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Background: Analysis of prescription of doctors is done to determine, evaluate, and improve the care of patients in a well-organized way and it estimates on-going practice against a defined standard. Aim and Objective: The aim of the study was to provide the broad outline of performance and delineate parameter as per the check list of prescription audit. Materials and Methods: An observational and non-interventional study was carried out from July 2021 to November 2021 at peripheral medical college, Gujarat. Randomly, we have selected 500 prescriptions. This prescriptions were evaluated as per World Health Organization prescribing indicators and then it were analyzed for errors in prescription writing. Results: In this study, total 500 prescriptions were analyzed and total 1839 drugs were prescribed. Average number of drugs per prescription was 3.67. The percentage of drugs prescribed by generic name was 94.6%. The percentage of encounters with an antibiotic prescribed was 29%. In our prescription audit study, 39.16% (1762 count) prescriptions were non complete and 60.84% (2738 count) prescription were having complete details. Conclusion: If the drug is prescribe by generic name and from essential drug list chances of dispensing error decrease and hand out of incorrect drug to patient is reduced. Minimizing drug per prescription attenuates chances of drug-drug interactions. Regular prescription audit should be conducted regularly which increase the awareness in prescriber and effective, safe, and economics therapeutic practice.
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Abstract The aims of the present study were to estimate the free-of-charge acquisition of psychotropic drugs among Brazilian adults; analyze the distribution of psychotropics according to their presence on the Relação Nacional de Medicamentos Essenciais (RENAME [National List of Essential Medicines]) and acquisition according to the source of funding (free of charge or direct payment); and estimate the proportion of free-of-charge psychotropic drugs according to therapeutic class and presence on the RENAME. This study involved the analysis of data from the 2014 National Survey on the Accessibility, Use and Promotion of the Rational Use of Medicines considering psychotropic drugs used by the adult population (≥20 years; n = 32,348). The prevalence of the acquisition of free-of-charge psychotropic drugs was 53.3% and 64.6% of these drugs were on the RENAME. Among the psychotropic drugs acquired by direct payment, 70.8% were not on the national list. Regarding free-of-charge acquisition according to the therapeutic class and presence on the RENAME, differences were found for antidepressants, anxiolytics and antipsychotics (p <0.05). In conclusion, the most used psychotropic medicines were listed in the RENAME, but free-of-charge acquisition was not provided for all of them
Subject(s)
Psychotropic Drugs , Drugs, Essential/classification , Access to Essential Medicines and Health Technologies , Population/genetics , Pharmacoepidemiology/statistics & numerical data , National Drug Policy , Fees and Charges/statistics & numerical dataABSTRACT
Background: Drug utilization studies are an important tool in evaluating the rationality of therapeutic practice and also it is said to improvise the therapeutic use of drugs. The present study will be undertaken to evaluate the drug utilization pattern in the department of Radiotherapy.Methods: This was a prospective, observational study that was undertaken in the department of Radiotherapy in a tertiary care teaching hospital. The study was conducted for a period of 6 months after obtaining permission from Institutional Ethical Committee. The study was conducted among cancer patients undergoing radiotherapy. The data was collected from the patient case records and was analyzed as per the WHO prescribing indicators.Results: In the present study it was observed that the average number of drugs prescribed per encounter was 7.7. The drugs prescribed by generic name were 41.4%. Percentage of encounters with an antibiotic prescribed was 100. Percentage of encounters with an injection prescribed was 20.5%. Percentage of drugs prescribed from essential drugs list was 35.8%.Conclusions: Drug utilization studies helps in modifying the prescription pattern and helps in making the drug usage more rational.
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Objective To investigate the types of common chronic diseases and common drugs in the elderly visiting primary medical institutions in China.Methods Cluster sampling was adopted in eight provinces/cities/autonomous region of Zhejiang,Jilin,Henan,Shanghai,Chongqing,Gansu,Guangxi and Jiangsu.Sampling sites were selected and information was collected through the online reporting system of common diseases and drug costs of the elderly in primary hospitals at all levels in China.On these grounds,the basic situation of primary medical institutions,the common chronic diseases and common drugs for people aged 65 years and above were investigated.Results Primary hypertension(65.7％ or 46/70)and arthropathy(10.0％ or 7/70)were the most common chronic diseases in the elderly visiting primary medical institutions.The consultation rate of primary hypertension was highest both in rural areas(58.3％,i.e.the ratio of 21 over 36 primary medical institutions)and in urban areas(73.5％,i.e.the ratio of 25 over 34 primary medical institutions).The primary medical institutions with consultation rates of hypercholesterolemia/hyperlipidemia (x2 =5.137,P=0.023),diabetes(x2 =3.868,P =0.049)and dyspepsia(Fisher's exact test,P =0.026)as the top 3 chronic diseases were more often seen in urban areas than in rural areas,while the primary medical institutions with consultation rates of cerebrovascular diseases as the top 3 chronic diseases were more often seen in the rural areas than in urban areas(x2=9.974,P =0.002).More primary medical institutions with consultation rates of benign prostatic hyperplasia and primary osteoporosis as the top 10 chronic diseases were found in urban areas than in rural areas(x2 =4.054 and 3.861,P =0.044 and 0.049,respectively),while more primary medical institutions with consultation rates of heart failure as the top 10 chronic diseases were found in rural areas than in urban areas(x2 =3.865,P =0.049).Aspirin,nifedipine and simvastatin one by one were most commonly used in people aged 65 years and over in primary medical institutions.Conclusions Primary hypertension is the most common chronic disease among the elderly visiting primary medical institutions in both rural and urban.Common chronic diseases in primary medical institutions are different between the urban and rural areas.Regional differences and urban-rural differences should be taken into account in drug preparation.There are some irregularities in the use of drugs and insufficient stocks of essential drugs in basic-level medical institutions.
