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1.
Acta sci., Health sci ; 44: e56764, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1367790

ABSTRACT

The aim of this study was to investigate possible factors related to antiretroviral therapy (ART) that contribute to the understanding of the highest rate of Aids detection on the coast of the state of Paraná, a port region identified administratively as the 1stRegional Health Division (1stHD) in the state of Paraná. Data on the sociodemographic profile of the population undergoing antiretroviral treatment (ART), medication changes, dropout of therapy, proportion of the population undergoing treatment and viral load were obtained through computerized systems. Between July 1, 2018 and June 31, 2019, 1,393 people were on ART in the 1stRS. Of these, 57.6% were male. During this period, 110 people started ART with a predominance of the age group between 30 and 39 years old. ART was switched for169 people and 211 patient dropouts were detected. The proportion of people diagnosed with HIV without treatment (gap) is still high, however 92.7% people on ART have suppressed viral load. It can be concluded that the lower educational level of the population undergoing treatment, the late diagnosis of those infected and the treatment gapprobably contribute to the highest rate of Aids detection in the 1stRS.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Acquired Immunodeficiency Syndrome/epidemiology , Pharmacoepidemiology/methods , Anti-Retroviral Agents/therapeutic use , Sociodemographic Factors , Population , Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/therapy , HIV/pathogenicity , Viral Load , Delivery of Health Care
2.
Acta Paul. Enferm. (Online) ; 35: eAPE039000134, 2022. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1374014

ABSTRACT

Resumo Objetivo Estimar a prevalência e fatores associados à automedicação entre estudantes de cursos de graduação do interior do Amazonas. Métodos Estudo transversal com 694 estudantes de uma universidade pública do interior do Amazonas, entre março a julho de 2018. Definiu-se automedicação como uso de, no mínimo, um medicamento sem prescrição. Estimaram-se Odds Ratio (OR) e Intervalos de Confiança de 95% (IC 95%) pela Regressão Logística. Resultados Dos 694 graduandos, 483 indicaram consumo medicamentoso. Destes, 80,1% referiram automedicação. Os analgésicos foram os mais utilizados (51,8%) e os motivos que mais levaram a se automedicarem foram os problemas álgicos (54,3%). As variáveis "ter filhos" (OR: 1,83; IC 95%: 1,06-3,16) e "ter a prática de indicar medicamentos para terceiros" (OR: 2,38; IC 95%: 1,47-3,86) permaneceram independentemente associadas à automedicação. Conclusão Observou-se alta prevalência da automedicação entre os estudantes, evidenciando a necessidade de discussão sobre o uso racional de medicamentos no ambiente universitário.


Resumen Objetivo Estimar la prevalencia y factores asociados con la automedicación entre estudiantes de cursos universitarios del interior del estado de Amazonas. Métodos Estudio transversal con 694 estudiantes de una universidad pública del interior del estado de Amazonas, entre marzo a julio de 2018. Se definió la automedicación como el uso de, como mínimo, un medicamento sin prescripción. Se estimaron Odds Ratio (OR) e Intervalos de Confianza del 95 % (IC 95 %) por Regresión Logística. Resultados De los 694 estudiantes universitarios, 483 indicaron un consumo medicamentoso. De estos, 80,1 % mencionaron automedicación. Los analgésicos fueron los más utilizados (51,8 %) y los motivos que más llevaron a la automedicación fueron los problemas álgicos (54,3 %). Las variables "tener hijos" (OR: 1,83; IC 95 %: 1,06-3,16) y "tener la práctica de indicar medicamentos a terceros" (OR: 2,38; IC 95 %: 1,47-3,86) permanecieron independientemente asociadas a la automedicación. Conclusión Se observó alta prevalencia de automedicación entre los estudiantes, evidenciando la necesidad de discusión sobre el uso racional de medicamentos en el ambiente universitario.


Abstract Objective To estimate the prevalence and factors associated with self-medication among undergraduate students in the countryside of Amazonas. Methods Cross-sectional study with a total of 694 students from a public university in the countryside of Amazonas, between March and July 2018. Self-medication was defined as the use of at least one medication without a prescription. Odds Ratio (OR) and 95% Confidence Intervals (95% CI) were estimated by Logistic Regression. Results Of the 694 undergraduate students, 483 indicated drug use. Of these, 80.1% reported self-medication. Analgesics were the most used (51.8%) and the reasons that most led to self-medicating were pain problems (54.3%). The variables "having children" (OR: 1.83; 95% CI: 1.06-3.16) and "having the practice of recommending medication to other people" (OR: 2.38; 95% CI: 1.47 -3.86) remained independently associated with self-medication. Conclusion There was a high prevalence of self-medication among students, highlighting the need for discussion about the rational use of medication in the university environment.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Risk-Taking , Self Medication , Students , Drug Utilization , Brazil , Cross-Sectional Studies , Surveys and Questionnaires , Pharmacoepidemiology
3.
Health sci. dis ; 23(8): 45-50, 2022. tables,figures
Article in English | AIM | ID: biblio-1391089

ABSTRACT

Introduction.Kawasaki disease (KD) is an acute multi-systemic vasculitis of young children and infants. It is the first cause of acquired cardiac disease in children and remains poorly described in Gabon. We therefore wanted to describe the epidemiological and therapeutic aspects of this disease in two hospitals in Libreville. Patients and methods.We conducted a retrospective, descriptive study from 2014 to 2021 at the Akanda University Hospital and the El Rapha polyclinic in Libreville. All records of patients hospitalised in paediatrics for MK were included. Results.Thirty three cases of MK were retrieved, giving ahospital prevalence of0.6%. The mean age of patients was 20.4 months, the proportion of patients <18 months was 60.6% and the sex ratio was 1.7. The symptoms were observed mainly during the dry season (69.7%). Fever (100%), conjunctivitis (78.8%) and desquamation (72.7%) were the main reasons for consultation. In 24.2% of cases, a traditional medicine was administered. The average time between the onset of symptoms and hospitalization was 11 days. Once hospitalized, the diagnosis of MK was evoked within an average of 3 days. The typical form was observed in 57.6% of cases. In 100% of cases, the hemoglobin level was <12g/dl and the CRP was >15mg/l. Echocardiography was abnormal in 5 patients. Acetylsalicylic acid was the only treatment with a mean time to apyrexia of 3 days after administration. No deaths were recorded. Conclusion:the MK is relatively present in Libreville. It is important to mention it in the event of a fever of more than 5 days.


