# Association Between Polypharmacy and Socioeconomic and Demographic Factors in Adults Aged 50 Years and Older by Brazilian Macroregions

## TL;DR

The study found that polypharmacy rates vary across Brazil's regions and are linked to factors like age, chronic diseases, and socioeconomic status.

## Contribution

The study provides new insights into regional disparities in polypharmacy among older adults in Brazil.

## Key findings

- Polypharmacy is more common in older adults aged 80+ and in regions like the Southeast and South.
- Chronic conditions like diabetes and hypertension strongly predict polypharmacy.
- Rural residents and non-white individuals in certain regions have lower polypharmacy rates.

## Abstract

This study aimed to investigate the proportions of polypharmacy in the macroregions of Brazil, considering socioeconomic and demographic factors and their associations.

A cross‐sectional analysis was conducted using data from the second wave (2019–2021) of ELSI‐Brazil. The outcome was self‐reported polypharmacy. Independent variables included sociodemographic, health, and behavioral factors, such as diabetes and hypertension. Descriptive analyses incorporated sample weights, and Poisson regression was employed to assess associations between polypharmacy and the independent variables. Analyses were stratified by the five macroregions of Brazil: North, Northeast, Southeast, South, and Central‐West.

The study included 6917 participants aged 50 years or older. Differences in polypharmacy prevalence were observed across Brazilian macroregions. In the Central‐West, polypharmacy was less frequent among rural residents (PR = 0.84; 95% CI: 0.82–0.85) than among urban residents. In the North, polypharmacy was more frequent among non‐white individuals (PR = 1.08; 95% CI: 1.02–1.15) and less frequent among Black individuals (PR = 0.92; 95% CI: 0.88–0.96) compared with white individuals. In the Southeast and South, polypharmacy was more frequent among adults aged 80 years or older (PR = 1.14; 95% CI: 1.08–1.19 and PR = 1.17; 95% CI: 1.08–1.27, respectively) than among younger groups. Although no formal statistical comparisons between regions were performed, the observed estimates and their confidence intervals indicate regional variation in polypharmacy.

This study identified regional disparities in polypharmacy prevalence across Brazil's macroregions, influenced by factors such as age, chronic conditions, and socioeconomic status. Strengthening primary care, promoting rational medication use, addressing inequalities, and integrating prevention strategies are crucial to mitigating its negative impacts.

Polypharmacy prevalence varies across Brazilian macroregions.Older adults (> 80 years) showed the highest prevalence of polypharmacy.Diabetes and hypertension are strong predictors of polypharmacy.Regional disparities may reflect healthcare access and socioeconomic differences.Addressing these disparities is essential to improving elderly care.

Polypharmacy prevalence varies across Brazilian macroregions.

Older adults (> 80 years) showed the highest prevalence of polypharmacy.

Diabetes and hypertension are strong predictors of polypharmacy.

Regional disparities may reflect healthcare access and socioeconomic differences.

Addressing these disparities is essential to improving elderly care.

This study examined the use of multiple medications, known as polypharmacy, in Brazilian adults aged 50 and older. Using national data from the ELSI‐Brazil survey, researchers analyzed differences by region and looked at how factors like age, income, education, and chronic diseases such as diabetes and hypertension were linked to polypharmacy. Results showed that older adults and those with chronic conditions were more likely to use many medications, especially in the South and Southeast regions. People in rural areas and with higher education had lower rates. The study highlights the need to improve access to healthcare, promote rational medicine use, and reduce inequalities in different parts of the country to improve health and safety for older people.