Facteurs socioéconomiques associés à l’usage des médicaments psychotropes chez les hommes et les femmes âgés de 65 à 74 ans vivant dans la communauté : l’étude internationale sur la mobilité des personnes âgées (IMIAS)
Study’s Objective: to estimate the association between socioeconomic position and use of psychotropic drugs in five diverse populations with 65-74 years of age. Method: The study sample was composed by 1,995 persons from the 2012 baseline data of the International Mobility in Aging Study (IMIAS) with 401 participants from Saint-Hyacinthe (Quebec), 398 from Kingston (Ontario), 394 elderly from Tirana (Albania), 400 from Manizales (Colombia) and 402 from Natal (Brazil). All psychotropic drugs consumed during the last 15 days were identified during a home visit and coded according to the ATC classification. Psychotropic medication included anxiolytics, sedatives and hypnotics (ASH), antidepressants (ADP) and analgesics/anti-epileptic/AntiParkinson (AEP). The associations between the prevalence in the consumption of psychotropic medications and education, income and occupation were estimated with prevalence ratios (PR) obtained by fitting a Poisson regression and using Andersen and Newman’s behavioral model for use of health services and controlling for needs (chronic medical conditions and depression), predisposing factors (age and sex) and  facilitating factors (using the study site as proxy for health system and environmental facilitating factors). Results: older people living in Canadian sites consumed more psychotropic medications than those outside of Canada, older people in Manizales people consumed less ASH and the elderly of Albania did not consume ADP. Socioeconomic inequalities varied by site. In Canadian sites, low socioeconomic position was associated with more consumption of psychotropic medication: in particular, those with low education consumed plus des antidepresseurs and those with low income consumed more analgesics.  In the Latin American research sites, the opposite patttern emerged, since those with higher education and higher income consumed more antidepresseurs and those with manual occupations consumed more analgesics. In Tirana (Albania), there was no consumption of antidepressive medication, but consumption of ASH was higher in those with lower income. Final multivariate analyses hid these across sites differences that are revealed in specific analyses through Canada, Latin America and Albania. Conclusion: There are socioéconomic inequalities related to the consumption of psychotropic drugs in the elderly population. These inequalities varied by site. Use of psychotropic medication was more frequent among the less educated and poorer people in Canada while the opposite was true in the Latin America sites. Albania was caracterized by the absence of antidepressant medication and a higher use of anxyiolitics in the lower income groups.
Socioeconomic factors psychotropic drugs elderly