Subject(s)
Pharmacoepidemiology , Mucocutaneous Lymph Node Syndrome , Therapeutics , Disease , Hyperthermia, Induced
4.
Article in English | LILACS | ID: biblio-1353078

ABSTRACT

Códigos da Classificação Internacional de Doenças como Rastreadores de Eventos Adversos a MedicamentosARTIGO DE REVISÃOJosé Romério Rabelo Melo1,2 , Elisabeth Carmen Duarte,3 Silvia Maria de Freitas4 , Eduardo Gabriel Pinheiro5 , Eudiana Vale Francelino6,7 , Paulo Sergio Dourado Arrais7 Introdução: Os Eventos Adversos a Medicamentos-EAM representam riscos à saúde e sua subnotificação representa um desafio para a saúde pública. A busca ativa de casos suspeitos de EAM nos bancos de dados de saúde utilizando a Classificação Internacional de Doenças-CID é uma das estratégias que pode reduzir as subnotificações desses eventos. Objetivo: O objetivo desse estudo é identificar os códigos da CID mais usados como rastreadores de EAM e avaliar a sua concordância entre os pesquisadores. Métodos: Foi realizada uma revisão sistemática da literatura utilizando as bases de dados PubMed, Scopus, Web of Science, MEDLINE e LILACS com os descritores "Classificação Internacional de Doenças", "CID-10", "Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos", "Envenenamento", "Erros de Medicação". Os artigos incluídos tiveram seus códigos CID identificados, comparados e sua qualidade avaliada. A análise de concordância dos códigos foi feita usando o modelo de ensaios de Bernoulli, testes de proporções binomial exata e a técnica de false discovery rate para analisar as hipóteses postas. A análise estatística foi feita com o software R. O estudo está registrado no PROSPERO sob n.º CRD42019120694. Resultados: Foram identificados 5.167 artigos e após os critérios de seleção, 33 foram incluídos nessa revisão. Foram identificados 1.105 códigos da CID. O coeficiente de prevalência dos EAM variou entre 0,18% e 18,4% em internações hospitalares e a taxa de mortalidade variou entre 0,12 a 45,9 óbitos por 100 mil óbitos. Somente 195 (17,7%) códigos tiveram alta concordância entre os pesquisadores. Muitos códigos CID utilizados para detectar EAM possuem baixa concordância entre os pesquisadores e produziram diferentes taxas do evento. Conclusão: Os códigos rastreadores de EAM identificados representam um método simples e eficiente para captação de eventos adversos em grandes bancos de dados em saúde, contribuindo na redução da subnotificação nos tradicionais sistemas de notificações de EAM.Palavras-chave: Informática médica, Farmacoepidemiologia, Segurança do paciente, Classificação internacional de doenças, Efeitos colaterais e reações adversas relacionadas a medicamentos. (AU)


International Classification of Diseases Codes as screeners for Adverse Drug EventsREVIEW ARTICLEJosé Romério Rabelo Melo1,2 , Elisabeth Carmen Duarte,3 Silvia Maria de Freitas4 , Eduardo Gabriel Pinheiro5 , Eudiana Vale Francelino6,7 , Paulo Sergio Dourado Arrais7 1. Agência Nacional de Vigilância Sanitária/Gerência Geral de Inspeção e Fiscalização, Brasília, (DF), Brasil2. Universidade Federal do Ceará-UFC. Programa de Pós-Graduação de Ciências Farmacêuticas, Fortaleza, (CE), Brasil3. Universidade de Brasília-UnB. Faculdade de Medicina. Núcleo de Medicina Tropical, (DF), Brasil4. Universidade Federal do Ceará-UFC. Departamento de Estatística e Matemática Aplicada. Fortaleza, (CE), Brasil5. Instituto de Matemática, Estatística e Computação Científica (IMECC). Programa de Pós-Graduação em Estatística, UNICAMP. Campinas, (SP), Brasil6. Universidade Federal do Ceará-UFC. Faculdade de Farmácia, Odontologia e Enfermagem. Grupo de Prevenção ao Uso Indevido de Medicamentos-GPUIM. Departamento de Farmácia, Fortaleza, (CE), Brasil7. Universidade Federal do Ceará-UFC. Faculdade de Farmácia, Odontologia e Enfermagem. Departamento de Farmácia, Fortaleza, (CE), Brasilhttps://doi.org/10.11606/issn.2176-7262.rmrp.2021.178993Introduction: Adverse drug events (ADEs) represent health risks and their underreporting represents a challenge to public health. The active search for suspected cases of ADE in health databases using the International Classification of Diseases-CID is one of the strategies that can reduce underreporting of these events. Objective: The aim of this study is to identify the ICD codes most commonly used as tracers of ADE and to assess their concordance among researchers. Methods: A systematic literature review was conducted using the PubMed, Scopus, Web of Science, MEDLINE and LILACS databases with the descriptors "International Classification of Diseases", "ICD-10", "Drug-Related Side Effects and Adverse Reactions", "Poisoning", "Medication Errors". The included articles had their ICD codes identified, compared and their quality assessed. The analysis of concordance of the codes was done using Bernoulli's test model, exact binomial proportions tests and the false discovery rate technique to analyze the hypotheses posed. Statistical analysis was done using R software. The study is registered in PROSPERO under CRD42019120694. Results: A total of 5,167 articles were identified and after the selection criteria, 33 were included in this review. A total of 1,105 ICD codes were identified. The prevalence coefficient of ADEs ranged from 0.18% to 18.4% in hospital admissions and the mortality rate ranged from 0.12 to 45.9 deaths per 100,000 deaths. Only 195 (17.7%) codes had high concordance among researchers. Many ICD codes used to detect ADEs have low inter-rater concordance and produced different event rates. Conclusion: The identified ADE tracking codes represent a simple and efficient method for capturing adverse events in large healthcare databases, contributing to the reduction of underreporting in traditional ADE reporting systems. (AU)


Subject(s)
Medical Informatics , International Classification of Diseases , Health Strategies , Pharmacoepidemiology , Health Risk , Delivery of Health Care , Drug-Related Side Effects and Adverse Reactions , Patient Safety
5.
Educ. med. super ; 35(2): e2132, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1286230

ABSTRACT

Introducción: El seguimiento de los egresados permite conocer su desempeño profesional. Este aspecto no se ha tenido en cuenta en la maestría en Farmacoepidemiología. Objetivo: Caracterizar el desempeño profesional de los egresados de las tres primeras ediciones de la maestría en Farmacoepidemiología entre 2010 y 2018. Métodos: Estudio descriptivo y transversal. El universo estuvo constituido por 73 egresados. Se midieron las variables: cargo relacionado con la farmacoepidemiología antes y después de la maestría, competencias en el área del conocimiento del programa, realización de actividades de farmacoepidemiología, promoción de cargo, categoría docente y científica, entre otras. Los egresados fueron encuestados por correo electrónico. Resultados: Respondieron la encuesta 52 egresados de los cuales el 57,7 por ciento residía en La Habana. Predominaron las mujeres (69,2 por ciento), la edad entre 41 y 50 años (53,8 por ciento) y los médicos (52 por ciento). La mayoría reconoció la influencia de la maestría para comunicar temas científicos y realizar investigaciones. El 46,2 por ciento trabajaba en farmacoepidemiología después del egreso; el 42,3 por ciento realizaba actividades de farmacoepidemiología como expertos del programa nacional de medicamentos, integraba los comités farmacoterapéuticos en su institución y desarrollaba estudios de utilización de medicamentos, entre otras; el 53,8 por ciento promovió de cargo; el 46,2 por ciento publicó los resultados de su tesis de maestría; y el 38,5 por ciento adquirió categorías docentes. Conclusiones: El desempeño profesional se caracterizó por cambios positivos, de magnitud heterogénea, sobre todo en actividades investigativas, lo que permitió considerar que existió impacto formativo en los egresados. La mayoría no trabajaba en farmacoepidemiología ni realizaba actividades relacionadas, lo que denotó incoordinación entre su formación y su vinculación con áreas de trabajo acordes con su capacitación(AU)