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Background: Drug utilization studies (DUS) are used as potential tool in the evaluation of healthcare system. DUS are conducted to facilitate the rational use of drugs in populations. The indicators of prescription in practice measure the performance of health care provider in several key dimensions related to appropriate use of drug. Therefore, the present study was undertaken to analyze the prescription written by doctors in a Tertiary Care Hospital in rural area.Methods: Present study is a cross sectional, prospective and observational study. The study was conducted in a rural tertiary, teaching hospital at JIIU’s Indian Institute of Medical Science and Research, Warudi, Taluka Badnapur from January 2017 to September 2017 for duration of 9 months. Data was obtained from 300 prescriptions. Data was analysed as per WHO prescribing indicators.Results: Average number of drugs in the present study was found to be 2.85. Percentage of drugs prescribed by generic name is 13.48%. Percentage of encounters with an antibiotic prescribed 60%. Percentage of encounters with an injection prescribed 4.33%. Percentage of drugs prescribed from essential drugs list 72.91%.Conclusions: These types of studies help to design policy for rational use of drugs and motivation of physician for rational use of drugs.
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In Brazil municipalities are responsible for initiating the guarantee of access to essential medicines by selecting those that will be included in their lists. This study aimed to analyze how the Municipal Lists of Essential Medicines (MLEM) are prepared, as well as their comparison with the National List of Essential Medicines (RENAME) 2014, and what their similarities and differences are. The municipalities belong to the 11th Regional Healthcare Coordination Center of Rio Grande do Sul State. A questionnaire was applied to the Pharmaceutical Assistance managers to characterize the preparation of the lists that were compared between themselves and with RENAME 2014, later Cluster Analysis was used to determine similarities. A total of 23 municipalities and 22 lists were received for the analysis. The main criteria for elaboration were medical prescription, presence in RENAME and need of the population. RENAME was cited as the most widely used source of information. Ten drugs were present in all lists and the percentage of agreement with RENAME was 60.6%. These results point to the need for a balance between what is accomplished by the municipalities and what is recommended in selecting essential medications.
No Brasil os municípios são responsáveis pelo início da garantia de acesso aos medicamentos essenciais ao selecionar aqueles que farão parte de suas listas. Esta pesquisa objetivou analisar a elaboração, similaridades e diferenças das Relações Municipais de Medicamentos Essenciais (REMUMEs) dos municípios pertencentes a 11ª Coordenadoria Regional de Saúde do Estado do Rio Grande do Sul, bem como a comparação com a Relação Nacional de Medicamentos Essenciais (RENAME) 2014. A aplicação de um questionário aos gestores da Assistência Farmacêutica caracterizou a elaboração das listas que foram comparadas entre si e com a RENAME 2014, posteriormente foi utilizada análise de agrupamentos para as similaridades. Responderam ao questionário 23 municípios e 22 listas foram recebidas para a análise. Como principais critérios de elaboração, foram citadas a prescrição médica, presença na RENAME e necessidade da população. A RENAME foi referenciada como fonte de informação mais utilizada. Dez medicamentos estavam presentes em todas as listas e o percentual de concordância com a RENAME foi de 60,6%. Estes resultados apontam a necessidade de um equilíbrio entre o que é realizado pelos municípios e o que é recomendado para seleção de medicamentos essenciais.
