Implications of self-medication among socially vulnerable older adults in the COVID-19 era (2021–2023)

Self-medication is a public health issue, exacerbated by limited healthcare access and the search for quick relief. In Brazil, resource shortages and the COVID-19 pandemic have intensified this behavior, leading to the indiscriminate use of medications among older adults in social vulnerability. This study aimed to analyze the health implications of self-medication among older adults in social vulnerability during the COVID-19 pandemic, considering sociodemographic factors and the context of medication use. A cross-sectional, descriptive-analytical study based on field interviews conducted between May 2022 and October 2023 across Brazil. The study focused on older adults (60 + years) in social vulnerability. Data were analyzed using descriptive statistics, Sankey diagrams, and binary logistic regression. The study included 308 older adults, with an average age of 66.4 years. Self-medication was prevalent, particularly among those with chronic diseases (61%), with common use of antiparasitics and antibiotics. Vaccination rates were high, with 96.9% of those with chronic diseases and 93.9% of those without receiving the COVID-19 vaccine. Logistic regression showed that being White or diagnosed with COVID-19 increased the likelihood of self-medication with antiparasitics and antibiotics. Vaccinated individuals were less likely to self-medicate, including with antimalarials and corticosteroids. Self-medication was highly prevalent among socially vulnerable older adults during the COVID-19 pandemic, particularly those with chronic conditions, posing substantial health risks. These risks were compounded by barriers to healthcare access and widespread misinformation. Public policies should prioritize health education on the rational use of medications and strengthen access to the Brazilian Unified Health System (SUS). Higher vaccination coverage was associated with lower self-medication, although this finding warrants cautious interpretation.