Introduction: Follow-up of graduates allows knowing their professional performance. This aspect has not been taken into account in the Master's Degree Course in Pharmacoepidemiology. Objective: To characterize professional performance of the graduates of the first three editions, between 2010 and 2018, of the Master's Degree Course in Pharmacoepidemiology. Methods: A descriptive and cross-sectional study was carried out, with a universe of 73 graduates. The following variables were measured: position related to pharmacoepidemiology before and after the Master's Degree Course, competences in the program's area of knowledge, carrying out pharmacoepidemiology activities, promotion of position, teaching and scientific rank, among others. Graduates were surveyed by email. Results: Fifty-two graduates answered the survey, 57.7 percent of whom live in Havana. There was a predominance of women (69.2 percent), the age group 41-50 years (53.8 percent) and of doctors (52 percent). Most of the respondents recognized the influence of the Master's Degree Course in communicating scientific topics and conducting research. 46.2 percent worked in pharmacoepidemiology after completing the Master's Degree Course; 42.3 percent carried out pharmacoepidemiology activities as experts in the National Drug Program, were members of the pharmacotherapeutic committees at their institution, and developed studies on drug use, among others. 53.8 percent promoted from their positions; 46.2 percent published the results of their master's thesis; and 38.5 percent acquired teaching ranks. Conclusions: Professional performance was characterized by positive changes, of heterogeneous magnitude, especially in research activities, which allowed to consider that there was a training impact on graduates. Most of them did not work in pharmacoepidemiology nor carried out related activities, which denoted lack of coordination between their training and their connection with working areas consistent with their training(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Pharmacoepidemiology , Professional Training , Epidemiology, Descriptive , Cross-Sectional Studies
6.
Rev. med. Risaralda ; 27(1): 56-63, ene.-jun. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1280493

ABSTRACT

Resumen Objetivo: Describir el tratamiento en un hospital de primer nivel de pacientes que consultaron el servicio de urgencias por hiperglucemia, el manejo previo y su probable relación con nuevas hiperglucemias. Materiales y métodos: Estudio observacional de corte transversal con seguimiento de un año en pacientes mayores de 18 años con hiperglucemia que consultaron en el servicio de urgencias entre septiembre-2016 y agosto-2017. Se revisaron las historias clínicas y se establecieron variables sociodemográficas, clínicas, y farmacológicas. Se empleó estadística descriptiva, X 2 y modelos de regresión logística binaria (P<0.05). Resultados: Se presentaron 86 pacientes con hiperglucemia (edad media de 52.1±14.93 años). Se encontró que en el 58,1% de casos había un diagnóstico previo de diabetes mellitus; 87,2% fueron tratados con insulina cristalina y el 47,0% de los pacientes consultaron nuevamente por una crisis de hiperglucemia en los seis meses posteriores al egreso. Conclusión: Existe alta proporción de pacientes con hiperglucemias no cetónicas, no hiperosmolares que desconocían presentar diabetes mellitus. Además, casi la mitad de los pacientes consultan nuevamente por crisis de hiperglucemia en los siguientes seis meses después del alta.


Abstract Objective: Describe the treatment in a first-level hospital of patients who consulted the emergency department for hyperglycemia, the previous management and its probable relationship with new hyperglycemia. Materials and methods: Observational cross-sectional study with a one-year follow-up in patients over 18 years of age with hyperglycemia who consulted in the emergency department between September-2016 and August-2017. The medical records were reviewed and sociodemographic, clinical, and pharmacological variables were established. Descriptive statistics, X2 and binary logistic regression models (P <0.05) were used. Results: There were 86 patients with hyperglycemia (mean age 52.1 ± 14.93 years). It was found that in 58.1% of cases there was a previous diagnosis of diabetes mellitus; 87.2% were treated with crystalline insulin and 47.0% of the patients consulted again for a hyperglycemic crisis in the six months after discharge. Conclusion: There is a high proportion of patients with non-ketonic, non-hyperosmolar hyperglycemia who were unaware of having diabetes mellitus. In addition, almost half of the patients consult again for a hyperglycemic attack in the following six months after discharge.


Subject(s)
Humans , Female , Middle Aged , Pharmacoepidemiology , Diabetes Mellitus , Hospitals , Hyperglycemia , Insulin , Therapeutics , Aftercare , Emergencies , Emergency Service, Hospital
7.
Arch. argent. pediatr ; 119(3): 192-197, Junio 2021. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1222951

ABSTRACT

Introducción. La inmunoglobulina G endovenosa (IGEV) es un medicamento hemoderivado de inmunoglobulina G polivalente y policlonal. Posee un amplio espectro de indicaciones como inmunomodulador o como terapia de reemplazo. Asimismo, si bien se considera un tratamiento seguro, la incidencia de reacciones adversas reportadas en la literatura varía del 1 % al 81 %. Este trabajo tuvo como objetivo evaluar la utilización de IGEV y describir los acontecimientos adversos por la medicación en un hospital pediátrico de alta complejidad.Población y métodos. Se realizó un estudio de farmacoepidemiología, observacional y prospectivo. Se evaluaron pacientes que recibieron IGEV durante 7 meses, en 6 áreas de un hospital pediátrico de alta complejidad de la Ciudad Autónoma de Buenos Aires. La unidad de análisis fue cada infusión de IGEV, y la principal variable de estudio fue la presencia de reacciones adversas.Resultados. Se analizaron 305 infusiones en 111 pacientes. El 81,6 % de las indicaciones fueron de tipo supletorio. La dosis máxima utilizada fue 1 g/kg. En el 99,6 % de las infusiones, se indicó algún tipo de premedicación; la difenhidramina fue la droga más utilizada, aunque con diferentes posologías. Se registraron 12 reacciones adversas (el 3,9 % de las infusiones), tres de las cuales se consideraron graves: dos meningitis asépticas y una crisis comicial. Todas se resolvieron ad integrum.Conclusiones. La tasa de reacciones adversas de la IGEV en nuestro medio fue baja, con mayoría de reacciones leves e inmediatas y evolución favorable en todos los pacientes.