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Humans , Pharmaceutical Services , Pharmaceutical Preparations , Drugs, Essential , National Drug Policy , BrazilABSTRACT
OBJECTIVE:To standardize the ward rescue and essential drugs quality management in wards,and reduce the med-ication risk of patients. METHODS:Failure mode and effect analysis(FMEA)was used to analyze the inspection items and failure modes of quality management of ward rescue and essential drugs. According to scoring the possibility,severity and detectability de-gree of the failure modes and calculating the risk priority number(RPN),failure modes that should be given priority improvement were quantified and determined,improvement measures were developed and conducted,and management effects were evaluated af-ter 6 months. RESULTS:12 failure modes were determined,including the residue treatment of narcotic and the first-class psycho-tropic drugs was not recorded,drug storage temperature was not up to standard and drug expired,etc. Improving related systems, enhancing the inspection management,cold chain management,daily management and other measures were implemented and con-ducted. After 6 months,the top 3 items with the highest RPNs were dropped from 320,240,216 score to 16,16,27 scores,re-spectively,all in a relatively low risk area. Numbers of failure mode event were dropped from 1869 to 218,dropping by 88.3%. CONCLUSIONS:According to qualifying the failure modes in ward rescue and essential drugs quality management by using FMEA in our hospital,the management items with the highest risk has determined and improved,the medication risk of patients has significantly reduced.
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OBJECTIVE:To standardize the ward rescue and essential drugs quality management in wards,and reduce the med-ication risk of patients. METHODS:Failure mode and effect analysis(FMEA)was used to analyze the inspection items and failure modes of quality management of ward rescue and essential drugs. According to scoring the possibility,severity and detectability de-gree of the failure modes and calculating the risk priority number(RPN),failure modes that should be given priority improvement were quantified and determined,improvement measures were developed and conducted,and management effects were evaluated af-ter 6 months. RESULTS:12 failure modes were determined,including the residue treatment of narcotic and the first-class psycho-tropic drugs was not recorded,drug storage temperature was not up to standard and drug expired,etc. Improving related systems, enhancing the inspection management,cold chain management,daily management and other measures were implemented and con-ducted. After 6 months,the top 3 items with the highest RPNs were dropped from 320,240,216 score to 16,16,27 scores,re-spectively,all in a relatively low risk area. Numbers of failure mode event were dropped from 1869 to 218,dropping by 88.3%. CONCLUSIONS:According to qualifying the failure modes in ward rescue and essential drugs quality management by using FMEA in our hospital,the management items with the highest risk has determined and improved,the medication risk of patients has significantly reduced.
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Chinese medicine prices often have sharp rise or fall, and even the impact of short-term price rise on the quality of feed can't be ignored.On the other hand, the production of traditional Chinese medicine is strictly subject to resource constraints, so much of the industrial production due to lack of or prohibited use of resources must bestopped. Based on 203 Chinese patent medicines in the National Essential Drugs (2012 Edition), the factors that influence the supply of essential drugs of traditional Chinese medicine were analyzed and seven indicators for the supply of essential medicines were designed in this paper. According to the Chinese herbal medicine resources survey and dynamic monitoring service system data, a multi-index comprehensive evaluation model based on radar chart analysis was proposed, providing a holistic and overall evaluation of the supply situation of essential drugs of traditional Chinese medicine. The evaluation results were concise, clear and intuitive. In this paper, Jiuwei Qianghuo Wan and Ganmao Qingre Keli were taken as the examples to prove that the proposed comprehensive evaluation method is concise, clear, intuitive, credible and practical.
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Drug Utilization Evaluation (DUE) promotes rational use of drugs. The aim of present study was to conduct DUE of anticancer drugs. Newly diagnosed and/or known case of carcinoma which required treatment with chemotherapy, patients of both sex, and age >18 years were included in the study. Patients diagnosed as having carcinoma that also required surgical intervention, radiotherapy or other modality of management were excluded from the study. WHO core prescribing indicators are used to know about polypharmacy, excessive use of antibiotics, percentage of drugs prescribed by from Essential Drugs List (EDL). Females were commonly affected than males. Patients of age group 41-50 years (mean 52.43, SD ±7.77) constituted the highest number, 34% and 13% in rural and urban population respectively. 5-Flurouracil and Cisplatin are most commonly prescribed anticancer drugs followed by Cyclophosphamide. The most commonly used adjuvant drugs in our study are Diclofenac, B-Complex, Granisetron, Ranitidine, Dexamethasone, Ondansetron, and Mannitol. The cytoprotectant drugs observed in our study are Leucovorin, Mesna and Peg-Filgrastim. Average number of Cytotoxic Drugs per prescription was 1.97. Average number of drugs per prescription was 8.16. Percentage of drugs prescribed from Essential Drugs List (EDL) was 88.4%. Percentage of encounters with an antibiotic prescribed was 54.8%. Polypharmacy, unnecessary antibiotic and injection prescribing were not observed. The percentage of drugs from EDL may be improved.
