Psychoactive drugs in the Brazilian public health system
Use profile and associated factors
DOI:
https://doi.org/10.1590/s2175-97902022e19739Keywords:
Pharmacoepidemiology, Drug utilisation studies, Psychotropic drugs, PrescribingAbstract
The purpose of this study is to estimate the prevalence of and characterize the use of psychoactive drugs among drug users in a Brazilian municipality, relating the findings to factors associated with the consumption of these substances. Through a cross-sectional design, 1,355 drug users from the public health systems community pharmacies were interviewed. Sociodemographic and health-related data were collected, as well as any other prescribed drugs. The prevalence of psychoactive drug use within the last month was 31.0%, with antidepressants and benzodiazepines being the most prescribed (53.5% and 24.6% respectively). Most psychoactive drug users were female (81.9%), lived with a partner (52.6%), had private health insurance (69.2%) and a monthly per-capita income up to one minimum wage (54.0%). The adjusted Odds Ratio (OR) confirmed the following factors to be positively associated with the use of psychoactive drugs: female gender (OR=2.06; 95% CI 1.44; 2.95), age ≥60 years old (OR=1.77; 95% CI 1.26; 2.48), follow-up with a psychologist (OR=4.12; 95% CI 1.84; 5.25), absence of regular physical activity (OR=1.59; 95% CI 1.13; 2.23), and smokers (OR=1.94; 95% CI 1.26; 2.97). Approximately one out of three individuals used at least one psychoactive drug. Health managers should focus the planning and actions aimed at their rational use for these groups, leading to increased overall treatment success.
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Almeida LM, Coutinho ESF, Pepe VLE. Consumption of Psychotropic Drugs in an Administrative Region of the City of Rio de Janeiro: Ilha do Governador. Cad Saúde Pública. 1994;10(1):5-16.
Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, et al. Psychotropic drug utilization in Europe: Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand. 2004;109(suppl. 420):55-64.
American Geriatrics Society Beers Criteria. American Geriatrics Society 2019 Updated AGS Beers Criteria®for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(1):674-694.
Andrade LH, Viana MC, Silveira CM. Epidemiology of women's psychiatric disorders. Rev Psiq Clín. 2006;33(2):43-54.
Andrade LH, Wang Y-P, Andreoni S, Silveira CM, Alexandrino-Silva C, Siu ER, et al. Mental disorders in megacities: Findings from the São Paulo Megacity Mental Health Survey, Brazil. PLoS One. 2012;7(2):e31879.
Atlantis E, Chow CM, Kirby A, Singh MF. An effective exercise-based intervention for improving mental health and quality of life measures: A randomized controlled trial. Prev Med. 2004;39(1):424-34.
Baldoni AO, Ayres LR, Martinez EZ, Dewulf NLS, Santos V, Obreli-Neto PR, et al. Pharmacoepidemiological profile and polypharmacy indicators in elderly outpatients. Braz J Pharm Sci. 2013;49(3):443-52.
Baldwin DS, Anderson IM, Nutt DJ, Allgulander C, Bandelow B, Den Boer JA, et al. Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: A revision of the 2005 guidelines from the British Association for Psychopharmacology. J Psychopharmacol. 2014;28(5):403-39.
Bateson AN. Basic pharmacologic mechanisms involved in benzodiazepine tolerance and withdrawal. Curr Pharm Des. 2002;8(1):5-21.
Bloom DE, Cafiero ET, Jané-llopis E, Abrahams-gessel S, Bloom LR, Fathima S, et al. The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum. 2011. Available from: http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommGlobalEconomicBu_2011.pdf
» http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommGlobalEconomicBu_2011.pdf
Brunoni AR, Nunes MA, Figueiredo R, Barreto SM, Fonseca MJM, Lotufo PA, et al. Patterns of benzodiazepine and antidepressant use among middle-aged adults: The Brazilian longitudinal study of adult health (ELSA-Brasil). J Affect Disord. 2013;151(1):71-7.
Bjerre LM, Farrel B, Hogel M, Graham L, Lemay G, McCarthy L. Deprescribing antipsychotics for behavioural and psychological symptoms of dementia and insomnia Evidence-based clinical practice guideline. Can Fam Physician. 2018;64(1):17-27.
Campanha AM, Siu ER, Milhorança IA, Viana MC, Wang YP, Andrade LH. Use of psychotropic medications in São Paulo Metropolitan Area, Brazil: pattern of healthcare provision to general population. Pharmacoepidemiol Drug Saf. 2015;24(1):1207-14.
Chien IC, Bih SH, Chou YJ, Lin CH, Lee WG, Chou P. Trends in the Use of Psychotropic Drugs in Taiwan: A Population-Based National Health Insurance Study, 1997-2004. Psychiatr Serv. 2007;58(4):554-7.
Fagan SC, Nichols FT. Neurologic Disorders. In: Dipiro J, Talbert B, Yee GC, Matzke GR, Wells BG, Posey LM (ed) Pharmacotherapy: A Pathophysiologic Approach. 7th ed. New York: McGraw-Hill; 2008. p 909-1203.
Finnerup NB, Otto M, McQuay HJ, Jensen TS, Sindrup SH. Algorithm for neuropathic pain treatment: an evidence based proposal. Pain. 2005;118(1):289-305.
Gualano MR, Bert F, Mannocci A, Torre G, Zeppegno P, Siliquini R. Consumption of Antidepressants in Italy: Recent Trends and Their Significance for Public Health. Psychiatr Serv . 2014;65(10):1226-31.