Introduction. Intravenous immunoglobulin G (IVIG) is a blood product from polyvalent and polyclonal immunoglobulin G. It covers a broad range of indications as immunomodulator or replacement therapy. In addition, although it is considered a safe therapy, the incidence of adverse reactions reported in the bibliography ranges from 1 % to 81 %. The objective of this study was to assess IVIG use and describe related adverse events in a tertiary care children's hospital.Population and methods. This was a pharmacoepidemiological, observational, and prospective study. Patients receiving IVIG for 7 months in 6 areas of a tertiary care children's hospital in the Autonomous City of Buenos Aires were assessed. The analysis unit was each IVIG infusion, and the main variable was the presence of adverse reactions.Results. A total of 305 infusions in 111 patients were analyzed. In 81.6 % of cases, the indication was for replacement. The maximum dose was 1 g/kg. In 99.6 % of infusions, some type of premedication was indicated; diphenhydramine was the most common drug, with varying dosages. A total of 12 adverse reactions (3.9 % of infusions) were recorded; 3 were severe: aseptic meningitis (2 cases) and seizures (1 case). All resolved to normal.Conclusions. The rate of IVIG adverse reactions in our setting was low; most reactions were mild and immediate and resolved favorably in all patients


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Immunoglobulin G/adverse effects , Pharmacovigilance , Immunoglobulin G/administration & dosage , Immunoglobulin G/therapeutic use , Prospective Studies , Immunoglobulins, Intravenous , Pharmacoepidemiology , Drug-Related Side Effects and Adverse Reactions
8.
Educ. med. super ; 35(1): e2079, ene.-mar. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1249726

ABSTRACT

Introducción: La aplicación del enfoque de competencias incluye los procesos de identificación, normalización, evaluación y certificación. Una vez definidas las competencias deben ser evaluadas. Una investigación realizada en la Escuela Nacional de Salud Pública definió las competencias profesionales de los especialistas de Farmacología en Farmacoepidemiología. Se conoce que a los especialistas de Farmacología no se les realiza examen de competencias. Objetivos: Determinar los criterios de realización requeridos para alcanzar las competencias profesionales del especialista de Farmacología en Farmacoepidemiología y las evidencias correspondientes para su evaluación. Métodos: Estudio de desarrollo en el que se obtuvieron como producto los criterios de realización necesarios para lograr las competencias profesionales que los especialistas de Farmacología debían alcanzar para desempeñarse como farmacoepidemiólogos y las evidencias para su evaluación posterior. El trabajo se realizó en La Habana entre marzo de 2018 y febrero de 2019. Se aplicaron técnicas cualitativas y revisiones documentales sobre las temáticas relacionadas con el objeto de la investigación. Se trabajó con dos grupos de expertos en dos etapas. Se empleó la metodología Delphi. Resultados: Se pudieron definir y validar los criterios de realización necesarios para alcanzar las competencias profesionales del especialista de Farmacología para su desempeño como farmacoepidemiólogo y se construyeron las evidencias correspondientes para su evaluación. Conclusiones: La definición de los criterios de realización y la construcción de las evidencias respectivas viabilizan la evaluación del desempeño del farmacólogo en Farmacoepidemiología(AU)


Introduction: The application of the competencies approach includes the identification, standardization, evaluation and certification processes. Once defined, competencies must be evaluated. A research carried out at the National School of Public Health defined the professional competencies in pharmacoepidemiology of Pharmacology specialists. It is known that Pharmacology specialists do not take a competency test. Objective: To determine the performance criteria required to achieve the professional competencies in pharmacoepidemiology of the Pharmacology specialist and the corresponding evidence for their evaluation. Methods: This was a development study in which the necessary performance criteria were obtained as a product for achieving the professional competencies that Pharmacology specialists had to achieve to perform as pharmacoepidemiologists, together with the evidence for their subsequent evaluation. The work was carried out in Havana, between March 2018 and February 2019. Qualitative techniques and document reviews were applied with regard to the topics related to the research object. The research work included two groups of experts in two stages. The Delphi methodology was used. Results: It was possible to define and validate the performance criteria necessary to achieve the professional competencies of the Pharmacology specialist for their performance as pharmacoepidemiologists. Also, the corresponding evidence was constructed for their evaluation. Conclusions: The definition of the performance criteria and the construction of the respective evidences permit the evaluation of the pharmacologist's performance in pharmacoepidemiology(AU)


Subject(s)
Humans , Pharmacology/education , Professional Competence , Staff Development , Pharmacoepidemiology
10.
Epidemiol. serv. saúde ; 30(1): e2020089, 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1154141

ABSTRACT

Objetivo: Analisar a prevalência do uso de medicamentos, fontes de acesso e fatores associados, em residentes da zona rural de Pelotas, RS, Brasil. Métodos: Estudo transversal com adultos ≥18 anos, realizado em 2016. Questionou-se o uso e fontes de acesso aos medicamentos no mês anterior à entrevista. Empregou-se regressão de Poisson. Resultados: Dos 1.519 entrevistados, 54,7% (IC95% 48,7;60,5) utilizaram algum medicamento e 3,3% (IC95% 2,4;4,5) deixaram de utilizar medicamento necessário. Exibiram maiores prevalências de utilização: mulheres (RP=1,23 - IC95% 1,12;1,34), idosos (RP=2,36 - IC95% 2,05;2,73), pessoas com pior autopercepção de saúde (RP=1,29 - IC95% 1,14;1,46), com maior número de doenças (RP=2,37 - IC95% 2,03;2,77). Obtiveram medicamentos exclusivamente pelo Sistema Único de Saúde (SUS) 14,0% (IC95% 11,2;17,4), com prevalências maiores entre pessoas de cor da pele autodeclarada não branca e classificação econômica inferior. Conclusão: Pequena parcela deixou de usar medicamentos de que necessitava. A obtenção gratuita de medicamentos foi maior nos grupos de menor poder aquisitivo.


Objetivo: Analizar la prevalencia del uso de medicamentos, las fuentes de acceso y los factores asociados en habitantes rurales de Pelotas, RS, Brasil. Métodos: Estudio transversal con adultos ≥18 años, en 2016. Se preguntó sobre el uso y fuentes de acceso a los medicamentos en el mes anterior a la entrevista. Se utilizó la regresión de Poisson. Resultados: De los 1.519 entrevistados, 54,7% (IC95% 48,7; 60,5) usó algún medicamento y 3,3% (IC95% 2,4; 4,5) dejó de usar un medicamento necesario. Las prevalencias de uso fueron mayores en mujeres (RP=1,23 - IC95% 1,12;1,34), adultos mayores (RP=2,36 - IC95% 2,05;2,73), personas con peor autopercepción de salud (RP=1,29 - IC95% 1,14;1,46) y con más enfermedades (RP=2,37 - IC95% 2,03;2,77). En total, 14,0% (IC95% 11,2;17,4) obtuvo medicamentos exclusivamente por el Sistema Único de Salud (SUS) y la prevalencia fue mayor en los de color de piel no blanca (autodeclarada) y clase económica más baja. Conclusión: Pequeña parcela indicó que dejó de usar medicamentos necesarios. La obtención gratuita fue mayor en grupos de menor poder adquisitivo.