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Objective:To investigate and analyze the influencing factors in the implementation of essential drugs in the medical in-stitutions in Hubei in order to provide reference for promoting the implementation of national essential drugs. Methods: The medical staff participating in the training class of clinical application guidelines and formulary of national essential drugs in Hubei (2014) was surveyed by a questionnaire to analyze and evaluate the statistical influencing factors in essential drugs implementation. Results: A-mong the factors affecting the implementation of essential drugs, the score of rational use was the highest (3. 86) followed by that of medicine quality, rational varieties of essential drugs, affordability and management system, and the factors with score below 3. 0 were pharmacy trusteeship and income of essential drugs in medical institutions. Conclusion: Based on the investigation and evaluation of influencing factors, the corresponding measures should be adopted, which can further improve the basic drug system and enhance the use effects of essential drugs.
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O objetivo deste trabalho foi analisar o elenco de medicamentos do Programa Farmácia Popular do Brasil (PFPB) frente à política de assistência farmacêutica vigente no país. O elenco de medicamentos do PFPB foi comparado com listas de referência de medicamentos essenciais (nacional e internacional), com os componentes da assistência farmacêutica no Sistema Único de Saúde (SUS) e com a produção pública de medicamentos nos Laboratórios Farmacêuticos Oficiais do Brasil (LFOB). O PFPB contém 119 medicamentos, dos quais 19,3% e 47,1% não foram selecionados nas listas de referência nacional e internacional, respectivamente; 16,8% não são utilizados na atenção primária e 40,3% não são produzidos por LFO. A revisão do elenco do PFPB com base na concepção de medicamentos essenciais da Organização Mundial da Saúde, o alinhamento às políticas de assistência farmacêutica e à produção pelos LFO são fundamentais para melhorar a qualidade da atenção à saúde, a gestão, a capacitação dos prescritores e a informação aos cidadãos.
This study aimed to analyze the list of drugs in the Popular Pharmacy Program in Brazil (PFPB) in relation to the country's pharmaceutical care policy. The list of drugs in the PFPB was compared to the Brazilian and international reference lists of essential medicines, the components of pharmaceutical care in Brazilian Unified National Health System (SUS), and drug production by the country's government pharmaceutical laboratories. The PFPB list includes 119 drugs, of which 19.3% and 47.1% were not selected on the Brazilian and international reference lists, respectively; 16.8% are not used in primary care, and 40.3% are not produced by the country's government laboratories. A revision of the PFPB list based on the essential medicines concept (World Health Organization), alignment of pharmaceutical care policies, and production by government laboratories are essential to improve quality of health care, management, training of prescribers, and information for the population.
El objetivo de este estudio fue analizar la lista de medicamentos del Programa Farmacia Popular de Brasil (PFPB), en contraste con la política de la asistencia farmacéutica, en vigor en el país. El catálogo de medicamentos del PFPB se comparó con las listas de referencias de medicamentos esenciales (nacionales e internacionales), así como con la lista de financiación de los componentes de la asistencia farmacéutica del sistema de salud pública, y la producción pública de medicamentos por Laboratorios Oficiales de Farmacéuticos de Brasil (LOFB). El PFPB contiene 119 medicamentos de los que un 19,3% y un 47,1% no fueron seleccionados en las listas de referencias nacionales e internacionales, respectivamente; un 16,8% no se utilizan en la atención primaria y un 40,3% no son producidos por los LOFB. La revisión del catálogo de PFPB, basado en la concepción de medicamentos esenciales de la Organización Mundial de la Salud, el alineamiento político de la asistencia farmacéutica, y la producción por los LOFB es fundamental para mejorar la calidad de la asistencia de salud, la gestión, la formación de los prescriptores y la información a los ciudadanos.
Subject(s)
Humans , Drugs, Essential/classification , Pharmaceutical Services/supply & distribution , Brazil , Cross-Sectional Studies , Delivery of Health Care , Drug and Narcotic Control , Health Policy , National Health Programs , World Health OrganizationABSTRACT
Venezuela cuenta con los auxiliares de medicina simplificada (AMS) y los agentes comunitarios para la atención primaria en salud (ACAPS), personal no profesional, capacitado para el diagnóstico y tratamiento de enfermedades frecuentes; brindando atención en áreas de difícil acceso y en zonas rurales dispersas. En este trabajo se describió el uso racional de medicamentos por el AMS/ACAPS en los ambulatorios rurales (AR) del municipio Atures, estado Amazonas, Venezuela, en el 2011. Para ello, se realizó un estudio no experimental, de campo, descriptivo, de corte transversal; utilizando los indicadores básicos del uso de medicamentos de la OMS. Se evaluaron 12 de los 16 AR tipo I y el AR tipo II del municipio; registrándose 830 consultas y 1.238 prescripciones de medicamentos durante el segundo trimestre del 2011. El AMS/ACAPS prescribió 1,51 medicamentos por consulta. Del total de las prescripciones, 86,92% se hicieron con su nombre genérico, 11,26% como un medicamento inyectable, 23,88% fueron un antibiótico y solo el 52,51% de las prescripciones estuvieron acordes al primer nivel de atención. De los 13 AR visitados, nueve tenían la lista de medicamentos, cuatro el formulario terapéutico nacional y ocho contaron con otra fuente de información (guías de formación del AMS o ACAPS). La disponibilidad de medicamentos clave tuvo un promedio crítico de 48,72%. La prescripción de medicamentos por el AMS/ACAPS resulta inadecuada debido a que se utiliza una lista de medicamentos que no es acorde para el primer nivel de atención.