Hirschfeld RMA. Clinical importance of long-term antidepressant treatment. Br J Psychiatry Suppl. 2001;179(S42):s4-8.
Ignácio VTG, Nardi HC. Medicalization as a biopolitical strategy: A study about the consuming of psychoactive prescribed drugs in a small town in state of Rio Grande do Sul. Psicologia e Sociedade. 2007;19(3):88-95.
Lahti J, Lallukka T, Lahelma E, Rahkonen O. Leisure-time physical activity and psychotropic medication: a prospective cohort study. Prev Med . 2013;57(3):173-7.
Lasserre A, Younès N, Balnchon T, Cantegreil-Kallen I, Passerieux C, Thomas G, Chan-Chee C, Hanslik T. Psychotropic drug use among older people in general practice:discrepacies betwee opinion and practice. Br J Gen Pract. 2010;60(573):e156-e162.
Luiz RR, Magnanini MMFO. Tamanho da Amostra em Investigações Epidemiológicas. In: Medronho RA (ed) Epidemiologia. São Paulo: Atheneu; 2006. p. 295-306.
Marcus M, Yasamy MT, Ommeren MV, Chisholm AD, Saxena S. Depression: a global public health concern. 2012. Available from: http://www.who.int/mental_health/management/depression/who_paper_depression_wfmh_2012.pdf
» http://www.who.int/mental_health/management/depression/who_paper_depression_wfmh_2012.pdf
McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res. 2011;45(8):1027-1035.
Meng X, D’Arcy C, Tempier R. Trends in psychotropic use in Saskatchewan from 1983 to 2007. Can J Psychiatry. 2013;58(7):426-31.
Mojtabai R, Olfson M. National Trends in Psychotropic Medication Polypharmacy in Office-Based Psychiatry. Arch Gen Psychiatry. 2010;67(1):26-36.
Moreno Luna ME, Clemente Lirola E, Pinero Acín MJ, Martinez Matías MR, Alonso Gómez F, Rodríguez Alcalá FJ. Influence of patient's gender on the management of clinical profiles of anxiety/depression. Aten Primaria. 2000;26(8):554-8.
Ohayon MM, Lader MH. Use of psychotropic medication in the general population of France, Germany, Italy and the United Kingdom. J Clin Psychiatry. 2002;63(9):817-25.
Podhorna J. The experimental pharmacotherapy of benzodiazepine withdrawal. Curr Pharm Des . 2002;8(1):23-43.
Pottie K, Thompson W, Davies S, Grenier J, Sadowski CA, Welch V, et al. Deprescribing benzodiazepine receptor agonists Evidence-based clinical practice guideline. Can Fam Pysician. 2018;64(5):339-51.
Prado MAMB, Francisco PMSB, Barros MBA. Uso de medicamentos psicotrópicos em adultos e idosos residentes em Campinas, São Paulo: um estudo transversal de base populacional. Epidemiol Serv Saúde. 2017;26(4):1-11.
Quintana MI, Andreoli SB, Moreira FG, Ribeiro WS, Feijo MM, Bressan RA, Coutinho ESF, Mari JJ. Epidemiology of psychotropic drug use in Rio de Janeiro, Brazil: gaps in mental illness treatments. PloS One. 2013;8(5):e62270.
Quintana MI, Andreoli SB, Peluffo MP, Ribeiro WS, Feijo MM, Bressan RA, Coutinho ESF, Mari JJ. Psychotropic drug use in São Paulo, Brazil: An epidemiological survey. PloS One . 2015;10(8):e 0135059.
Rocha BS, Werlang MC. Psychotropic drugs in the Family Health Strategy: profile of use, access and strategies to promote rational use. Cien Saude Colet. 2013;18(11):3291-3300.
Rodrigues MAP, Facchini LA, Lima MS. Modifications in psychotropic drug use patterns in a Southern Brazilian city. Rev Saude Publica. 2006;40(1):107-14.
Rudolph JL, Salow MJ, Angelini MC, McGlinchey RE. The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med. 2008;168(5):508-13.
Schramm JMA, Oliveira AF, Leite IC, Valent JG, Gadelha AMJ, Portela MC, et al. Epidemiological transition and the study of burden of disease in Brazil. Cien Saude Colet . 2004;9(4):897-908.
Slabaugh SL, Maio V, Templin M, Abouzaid S. Prevalence and risk of polypharma Slabaugh cy among the elderly in an outpatient setting a retrospective cohort study in the Emilia-Romagna region, Italy. Drugs Aging. 2010;27(1):1019-28.
Spring B, Pingitore R, McChargue DE. Reward value of cigarette smoking for comparably heavy smoking schizophrenic, depressed, and nonpatient smokers. Am J Psychiatry. 2003;160(2):316-22.
Stewart DE, Ashraf IJ, Munce SE. Women's mental health: A silent cause of mortality and morbidity. Int J Gynaecol Obstet. 2006;94(1):343-9.
Stewart DE. Social determinants of women’s mental health. J Psychosom Res. 2007;63(3):223-4.
Studer HK, Weicker H. Physiology and pathophysiology of the serotonergic system and its implications on mental and physical performance: Part I. Int J Sports Med. 2001;22(7):467-81.
WHO. World Health Organization. The global burden of disease: 2004 update. Geneva: World Health Organization. Available from: http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf
» http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf
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