Objective: To analyze the prevalence of medication use, sources of access, and associated factors among rural residents in Pelotas, RS, Brazil. Methods: This was a cross-sectional study conducted in 2016 with adults ≥18 years old. Participants reported on medication use and sources of access to medication in the month prior to the interview. Poisson regression was used. Results: Among the 1,519 respondents, 54.7% (95%CI 48.7;60.5) used some form of medication and 3.3% (95%CI 2.4;4.5) stopped taking necessary medication. Higher prevalence of use occurred in: women (PR=1.23 - 95%CI 1.12;1.34), the elderly (PR=2.36 - 95%CI 2.05;2.73), people with poorer self-perceived health (PR=1.29 - 95%CI 1.14;1.46) and people with a higher number of diseases (PR=2.37 - 95%CI 2.03;2.77). A total of 14.0% (95%CI 11.2;17.4) obtained medication exclusively from the Brazilian National Health System, prevalence of which was higher among those who self-reported themselves to be non-white and from lower economic classification. Conclusion: A low number stopped taking medication they needed to take. Use of free-of-charge medication was greater in groups with lower income.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pharmaceutical Services/statistics & numerical data , Pharmacoepidemiology , Health Services Accessibility/statistics & numerical data , Self Medication , Socioeconomic Factors , Brazil , Rural Health , Drug Utilization
11.
Rev. Bras. Saúde Mater. Infant. (Online) ; 20(3): 799-807, July-Sept. 2020. tab
Article in English | LILACS, SES-SP | ID: biblio-1136446

ABSTRACT

Abstract Objectives: to describe the prevalence and factors associated with the consumption of folic acid and iron among puerperal women in the city of São Luís, Maranhão. Methods: a cross-sectional study with 4,036 puerperal women through a standardized questionnaire. The dependent variables (outcomes) were: the consumption of folic acid during pregnancy, iron and folic acid before pregnancy. The independent variables: age; schooling; skin color; marital status; income; planned pregnancy; place and number of prenatal consultations. Statistical analyzes were performed on STATA 14.0. For the first two outcomes, Poisson model with a robust variance was used. And for the last one, logistic regression. Results: the prevalence of consuming folic acid and iron during pregnancy were, respec-tively, 77.27% and 84.98%. However, only 0.37% reported the consume of folic acid and iron before pregnancy. In the adjusted analysis, the variables associated with the consumption of folic acid during pregnancy were: schooling and income; the consume of iron during preg-nancy, age only; and for those who consumed folic acid before pregnancy, no variable was statistically significant. Conclusions: high percentage of puerperal women who consumed folic acid and iron supplements during pregnancy, however, the recommended consumption of folic acid before pregnancy was low and maternal, social and economic factors influence the consumption of these supplements.


Resumo Objetivos: descrever prevalência e fatores associados ao uso deácido fólico e ferro entre puérperas do município de São Luís, Maranhão. Métodos: estudo transversal com 4.036 puérperas através de questionário padronizado. As variáveis dependentes (desfechos) foram: uso durante a gestação de ácido fólico, ferro e ácido fólico antes da gestação. As variáveis independentes: idade; escolaridade; cor da pele; situação conjugal; renda; gravidez planejada; local e número de consultas do pré-natal. As análises estatísticas foram realizadas no STATA 14.0. Para os dois primeiros desfechos, utilizou-se modelo de Poisson com variância robusta. Para o último, regressão logística. Resultados: a prevalência do uso de ácido fólico e ferro durante a gestação foram, respectivamente, 77,27% e 84,98%. Entretanto, apenas 0,37% declararam uso antes da gestação. Na análise ajustada, as variáveis associadas com uso de ácido fólico durante a gestação foram: escolaridadee renda; parausode ferro durante a gestação, apenas a idade; e para as que fizeram uso de ácido fólico antes da gestação, nenhuma variável mostrou-se estatisticamente significativa. Conclusões: alto percentual de puérperas fez uso de suplementos de ácido fólico e ferro-durante a gestação, porém o uso recomendado de ácido fólico antes da gestação mostrou-se baixo e que fatores maternos, sociais e econômicos influenciam no consumo destes suple-mentos.


Subject(s)
Humans , Female , Pregnancy , Prenatal Care , Socioeconomic Factors , Pharmacoepidemiology/statistics & numerical data , Dietary Supplements/statistics & numerical data , Folic Acid/therapeutic use , Iron/therapeutic use , Brazil/epidemiology
12.
Rev. bras. oftalmol ; 79(2): 114-117, Mar.-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1137947

ABSTRACT

Abstract Purpose: To outline the epidemiological profile of clinical treatments for glaucoma provided by the Brazilian Unified Health System (SUS, acronym in Portuguese) between January 2012 and December 2018. Methods: A quantitative and descriptive study was conducted using available data based on the outpatient information system from SUS (SIA/SUS, acronym in Portuguese). The variables were monocular treatment with first, second, and third-line drugs; monocular treatment with combinations of two drugs and three drugs from different lines; binocular treatment with first, second, and third-line drugs; and binocular treatment with combinations of two drugs and three drugs from different lines. Results: During the analysis period, the prevalence of clinical therapies for glaucoma increased from 2012 to 2017 and decreased from 2017 to 2018. Of the clinically treated patients, 96% were carriers of binocular glaucoma. Among the regions of Brazil, the Northeast had the highest prevalence of binocular glaucoma (about 60% of the number of cases), and the most common therapy was combinations of two drugs from different lines. The Southeast region had the highest concentration of monocular glaucoma (53% of cases), and the predominant therapy was combinations of three drugs from different lines. The Midwest region had the lowest prevalence of monocular-treatments for glaucoma (less than 6%). Conclusion: In Brazil, the highest number of treatments offered by the public health system was in the Northeast and Southeast regions. There is a high national prevalence and potential for the morbidity of this disease. Therefore, it is necessary to strengthen programs aimed at early diagnosis and appropriate treatment to reduce adverse outcomes.