Venezuela has simplified medical assistants (AMS) and non-professional community workers for primary health care (ACAPS), trained in the diagnosis and treatment of common diseases; providing care in inaccessible and remote rural areas. In this paper the rational use of drugs by the AMS/ACAPS in rural clinics (AR) of the municipality Atures, Amazonas state (Venezuela) in 2011, was described. For this, a descriptive, non-experimental, field and cross sectional study took place; using the WHO basic indicators of drug use. We evaluated 12 of the 16 type I ARs and the type II AR in the municipality; recording 830 consultations and 1,238 drug prescriptions during the second quarter of 2011. The AMS/ACAPS prescribed 1.51 drugs per consultation. Of all prescriptions, 86.92% were by generic names, 11.26% as an injectable drug, 23.88% were an antibiotic and only 52.51% were in accordance to the primary care level. Of the 13 ARs visited, 9 had the drug list, 4 the national therapeutic formulary and 8 had another source of information (AMS or ACAPS training guides). The availability of key drugs had a critical average of 48.72%. The prescription of drugs by the AMS/ACAPS is inadequate because a list of drugs, which is not according to the first level of care, is used.
Subject(s)
Humans , Male , Female , Health/ethics , Community Health Workers , Drugs, Essential/supply & distribution , Drug Utilization/standards , Technology Assessment, Biomedical , Therapeutics , Public HealthABSTRACT
Os medicamentos essenciais são definidos pela Organização Mundial da Saúde (OMS) como aqueles que satisfazem as necessidades prioritárias de cuidado de saúde da população. Sua seleção busca refletir necessidades coletivas, recomendando-se, para tanto, a utilização dos estudos de carga global de doença. Foi realizado um estudo exploratório relacionando os medicamentos das RENAME aos estudos de Carga Global de Doença no Brasil, de 1998 e 2008, e às evidências científicas. Buscou-se, assim, verificar se os elencos de medicamentos nas RENAME (2002 a 2012) atenderam às recomendações da OMS para seleção de medicamentos. Embora as RENAME 2010 e 2012 acatem semelhantemente à Carga Global de Doença Brasil 2008, a versão de 2012 o faz com maior número de medicamentos, parecendo ter sido tensionada por pressões do crescente mercado de novas tecnologias. Dessa forma, a RENAME deixou de ser uma relação de medicamentos essenciais, tornando-se uma lista de financiamento da assistência farmacêutica.
The World Health Organization (WHO) defines essential medicines as those that meet the population’s priority healthcare needs. Their selection aims to reflect collective needs, thus recommending the use of studies on global burden of disease. An exploratory study was performed to link the medicines from the RENAME lists to Global Burden of Disease in Brazil (1998 and 2008) and the scientific evidence. The study thus sought to verify whether the RENAME (2002 to 2012) met WHO guidelines for drug selection. Although RENAME 2010 and 2012 both adhere to Global Burden of Disease in Brazil 2008, the 2012 version includes a longer list of medicines and appears to be pressured by the growing market for new technologies. Thus, RENAME is no longer a list of essential medicines, but has become a list of financing for pharmaceutical care.
Los medicamentos esenciales son definidos por la Organización Mundial de la Salud (OMS) como aquellos que satisfacen las necesidades de atención de salud prioritarias de la población. Su selección tiene como objetivo reflejar las necesidades colectivas, recomendando, por lo tanto, el uso de estudios de carga global de enfermedades. Se realizó un estudio exploratorio que une el fármaco a los estudios de cambios de nombres en la Carga Global de Enfermedad de Brasil, 1998 y 2008, y evidencia científica. Buscamos, por lo tanto, verificar que la relación de los medicamentos en RENAME (2002-2012) cumplen las recomendaciones de la OMS para la selección de medicamentos. Pese a que RENAME 2010 y 2012 se sitúan de manera similar por la Carga Global de Enfermedad de Brasil 2008, la versión 2012 incluye más medicamentos, lo que se ha producido por las presiones en el crecimiento del mercado de las nuevas tecnologías. Así, el RENAME, ya no es una relación de los medicamentos esenciales y ha pasado a convertirse en una lista de financiación para la atención farmacéutica.
