(172) Use of Medicines by The Elderly in Portugal in 2019

Publication Number: 846

Background: Like in other countries worldwide, a marked increase in the size of the older population has been observed in Portugal. With ageing, co-occurrence of several diseases becomes frequent requiring multiple medications. Polypharmacy in the older population is particularly relevant given the physiological changes associated with the ageing process leading to poor adherence to treatment and higher risk of interactions and adverse reactions, especially in the oldest-old population (+85 years).

Objectives: The aim of this study is to characterise medication use by the elderly in Portugal, with specific focus on the oldest-olds.

Methods: Cross-sectional study on National Health System's data on reimbursed medicines prescribed and dispensed to 65+ year-olds in 2019 in community pharmacies in Portugal mainland. Descriptive demographic and geographic analysis regarding INN and therapeutic groups was performed. Differences of medicines’ consumption on gender and age groups for district of dispensing, INN and therapeutic group were assessed in a generalized linear model. Spearman correlation assessed the monotonic relationship between study variables.

Results: A higher consumption of medicines was observed in women, more evident with ageing, except in the oldest olds, where the gender difference tends to shrink. Use per capita shows an opposite trend, with the oldest-old men surpassing oldest-old women (mean packages 55.5 in men (M) vs. 55.1 in women (W)). Therapeutic class ranking is led by cardiovascular medicines (37% M vs. 31% W) followed by CNS medicines (30%) and antidiabetics (13%) in women, and antidiabetics (16%) and benign prostatic hypertrophy drugs (14%) in men. There were statistically significant differences regarding gender in the per capita use of antidepressants, anxiolytics, antithrombotic agents and opioids, the latter two also with significant differences in the younger and older age groups. Similarly, differences were found in all three age groups (65-74, 75-84, 85+) in 10 of the 18 districts of Portugal mainland. There is a very strong positive correlation, irrespective of gender, between per capita consumption and age, concerning therapeutic group (Spearman correlation 0.9541, p< 0.001) and district (Spearman correlation 0.8058, p< 0.001). Regarding INN, a very strong positive correlation was also found (Spearman correlation 0.9758, p< 0.001), for all age groups and both genders.

Conclusions: In the elderly, the pattern of medicines’ use is clearly gender-based, with significant age-related differences. Consumption analysis at patient level currently undergoing will enable assessment of the most frequent combinations of medicines, providing the grounds to develop measures to tackle polypharmacy-associated risks in the elderly.