Resumo Objetivo: Traçar o perfil epidemiológico do tratamento clínico para o glaucoma no Brasil fornecido pelo Sistema Único de Saúde (SUS), no período de janeiro de 2012 a dezembro de 2018. Métodos: Estudo quantitativo e descritivo, utilizando a base de dados disponível no Sistema de Informações Ambulatoriais do SUS (SIA/SUS). As variáveis utilizadas foram: tratamento monocular com drogas de primeira, de segunda e de terceira linha; tratamento monocular com combinações de duas drogas e de três drogas de diferentes linhas; tratamento binocular com drogas de primeira, de segunda e de terceira linha; e tratamento binocular com combinações de duas drogas e de três drogas de diferentes linhas. Resultados: Durante o período analisado, a prevalência de terapias clínicas para o glaucoma aumentou entre 2012 e 2017 e diminuiu entre 2017 e 2018. Dos pacientes tratados clinicamente, 96% eram portadores de glaucoma binocular. Entre as regiões do Brasil, o Nordeste teve a maior prevalência de glaucoma binocular (cerca de 60% do número de casos), e a terapia mais comum foi a combinação de duas drogas de diferentes linhas. A região Sudeste teve a maior concentração de glaucoma monocular (53% dos casos), e a terapia predominante foi a combinação de três drogas de diferentes linhas. A região Centro-Oeste apresentou a menor prevalência de tratamentos monoculares para o glaucoma (menos de 6%). Conclusão: No Brasil, o maior número de tratamentos oferecidos pelo sistema público de saúde foi nas regiões Nordeste e Sudeste. Existe uma alta prevalência nacional e um alto potencial para morbidade desta doença. Portanto, é necessário fortalecer programas voltados para o diagnóstico precoce e para o tratamento adequado a fim de reduzir os resultados adversos.


Subject(s)
Humans , Unified Health System , Glaucoma/drug therapy , Glaucoma/epidemiology , Pharmacoepidemiology/methods , Intraocular Pressure , Brazil , Epidemiology, Descriptive , Evaluation Studies as Topic
13.
Rev. bras. med. fam. comunidade ; 15(42): 2310, 20200210. ilus, tab
Article in English | LILACS | ID: biblio-1282582

ABSTRACT

Introduction: The effectiveness and safety of alendronate sodium are dependent on patient adherence to very specific guidelines regarding use. This study aims to estimate the rational use of alendronate sodium in the elderly. Methods: This is a cross-sectional study carried out with a structured questionnaire containing form of use and occurrence of adverse events related to alendronate sodium. The patients were recruited in their own homes. Rational use was considered as being the participants who: a) took the tablet in the morning; b) were fasting; c) waited at least 30 minutes before eating; d) ingested with a full glass of water; e) ingested the whole tablet; f) and remained in the orthostatic position for at least 30 minutes after use. Additionally, the odds ratio (OR) was used to analyze the association between the irrational use of alendronate sodium and the independent variables. Results and Discussion: Of the 248 participants in the study, most of the participants administered the medication in the morning (95.2%), with fasting (89.1%), waited at least 30 minutes to eat the first meal of the day (87.9%), and were in the orthostatic position until the time of the first meal (78.6%), but less than half ingested the tablet with a full glass of water (43.6%). Rational use of the medication was observed in only 30.7% of the participants. Regarding possible adverse events, 13.3% of the participants reported some event. Among the most prevalent were dry cough (6.5%), stomach pain (5.2%) and some throat discomfort (4.8%). The irrational use of this medication is associated with age and education level. Conclusion: The prevalence of irrational use of alendronate sodium in the elderly is high, and this use is associated with patients' sociodemographic factors.


Introdução: A efetividade e segurança do alendronato de sódio são dependentes da adesão dos pacientes em relação às orientações específicas sobre o uso. Assim, este trabalho, tem como objetivo estimar a racionalidade de uso do alendronato de sódio em idosos. Metodologia: Trata-se de um estudo transversal realizado através de um questionário estruturado contendo a forma de utilização e a ocorrência de eventos adversos relacionados ao uso do medicamento. Os pacientes foram recrutados em suas próprias casas. Considerou-se uso racional os participantes que: a) tomaram o comprimido pela manhã; b) em jejum; c) esperaram pelo menos 30 minutos para se alimentar; d) ingeriu com um copo cheio de água; e) ingeriu o comprimido inteiro; f) e permaneceu na posição ortostática por pelo menos 30 minutos após o uso. Adicionalmente, o odds ratio (OR) foi utilizado para analisar associação entre o uso irracional do alendronato de sódio e as variáveis independentes. Resultados e Discussão: Dos 248 participantes do estudo a maioria administravam o medicamento pela manhã (95,2%), em jejum (89,1%), aguardavam pelo menos 30 minutos para realizar a primeira refeição do dia (87,9%), ficavam em posição ortostática até o horário da primeira refeição (78,6%), porém menos da metade ingeria o comprimido com um copo cheio de água (43,6%). O uso racional do medicamento foi observado em apenas 30,7% dos participantes. Em relação aos possíveis eventos adversos, 13,3% dos participantes relataram algum evento. Dentre os mais prevalentes, destacaram-se a tosse seca (6,5%), dor de estômago (5,2%) e algum desconforto na garganta (4,8%). O uso irracional deste medicamento está associado à idade e ao nível de escolaridade. Conclusão: É elevada a prevalência de uso irracional do alendronato de sódio em idosos e este uso está associado a fatores sociodemográficos dos pacientes.


Introducción: La eficacia y seguridad del alendronato sódico dependen de la adherencia de los pacientes en relación con directrices específicas sobre el uso. Por lo tanto, este trabajo tiene como objetivo estimar la racionalidad del uso del alendronato sódico en los ancianos. Metodos: Este es un estudio transversal realizado a través de un cuestionario estructurado que contiene la forma de uso y la ocurrencia de eventos adversos relacionados con el uso de la droga. Los pacientes fueron reclutados en sus propios habitación. Se consideró el uso racional como los participantes que: a) tomaron la tableta por la mañana, b) en ayuno, c) esperaron al menos 30 minutos antes de comer; d) Ingerido con un vaso lleno de agua; e) ingirió toda la tableta, f) y permaneció en la posición ortostática durante al menos 30 minutos después de su uso. Además, el odds ratio (OR) se utilizó para analizar la asociación entre el uso irracional de alendronato de sodio y las variables independientes. Resultados y Discusión: De los 248 participantes en el estudio, la mayoría administró el medicamento por la mañana (95,2%), em ayuno (89,1%), esperó al menos 30 minutos para realizar la primera comida del día (87,9%), estaban en posición ortostática hasta el momento de La primera comida (78,6%), pero menos de la mitad ingeriría el comprimido con un vaso lleno de agua (43,6%). El uso racional de la droga se observó en sólo 30.7% de los participantes. En cuanto a los posibles acontecimientos adversos, el 13,3% de los participantes informaron de algún evento. Entre los más frecuentes, tos seca (6,5%), dolor de estómago (5,2%) Y algunas molestias en la garganta (4,8%). El uso irracional del medicamento está asociado a la ida y al nivel de escolaridad. Conclusión: La prevalencia del uso irracional del alendronato de sodio en los ancianos es alta, y este uso está asociado a factores sociodemográficos de los pacientes.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Osteoporosis , Aged , Pharmacoepidemiology , Alendronate
14.
Rev. bras. promoç. saúde (Impr.) ; 33: 1-10, 03/01/2020.
Article in English, Portuguese | LILACS | ID: biblio-1099875

