Related Factors to the Use of Psychotropic Medicines in Primary Health Care Units

Monday, 9 November 2015

Adriana Inocenti Miasso, PhD
Departamento de Enfermagem Psquiátrica e Ciências Humanas, University of São Paulo, Ribeirão Preto College of Nursing. WHO Collaborating Centre for Nursing Research Development, Ribeirao Preto, Brazil
Tatiana Longo Borges Miguel, PhD, MSc, RN
Departamento de Enfermagem Psiquiátrica e Ciências Humanas, Escola de Enferamgem de Ribeirão Preto, Ribeirão Preto, Brazil
Kathleen Mary Hegadoren, PhD
Faculty of Nursing, Professor, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada

Purpose: Not always psychotropic drugs are used for specific mental disorders. Sometimes the doctor who prescribed the psychotropic can not point accurately the reason for its utilization. There is a gap in the literature to investigate in primary health care the factors related to the psychotropic drugs consumption; and, if people using psychotropic medicines without a defined psychiatric diagnosis are positive to Mental Common Disorders.This study aims to identify psychotropic medicines use in patient visiting the units; and, its association with: the presence of Mental Common Disorders, socio-demographic profile, use of other pharmacotherapy and presence of clinical comorbidities.

 Methods: This study was performed with a quantitative approach, cross-sectional and descriptive correlational character. A stratified sample of 430 patients was interviewed in five primary health care units at Ribeirao Preto city, Brazil. Data collection included questionnaires with socio-demographic information, medication history and the SRQ-20 (Self-Reporting Questionnaire - to assess Mental Common Disorders). The health records were also examined. To assess those associations was used chi-square test, with accepted association when p is less than or equal to 0.05; and, logistic regression models.

 Results: The prevalence of psychotropics use was 25,8% (N=111). The most prevalent prescribed psychotropic were antidepressants (73% - N=81). Chi-square test indicated association between psychotropics use and SRQ-20 result (the prevalence of CMD:41,4% - N=178), other medicines use, number of prescribed medicines, number of pills prescribed per day, clinical comorbidities, age and education. However, according to multivariate analysis the predictor factors were: Mental Common Disorders (OR=3,9; IC95% 2,36-6,55), clinical comorbidities (OR=5,4, IC95% 2,84-10,2) and lower level of education (OR=1,7; IC95% 1,02-2,92). This study is the first in Brazil to have contemplated the question of the presence of CMD and use of psychotropic medication at Basic Health Units.  

 Conclusion: Considering the association between use of psychotropic medicines and socio-demographic factors, the results highlight the need for an assessment focused on psychosocial aspects so that patients would have their symptoms seen by health professionals and be attended in their needs.