Factors associated with psychotropic drug use among community-dwelling older persons: A review of empirical studies

BACKGROUND: In the many descriptive studies on prescribed psychotropic drug use by community-dwelling older persons, several sociodemographic and other factors associated with drug use receive inconsistent support. METHOD: Empirical reports with data on at least benzodiazepine or antidepressant drug use in samples of older persons published between 1990 and 2001 (n = 32) were identified from major databases and analyzed to determine which factors are most frequently associated with psychotropic drug use in multivariate analyses. Methodological aspects were also examined. RESULTS: Most reports used probability samples of users and non-users and employed cross-sectional designs. Among variables considered in 5 or more reports, race, proximity to health centers, medical consultations, sleep complaints, and health perception were virtually always associated to drug use. Gender, mental health, and physical health status were associated in about two-thirds of reports. Associations with age, marital status, medication coverage, socioeconomic status, and social support were usually not observed. CONCLUSIONS: The large variety of methods to operationalize drug use, mental health status, and social support probably affected the magnitude of observed relationships. Employing longitudinal designs and distinguishing short-term from long-term use, focusing on samples of drug users exclusively, defining drug use and drug classes more uniformly, and utilizing measures of psychological well-being rather than only of distress, might clarify the nature of observed associations and the direction of causality. Few studies tested specific hypotheses. Most studies focused on individual characteristics of respondents, neglecting the potential contribution of health care professionals to the phenomenon of psychotropic drug use among seniors

Internações pediátricas por condições sensíveis à atenção primária em Montes Claros, Minas Gerais, Brasil Admissions to pediatric hospital for conditions amenable to primary care in Montes Claros, Minas Gerais, Brazil

OBJETIVOS: avaliar a prevalência e os fatores associados às internações pediátricas por condições sensíveis à atenção primária (CSAP). MÉTODOS: realizouse inquérito hospitalar ao longo de um ano, com amostra representativa ealeatória de crianças internadas em um município do norte de Minas Gerais. Enfermarias pediátricas foram visitadas uma vez por semana em dias diferentes. Foram investigadas variáveis demográficas, socioeconômicas e relacionadas às condições de saúde. Para a definição das afecções sensíveis a atenção primária utilizou-se a relação oficial publicada pelo Ministério da Saúde. A regressão de Poisson foi utilizada para avaliação conjunta das variáveis associadas às internações por CSAP. RESULTADOS: foram entrevistadas 365 famílias e a prevalência de internações por CSAP foi de 41,4%(n=151). O modelo final revelou que, em uma análise conjunta, as variáveis se mantiveram estatisticamente associadas com as internações por CSAP foram: residir em área da Estratégia de Saúde da Família (RP=1,19; IC95%=1,03-1,61) e idade menor que dois anos de idade (RP=1,42; IC95%=1,35-1,51). CONCLUSÕES: a prevalência observada é semelhante à encontrada em outros estudos e salienta a necessidade de melhoria dos cuidados ambulatoriais para a faixa etária estudada.<br>OBJECTIVE: to evaluate the prevalence and factors associated with admission to pediatric hospital for conditions amenable to primary care. METHODS: an investigation was carried out for the duration of one year, with a representative sample of children admitted to hospital in a municipality in thenorth of the Brazilian State of Minas Gerais. Pediatric wards were visited once a week on different days. Demographic, socio-economic and health variables were studied. Conditions amenable to primary care were established using the official report published by the Brazilian Ministry of Health. The Poisson regression was used to evaluate the set of variables associated with admission to hospital for conditions amenable to primary care. RESULTS: 365 families were interviewed and the prevalence of admission to hospital for conditions amenable to primary care was 41.4% (n=151). Thefinal model revealed that, when taken together, the variables that continued to be associated in a statistically significant fashion with admissions to hospital for conditions amenable to primary care were: living in a Family Health Strategy area (PR=1.19;CI95%=1.039-1.61) and being aged under two years(PR=1.42; CI95%=1.35-1.51). CONCLUSION: the prevalence observed is similar to that found by other studies and highlights the need to improve out patient care for the age group covered by this study