ABSTRACT

Objetivo: Analisar o uso de medicamentos por automedicação em pacientes renais crônicos hemodialíticos. Métodos: Estudo quantitativo, descritivo e transversal, realizado em um centro de tratamento hemodialítico, na região Sudoeste da Bahia, em março de 2015, por meio da aplicação de formulário contendo variáveis sociodemográficas, clínicas e farmacoterapêuticas de 170 pacientes. A amostra compôs-se de pacientes em tratamento hemodialítico crônico há mais de um ano, com idade maior ou igual a 18 anos. Utilizou-se o Epidata 3.1 como banco de dados. Realizou-se análise descritiva e empregou-se o método de regressão logística binária, usado para avaliar a associação entre automedicação e variáveis independentes, utilizando o programa SPSS, versão 21.0. Resultados: Dos participantes, 64,1% (109) eram homens, com idade média de 50,5 anos (± 14,9); 57% (98) possuíam renda menor que um salário mínimo; 20% (34) nunca estudaram; 48,2% (82) estavam dialisando em período de um a cinco anos e 92,9% (158) não possuíam plano de saúde. Contabilizaram-se 104 medicamentos utilizados por automedicação, com destaque para o calcitriol (9,6%) e a clonidina (6,7%). Verificou-se que pacientes com maior escolaridade (OR=1,32; IC95%=1,32-28,72) e que usam sobra de medicamentos em casa (OR=22,48; IC95%=6,53-77,38) têm mais chances de se automedicar. Conclusão: Há baixa frequência de automedicação na população de renais crônicos investigada, sendo associada ao uso de medicamentos guardados em casa e à baixa escolaridade.


Objective: To analyze self-medication in chronic kidney disease patients on hemodialysis. Methods: A quantitative descriptive cross-sectional study was conducted at a hemodialysis center in Southwestern Bahia in March 2015 using a form to collect sociodemographic, clinical and drug therapy data from 170 patients in March 2015. The sample comprised patients undergoing chronic hemodialysis treatment for over one year aged 18 years or older. Epidata 3.1 was used as a database. Descriptive analysis was performed and binary logistic regression was used to check for associations between self-medication and independent variables using the SPSS software version 21.0. Results: In all, 64.1% (109) of the participants were men and the mean age was 50.5 years (±14.9). 57% (98) of the participants earned less than one minimum wage, 20% (34) had never studied, 48.2% (82) had been on dialysis for one to five years, and 92.9% (158) had no health insurance. We confirmed self-medication of 104 drugs, particularly calcitriol (9.6%) and clonidine (6.7%). Patients with higher levels of education (OR=1.32; 95%CI=1.32-28.72) and those who use leftover drugs at home (OR=22.48; 95%CI=6.53-77.38) were more likely to self-medicate. Conclusion: The rate of self-medication in chronic kidney disease patients is low and it is associated with the use of drugs stored at home and low levels of education.


Objetivo: Analizar el uso de medicamentos por automedicación de pacientes renales crónicos en hemodiálisis. Métodos: Estudio cuantitativo, descriptivo y transversal realizado en un centro de tratamiento de hemodiálisis de la región Sudoeste de Bahía en marzo de 2015 a través de la aplicación de un formulario con variables sociodemográficas, clínicas y de tratamiento farmacológico de 170 pacientes. La muestra ha sido de pacientes en tratamiento de hemodiálisis desde hace más de un año con edad mayor o igual a 18 años. Se utilizó el Epidata 3.1 para el banco de datos. Se realizó un análisis descriptivo y se utilizó el método de regresión logística binaria para evaluar la asociación entre la automedicación y las variables independientes con el programa SPSS, versión 21.0. Resultados: Entre los participantes, el 64,1% (109) era hombres con edad media de 50,5 años (± 14,9); el 57% (98) tenía renta de menos de un sueldo mínimo; el 20% (34) nunca ha estudiado; el 48,2% (82) realizaba la hemodiálisis desde el periodo entre uno y cinco años y el 92,9% (158) no tenía seguro de salud. Se ha contabilizado 104 medicamentos utilizados por la automedicación con énfasis para el calcitriol (9,6%) y la clonidina (6,7%). Se verificó que los pacientes con mayor escolaridad (OR=1,32; IC95%=1,32-28,72) y los que usan lo que queda de los medicamentos que tienen en casa (OR=22,48; IC95%=6,53-77,38) tienen más oportunidades para la automedicación. Conclusión: Hay baja frecuencia de automedicación en la población de renales crónicos investigados y la misma se asoció con el uso de medicamentos almacenados en casa y las personas de baja escolaridad.


Subject(s)
Outpatients , Renal Dialysis , Pharmacoepidemiology , Drug Utilization , Nonprescription Drugs , Renal Insufficiency, Chronic
15.
Article in English | WPRIM | ID: wpr-811068

ABSTRACT

PURPOSE: The incidence of drug-induced liver injury (DILI) has been increasing; however, few algorithms are available to identify DILI in electronic health records (EHRs). We aimed to identify and evaluate DILI with an appropriate screening algorithm.METHODS: We collected data from 3 university hospitals between June 2015 and May 2016 using our newly developed algorithm for identifying DILI. Among patients with alanine transferase (ALT) ≤ 120 IU/L and total bilirubin (TB) ≤ 2.4 mg/dL in blood test results within 48 hours of admission, those who either had 1) ALT > 120 IU/L and TB > 2.4 mg/dL or 2) ALT > 200 IU/L at least once during hospitalization were identified. After excluding patients with liver disease-related diagnosis at discharge, medical records were retrospectively reviewed to evaluate epidemiological characteristics of DILI.RESULTS: The total number of inpatients was 256,598, of whom 1,100 (0.43%) were selected by the algorithm as suspected DILI. Subsequently, 365 cases (0.14% of total inpatients, 95% confidence interval, 0.13–0.16) were identified as DILI, yielding a positive predictive value of 33.1%. Antibiotics (n = 214, 47.2%) were the major class of causative drug followed by chemotherapeutic agents (n = 87, 19.2%). The most common causative drug was piperacillin-tazobactam (n = 38, 8.4%); the incidence of DILI by individual agent was highest for methotrexate (19.4 cases/1,000 patients administered the drug). Common reasons for excluding suspected DILI cases were ischemic hepatitis and postoperative liver dysfunction.CONCLUSIONS: Using our EHR-based algorithm, we identified that approximately 0.14% of patients developed DILI during hospitalization. Further studies are needed to modify criteria for more accurate identification of DILI.