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In order to gauge the accessibility of essential medicines in the service network pertaining to the Brazilian Public Health System (SUS) in the city of Várzea Grande (MT), we performed a case study with multiple levels of analysis. We identified public access as an important dimension of pharmaceutical services in the city after carrying out an exploratory analysis (or feasibility study) on how to assess their implementation. We designed a logical model of pharmaceutical services in the city, from which was derived a matrix containing the questions and criteria for assessment. This matrix was validated by a consensus of experts and with information gathered from semi-structured interviews, document analysis and observation. The findings show that the National Policy for Pharmaceutical Service has been implemented only to a limited extent (34.7%) in this city, given that problems were found in all the component parts of the cycle of pharmaceutical service. Only geographical accessibility was ranked as at an advanced stage (89.5%). We conclude with recommendations for improvements related to criteria assessed as still at an early stage, especially with respect to the components of organizational accessibility. Finally, we note that the obstacles to be overcome not only call for specific measures related to pharmaceutical service itself, but also concern more general issues regarding health care organization...
Com o objetivo de avaliar a acessibilidade a medicamentos essenciais na rede de serviços pertencentes ao Sistema Único de Saúde (SUS) no município de Várzea Grande-MT, foi realizado um estudo de caso com múltiplos níveis de análise. A identificação do acesso como dimensão importante para avaliação da Assistência Farmacêutica no município foi identificada após a realização de uma análise exploratória ou estudo de avaliabilidade. Foi elaborado um modelo lógico da Assistência Farmacêutica no município do qual foi derivada uma matriz contendo as dimensões e critérios para avaliação. Essa matriz foi validada por meio de consenso de experts e as informações obtidas por meio de entrevistas semiestruturadas, análise documental e observação. Os achados mostram que a Política Nacional de Assistência Farmacêutica está implantada de forma incipiente (34,7%), no município estudado, tendo em vista que foram encontrados problemas em todos os componentes do ciclo de Assistência Farmacêutica. Apenas a acessibilidade geográfica foi classificada como em avançada (89,5%). Os autores concluem com recomendações relacionadas ao aperfeiçoamento dos critérios avaliados como em estágio incipiente, principalmente no que diz respeito aos componentes da acessibilidade organizacional. Registram ainda que a superação dos obstáculos encontrados relaciona-se não apenas com medidas específicas relacionadas à Assistência Farmacêutica propriamente dita, mas também com aspectos de ordem mais geral relacionados a organização da atenção a saúde...
Subject(s)
Humans , Drugs, Essential , Health Services Accessibility , Pharmaceutical Services , Unified Health SystemABSTRACT
OBJETIVO: Investigou-se a adesão de médicos brasileiros em atuação no SUS a listas de medicamentos essenciais (LME), buscando conhecer o papel das LME na prática prescritiva e identificar a aceitação e barreiras para sua utilização no Brasil. MÉTODOS: O estudo, de âmbito nacional, entrevistou médicos da Atenção Primária e da hospitalar de 30 unidades públicas de saúde de municípios com e sem LME definida. Na análise dos dados foram utilizadas técnicas da pesquisa qualitativa em saúde. As categorias finais de análise foram: (i) contato com diferentes LME; (ii) utilização das LME na prática clínica; (iii) percepção do conceito de medicamentos essenciais. RESULTADOS: Foram ouvidos 58 médicos, sendo 11 do Nordeste e do Centro-Oeste e 12 do Sudeste, Norte e Sul. Apenas 17 dos 58 médicos entrevistados informaram contato anterior com uma LME, a maior parte referindo-se à lista municipal. Quando perguntados se utilizavam a Rename em sua prática clínica, todos os entrevistados responderam que não. Dentre os motivos citados, estão (i) a indisponibilidade dos medicamentos (da lista) no momento requerido; (ii) a falta de orientação necessária para o uso; (iii) a impressão de que a composição da lista é inadequada à demanda clínica. CONCLUSÕES: Os resultados das falas expõem desconhecimento e baixa adesão a LME. Ainda que tenham tido algum contato prévio com uma LME, esta não é valorizada como fonte de informações para a prescrição baseada em evidências.
