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

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