Analysis of prescription and dispensation of psychotropic medications in two cities in the State of Säo Paulo, Brazil

OBJECTIVES: To investigate the prescription and dispensation of psychotropic medications through the analysis of the prescriptions/notices kept at various institutions in two cities in the state of Säo Paulo. METHODS: The prescriptions kept at drugstores, magistral pharmacies, primary care settings and hospitals were collected and analyzed in collaboration with the Sanitary Vigilance agencies in the year of 1999. The information in the prescriptions/notices were typed and tabulated. RESULTS: A total of 108,215 prescriptions were processed, being 76,954 for benzodiazepines, 26,930 for anorexigenic drugs, 3,540 for opiates and 788 for other drugs. The benzodiazepines most frequently prescribed were: diazepam (31,644), bromazepam (16,911) and clonazepam (7,929). Among the anorexigenic drugs, diethylpropion (14,800) and femproporex (10,942) were the most common. When compared to men, women were given more prescriptions, mainly for anorexigenic drugs: the ratio was 10:1 in the prescriptions for diethylpropion and femproporex. The few magistral pharmacies (n=6) handled even more prescriptions than did the drugstores (n=49). A number of errors and inconsistencies were detected in the prescriptions analyzed. CONCLUSIONS: The results confirm the occurrence of an irrational use of such medications and a series of inadequate practices related to their prescription in Brazil. Therefore, they point out to the need of a comprehensive review of the government's control system of these substances

A experiência do desenvolvimento gerencial no distrito de saúde de Campo Limpo / Experience of managerial developement in the health district of Campo Limpo, SP, Brazil

Para concretizar o conceito de distrito sanitário como um processo social de transformaçäo das práticas sanitárias, a equipe do Distrito Sanitário de Campo Limpo iniciou, a partir de março de 1991, um processo de trabalho sob a coordenaçäo da Cooperaçäo Italiana em Saúde. O método de trabalho utilizado desenvolveu-se por meio de oficinas de processo, nas quais os consultores funcionavam como facilitadores e orientadores na aplicaçäo da metodologia básica utilizada durante o trabalho. Foram efetuadas as oficinas de territorializaçäo, sistema de informaçäo e planejamento e programaçäo local. Posteriormente, as oficinas foram repassadas pela equipe de coordenaçäo para todas as demais áreas do distrito