OBJECTIVE: To investigate the adherence to the essential medicines lists (EML) by Brazilian physicians practicing in the public health system and the role of the EML in prescribing practices, identifying barriers to their use in Brazil. METHODS: A nationwide study interviewed physicians from diverse public healthcare settings in 30 facilities, in municipalities with different statuses in regard to the existence of EMLs. Research data was analyzed through content analysis and perception analysis techniques. The final analytical categories were (i) physician's contact with different EMLs, (ii) use of EMLs in clinical practice and (iii) physician's perceptions regarding the essential medicines concept. RESULTS: A total of 58 physicians were interviewed, from all five Brazilian regions: eleven from the Northeast, eleven from the Mid-West, and twelve each from the Southeast, the North and the South. Seventeen of the 58 physicians reported previous contact with an EML, most of which had occurred with municipal lists. All physicians informed that they did not use the Brazilian Essential Medicines List (RENAME) in their clinical practices. Among the main reasons for this were: (i) unavailability of listed medicines at required moment, (ii) the lack of necessary information and training for adequate use of EML, and (iii) the perception that the composition of the EML is inadequate for clinical demands. CONCLUSIONS: Results from content analysis exposed low awareness regarding EMLs and the essential medicines concept, in addition to a low level of adherence to EMLs. Even though some physicians reported having previous contact with an EML, this tool is not valued as an evidence-based information source for writing prescriptions.
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Background: According to a report by World Health Organization (WHO) in 2003, approximately 50% of all patients fail to take their medicine correctly. This is due to errors in prescription, underuse or misuse of medicines and ignorance of prescribers, dispensers, and patients. Methods: It is a hospital-based interventional-study carried out in a secondary level multispecialty hospital of Delhi. Investigators collected 536 prescriptions from the outpatient department of various departments and studied according to WHO core prescribing indicators for assessing drug prescription writing pattern. Interventions to improve the prescribing pattern included one continued medical education session and one workshop on prescription writing (providing essential drug list [EDL] etc.,), sharing the baseline data with the physicians and administrative approach. Evaluation of the prescribing pattern after 6 weeks of the intervention was done to find out the impact. Results: On an average 3.43 drug per encounter before intervention increased to 3.46 drugs per encounter. Inclusion of generic drugs and from EDL increased significantly from 54.8% to 73.4% and 76.9% to 88.4% respectively.. Prescribing antibiotics and injectables showed no significant reduction from baseline. The completeness of the prescriptions with respect to the various components improved significantly. Conclusion: Combining different intervention seems a noble approach to improve the prescription writing practices with respect to completeness and inclusion of generic drugs, drugs from EDL.
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OBJETIVO: Obter um painel dos principais indicadores utilizados para a seleção de medicamentos por meio da realização de uma revisão integrativa da literatura. MÉTODOS: Após elaborar um protocolo de revisão, foram realizadas buscas nas bases LILACS, MEDLINE, Embase e SciELO. Foram utilizados os descritores "indicadores", "critérios", "seleção de medicamentos", "comitê de farmácia e terapêutica" e "formulário de medicamentos", com suas variações em inglês e espanhol. Foram selecionados e revisados 16 artigos originais publicados entre janeiro de 1996 e março de 2012 para compor um painel de indicadores. RESULTADOS: Foram identificados 45 indicadores quantitativos e qualitativos. Esses indicadores foram agrupados de acordo com semelhanças conceituais em três categorias: 1) avaliação da estrutura da comissão de farmácia e terapêutica; 2) avaliação dos processos gerais de seleção de medicamentos; e 3) avaliação dos resultados da seleção de medicamentos. CONCLUSÕES: Os indicadores avaliados demonstram relativa uniformidade nos padrões estabelecidos para a seleção de medicamentos. O grupo de indicadores estabelecidos neste estudo deve servir como referência para fomento e consolidação dessa atividade nos serviços de saúde pública.
OBJECTIVE: To produce a panel of the main drug selection indicators by performing an integrative literature review. METHODS: After the elaboration of a review protocol, searches were conducted in LILACS, MEDLINE, Embase, and SciELO databases. The following search terms were used: "indicators"; "criteria"; "drug selection"; "pharmacy and therapeutics committee"; and "medication form"; with the applicable variations in English and Spanish. Sixteen original articles published between January 1996 and March 2012 were retrieved and reviewed to compose a panel of indicators. RESULTS: Forty-five quantitative and qualitative indicators were identified. These indicators were grouped according to conceptual similarities in three categories: 1) assessment of pharmacy and therapeutics committee structure; 2) evaluation of the general processes of drug selection; and 3) evaluation of the results of drug selection. CONCLUSIONS: The indicators identified reveal relative uniformity in the established patterns for drug selection. The group of indicators established in this study should serve as reference for the development and consolidation of drug selection in public health services.
