamentos e demandas populacionais, bem como maior refinamento profissional.

Pharmacist's contribution to the promotion of access and rational use of essential medicines in SUS. / A contribuição do farmacêutico para a promoção do acesso e uso racional de medicamentos essenciais no SUS.

OBJECTIVE:: to describe the pharmaceutical inclusion process in a Basic Health Unit multidisciplinary team and evaluate results related to rational use and promotion of access to essential medicines. METHODS:: This is a descriptive, cross-sectional study conducted in a primary care health unit in the city of São Paulo. Pharmacist's activities were evaluated regarding the service structure and organization and prescribing quality improvement, guidance method creation, and implementation of clinical pharmacy service. Data measured before and after the interventions and between 2010 and 2011 were analyzed using Pearson´s chi-square test with a significance level of 5%, and odds ratio. RESULTS:: Pharmacist's activities had statistically significant result in drug shortage reduction; prescribing quality improvement associated with an increased proportion of prescriptions met; decrease in the total of prescribed drugs among patients receiving pharmacotherapeutic follow-up and, comparing the years 2010 and 2011, changes in the pharmacotherapy recommendations have gained increased acceptance level. CONCLUSIONS:: Pharmacist's activities may effectively provide rational use and promotion of access to essential medicines.

A contribuição do farmacêutico para a promoção do acesso e uso racional de medicamentos essenciais no SUS / Pharmacist's contribution to the promotion of access and rational use of essential medicines in SUS

Resumo O objetivo deste artigo é descrever o processo da inserção do farmacêutico na equipe de uma Unidade Básica de Saúde e os resultados na promoção do acesso e uso racional de medicamentos. Trata-se de estudo descritivo, transversal, realizado em unidade de atenção primária do município de São Paulo. As atividades do farmacêutico foram avaliadas em relação à estruturação e organização do serviço, melhoria do padrão de prescrição médica, elaboração de método de orientação e implantação de serviços farmacêuticos clínicos. A análise estatística foi realizada empregando o teste Qui-Quadrado de Pearson, com nível de significância de 5%, e o ODDs Ratio, quando comparados os períodos anterior e posterior à intervenções e resultados entre os anos de 2010 e 2011. A atuação do farmacêutico apresentou resultados estatisticamente significativos na redução da falta de medicamentos; melhora da qualidade da prescrição (com aumento do número de prescrições atendidas); redução do número de medicamentos prescritos entre os pacientes em seguimento farmacoterapêutico; e, comparando-se os anos 2010 e 2011, as recomendações de mudanças na farmacoterapia passaram a ter maior nível de aceitação. O farmacêutico contribuiu efetivamente para o acesso e a promoção do uso racional de medicamentos.

Abstract Objective: to describe the pharmaceutical inclusion process in a Basic Health Unit multidisciplinary team and evaluate results related to rational use and promotion of access to essential medicines. Methods: This is a descriptive, cross-sectional study conducted in a primary care health unit in the city of São Paulo. Pharmacist's activities were evaluated regarding the service structure and organization and prescribing quality improvement, guidance method creation, and implementation of clinical pharmacy service. Data measured before and after the interventions and between 2010 and 2011 were analyzed using Pearson´s chi-square test with a significance level of 5%, and odds ratio. Results: Pharmacist's activities had statistically significant result in drug shortage reduction; prescribing quality improvement associated with an increased proportion of prescriptions met; decrease in the total of prescribed drugs among patients receiving pharmacotherapeutic follow-up and, comparing the years 2010 and 2011, changes in the pharmacotherapy recommendations have gained increased acceptance level. Conclusions: Pharmacist's activities may effectively provide rational use and promotion of access to essential medicines.

An evaluation of elderly people's understanding of pharmacotherapy among those treated in the Primary Healthcare System in Belo Horizonte, Brazil. / Avaliação da compreensão da farmacoterapia entre idosos atendidos na Atenção Primária à Saúde de Belo Horizonte, MG, Brasil.

There are a greater number of elderly people with diseases which has led to a greater use in medication and complexity in pharmacotherapy. The aim of this study was to understand the level of understanding on pharmacotherapy amongst the elderly and associated factors. An analytical transversal study was carried out in the Primary Health Care Units. Sociodemographic, clinical, and functional characteristics relative to the use of medication were explored. The level of understanding was obtained after a concordance analysis had been done based on the responses from the interviewees and the information on the medical prescriptions such as: name of medication, dosage, frequency, indication, precautions and side effects. The global level of understanding was classified as insufficient in cases where the discordance was ≥ 30%. Of the 227 elderly people interviewed, 51.1% showed an insufficient understanding in relation to their medication. We carried out multivariate logistic regression to observe the factors associated with an understanding of pharmacotherapy. We noted that those with a low level of education and a dependency on the use of medication showed insufficient understanding. (p < 0,05). It is necessary to implement strategies to increase the quality of the guidance given to the elderly and to ensure compliance.

Avaliação da compreensão da farmacoterapia entre idosos atendidos na Atenção Primária à Saúde de Belo Horizonte, MG, Brasil / An evaluation of elderly people´s understanding of pharmacotherapy among those treated in the Primary Healthcare System in Belo Horizonte, Brazil

Resumo Os idosos apresentam maior número de doenças, levando a maior uso de medicamentos e a farmacoterapia mais complexa. O objetivo do estudo foi avaliar o nível de compreensão da farmacoterapia entre idosos e fatores associados. Realizou-se estudo transversal analítico em Unidades Básicas de Saúde. Foram investigadas as características sociodemográficas, clínicas, funcionais e relativas ao uso de medicamentos. O nível de compreensão foi obtido após a análise de concordância entre a resposta do entrevistado e a informação contida na prescrição para: nome do medicamento, dose, frequência, indicação, precauções e efeitos adversos. O nível global de compreensão foi classificado como insuficiente em caso de discordância ≥ 30%. Dos 227 idosos entrevistados, 51,1% apresentaram compreensão insuficiente em relação aos medicamentos. Realizou-se regressão logística multivariada para observar os fatores associados à compreensão da farmacoterapia, sendo menor escolaridade e dependência para uso dos medicamentos os que apresentaram associação com a compreensão insuficiente (p < 0,05). É necessário implementar estratégias para aumentar a qualidade das orientações fornecidas aos idosos e garantir seu cumprimento.

Abstract There are a greater number of elderly people with diseases which has led to a greater use in medication and complexity in pharmacotherapy. The aim of this study was to understand the level of understanding on pharmacotherapy amongst the elderly and associated factors. An analytical transversal study was carried out in the Primary Health Care Units. Sociodemographic, clinical, and functional characteristics relative to the use of medication were explored. The level of understanding was obtained after a concordance analysis had been done based on the responses from the interviewees and the information on the medical prescriptions such as: name of medication, dosage, frequency, indication, precautions and side effects. The global level of understanding was classified as insufficient in cases where the discordance was ≥ 30%. Of the 227 elderly people interviewed, 51.1% showed an insufficient understanding in relation to their medication. We carried out multivariate logistic regression to observe the factors associated with an understanding of pharmacotherapy. We noted that those with a low level of education and a dependency on the use of medication showed insufficient understanding. (p < 0,05). It is necessary to implement strategies to increase the quality of the guidance given to the elderly and to ensure compliance.