Subject(s)
Humans , Delivery of Health Care , Pharmaceutical Services , Pharmacy and Therapeutics CommitteeABSTRACT
El MPPS cuenta con los Agentes Comunitarios para la Atención Primaria en Salud (ACAPS) para la atención de la población en áreas de difícil acceso y zonas rurales dispersas. Para promover el Uso Racional de Medicamentos (URM), está publicada la Lista Básica Nacional de Medicamento Esenciales (LBNME) de uso en el Sistema Público Nacional de Salud a pesar de ello, se refleja una deficiencia en la selección de medicamentos de acuerdo a los niveles de atención, uso inadecuado de antimicrobianos, polimedicación y recetado no acorde con las directrices clínicas. Objetivo General: proponer un Manual Terapéutico dirigido a los ACAPS del Municipio Atures del Estado Amazonas, utilizando como metodología los Indicadores Básicos del Uso de Medicamentos de la OMS. Metodología: se evaluaron 13 ARI ubicados en el Municipio Atures donde labora un ACAPS/AMS, se registraron 830 consultas y 1.238 prescripciones de medicamentos durante el trimestre AbrilJunio del año 2011. Resultados: el ACAPS/AMS utiliza una media de 1,51 medicamentos por consulta, en promedio 86,92% prescribieron un genérico y 11,26% un inyectable, del total de prescripciones 23,88% correspondía a un antibiótico y solo 52,51% de las prescripciones estaban acordes para el Primer Nivel de Atención. Una evaluación complementaria determinó que de 295 prescripciones de antibióticos, 263 (89,15%) no estaban seleccionados para el Primer Nivel de Atención, de la revisión comparativa del Listado de Medicamentos local con la LBNME solo hay coincidencia de un 40%. El 69,23% de los ambulatorios cuentan con una Lista de medicamentos esenciales, el 30,77% disponen de un FTN en comparación a un 61,54% que cuenta con otras fuentes de información. La disponibilidad de medicamentos claves tiene un promedio crítico de 48,72 %. La accesibilidad de información actualizada e imparcial sobre las pautas de tratamientos establecidas para los ACAPS dentro de la APS como la propuesta del Manual Terapéutico, puede favorecer en proporcionar a cada paciente el mejor tratamiento y permitir el uso racional de los recursos disponibles.
MPPS has with Community Agents for Primary Health Care (ACAPS) to the attention of the population in areas of difficult access and remote rural areas. To promote Rational Use of Drugs (RUD), it is published la Lista Básica Nacional de Medicamentos Esenciales (LBNME) for use in the National Public Health System however a deficiency is reflected in the selection of drugs according to levels care, inappropriate use of antimicrobials, polypharmacy and prescribed not in accordance with clinical guidelines. General Objective: To propose a Therapeutic Manual aimed at ACAPS Atures Municipality State of Amazonas, using as a methodology the Core Drug Use Indicators WHO. Methodology: ARI 13 located in the municipality where they work one Atures ACAPS / AMS were evaluated 830 consultations and 1,238 drug prescriptions were recorded during the quarter April-June 2011 year Results: ACAPS / AMS uses an average of 1.51 drugs per encounter on average 86.92% prescribed a generic injectable and 11.26% of the total prescriptions 23.88% corresponded to an antibiotic and only 52.51% of prescriptions were in line for the primary care level. A complementary evaluation found that of 295 antibiotic prescriptions, 263 (89.15%) were not selected for the first level of care, comparative review of the local Drug List with no coincidental LBNME 40%. 69.23% of outpatients have a list of essential drugs, 30.77% have a FTN compared to 61.54% who have other sources of information. The availability of key drugs is a critical average of 48.72%. The accessibility of current and impartial treatment guidelines established for ACAPS within the APS as the proposal of Manual Therapy information can favor in providing each patient the best treatment and allow the rational use of available resources
Subject(s)
Humans , Male , Female , Primary Health Care , Guidelines as Topic , Community Health Workers , Drug Utilization , Drugs, Essential , Form , PharmacovigilanceABSTRACT
Objective To analysis the major problems and the causes in the process of centralized purchasing of national essen -tial drugs, and to give some effective solutions according to the price problems for ensuring the quality and regular supply of national es -sential drugs , decrease patients burden effectively and safeguard the medication safety of patients .Methods The implementation of cen-tralized purchasing of national essential drugs was investigated , the problems which were major and outstanding were analyzed to find out the internal causes and the effective solutions were given .Results The progression of centralized purchasing of national essential drugs was successfully in general .The implementation of the principle of winning of the bidding with the lowest bid price lead to excessive low price, which caused some problems such as lower quality or bad supplied of some national essential drugs .Conclusion The price policy of centralized purchasing of national essential drugs should not be instituted based on the lower price , more winning of biddings .It needed more scientific and overall perspective thoughts .It maybe solve the problems mentioned above by winning of the bidding with the lowest bid price in the interval average price , appropriately loosing the control of difference rate with the results of decreasing the drug price , avoiding cut-throat competition, ensuring the quality and supply of drugs , lightening the patients′burden, releasing the problem of high cost of getting medical treatment .