Subject(s)
Alanine , Anti-Bacterial Agents , Bilirubin , Diagnosis , Chemical and Drug Induced Liver Injury , Drug-Related Side Effects and Adverse Reactions , Electronic Health Records , Hematologic Tests , Hepatitis , Hospitalization , Hospitals, University , Humans , Incidence , Inpatients , Liver , Liver Diseases , Mass Screening , Medical Records , Methotrexate , Pharmacoepidemiology , Retrospective Studies , Transferases
16.
Article in English | AIM | ID: biblio-1257717

ABSTRACT

Background: In Morocco, and many other African countries, there is a paucity of antihypertensive and antidiabetics use amongst the general population. Aim: To investigate the epidemiological profile of antihypertensive and antidiabetics use and analysis their adverse reactions. Setting: This study was conducted in the prefecture of Figuig, Morocco. Methods: A cross-sectional descriptive study. Data was collected using semi-structured questionnaire about their pharmacological treatment and presented using descriptive statistical analysis. Results: Sample of 244 subjects, predominantly women 58.15% (p < 0.03) composed of diabetic patients 56.96% (n = 139) and hypertensive patients 43.03% (n = 105). After adjustments, 60.24% of all patients were under monotherapy. The diabetics were being treated using the Biguanide class (26.92%), insulin (20.0%) and sulfonylureas (10.0%) while hypertensive patients were treated by Calcium Channel Blockers (27.36%), Angiotensin Converting Enzyme Inhibitors (21.05%), Angiotensin T-Blockers (16.84%), Diuretics (7.36%) and ß-adrenergic receptors blockers (3.15%). In total, 23.00% of all subjects have experienced negative side-effects, mostly, reported (90.38%) to health professionals and 23.52% of them have interrupted temporarily or try to change their treatment. Gastro-intestinal problems were the most adverse reactions reported (11.11%) followed by headache, dizziness and tinnitus (6.66%) and asthenia, feeling sick and feeling of faintness (5.33%). Conclusion: Managing diabetes and hypertension entails a lot of public challenges and requires more focus and interest, especially amongst the illiterate population in remote areas. Some of the suggested ways to help face the problem include the introduction of new innovative measures, systems of fellow-up and adverse reactions


Subject(s)
Antihypertensive Agents , Hypoglycemic Agents , Morocco , Pharmacoepidemiology , Pharmacovigilance , Population
17.
Rev. med. Risaralda ; 25(2): 129-137, jul.-dic. 2019. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1115755

ABSTRACT

Resumen Introducción: las heparinas son esenciales para el manejo de muchos pacientes en los servicios de hospitalización. Objetivo: determinar los patrones de prescripción de heparinas en distintos ambientes hospitalarios en Colombia. Metodología: estudio observacional con prescripciones de pacientes tratados con heparinas en 14 clínicas de 12 ciudades colombianas durante octubre de 2015. Se evaluaron variables sociodemográficas, farmacológicas, comedicaciones; se realizaron análisis descriptivos y multivariados. Resultados: se encontraron 3 776 pacientes tratados con heparinas, con edad promedio: 60,1 ± 20,1 años, 56,9 % fueron mujeres; con una prevalencia de uso de 9,1 %, se emplearon en promedio 6,3 dosis por sujeto, siendo enoxaparina (74,8 %), y dalteparina (24,9 %) los más utilizados. Se prescribió terapia combinada con dos antiagregantes en 34,1 % de casos y las comedicaciones más frecuentes fueron antiinflamatorios no esteroideos (28,9 %) y benzodiazepinas (14,6 %). El uso de dalteparina, haber sido atendido en Cartagena, Barranquilla y ser adulto joven se asociaron con menor probabilidad de recibir alguna comedicación. Conclusión: predomina el uso de heparinas de bajo peso molecular sin utilización de la heparina convencional en las clínicas evaluadas, lo que puede estar asociado con su fácil manejo, menores efectos secundarios y mayor costo-efectividad haciéndolas más convenientes para el uso intrahospitalario.


Abstract Introduction: Heparins are essential for the management of many patients in inpatient services. Objective. To determine the prescribing patterns of heparins in hospitals in a group of patients of Colombia. Methods. An observational study with data of prescriptions of patients treated with heparins in 14 hospitals in 12 cities of Colombia during October 2015. Sociodemographic, pharmacological, combined therapy, and co-medication variables were evaluated. Descriptive and multivariate analyzes were performed. Results. A total of 3776 patients on heparin treatment were found; mean age: 60.1±20.1 years, 56.9 % were women; with a prevalence of 9.1 %; a mean of 6.3 doses per patient was used. Enoxaparin (74.8 %) and dalteparin (24.9 %) being the most used injecting anticoagulants. Dual antiplatelet therapy was prescribed in 34.1 % of cases, and the most frequent co-medications were non-steroidal anti-inflammatory drugs (28.9 %), benzodiazepines (14.6 %). The use of dalteparin, have been treated in Cartagena, Barranquilla and being a young adult, reduced the risk of receiving some co-medication. Conclusion. The use of low-molecular-weight-heparins is predominant without the use of conventional heparins in clinics, which may be associated with their easy use, less side effects and greater cost-effectiveness, making them more convenient for intra-hospital use.


Subject(s)
Humans , Female , Adult , Middle Aged , Heparin , Hospitals , Effectiveness , Pharmaceutical Preparations , Pharmacoepidemiology , Colombia , Prescriptions , Hospitalization , Anticoagulants
18.
Ciênc. cuid. saúde ; 18(4): e46518, 20190804.
Article in Portuguese | LILACS, BDENF | ID: biblio-1119864

ABSTRACT

Objective: to characterize the medication profile of people with hypertension followed-up by the Family Health Strategy (ESF). Method:A cross-sectional study with 417 people in the municipality of Maringá, located in the northwestern part of the state of Paraná, Brazil. Data collection took place in the first semester of 2016. An instrument was used to evaluate the satisfaction of users with arterial hypertension on the services provided by Primary Health Care (APS). In this study, only questions related to sociodemographic and drug profile were used. In the data analysis, descriptive statistics were applied. Results:there was a prevalence of the elderly (62.3%), most female (67.9%), with complete primary schooling (78.4%), color/race white (62.3%), retirees/pensioners (55.2%), predominance of individuals with partners (58.3%) and economically classified in C level (43.9%). Regarding medication, 34.8% were classified as polypharmacy and 58.8% received medication by the public health system. The most commonly used drugs were those of the cardiovascular, nervous, digestive and metabolic system. Conclusion:Through this study, it was possible to know the medication profile of patients with hypertension, which contributes to the adequate follow-up of patients in the basic healthcare network.


Objetivo: caracterizar o perfil medicamentoso de pessoas com hipertensão arterial acompanhadas pela Estratégia Saúde da Família (ESF). Método: estudo transversal realizado com 417 pessoas, no município de Maringá, localizado no noroeste do estado do Paraná, Brasil. A coleta de dados foi realizada no primeiro semestre de 2016. Foi utilizado um instrumento para avaliar a satisfação de usuários com hipertensão arterial com os serviços prestados pela Atenção Primária à Saúde (APS). Neste estudo, foram usadas somente as questões referentes ao perfil sociodemográfico e medicamentoso. Na análise dos dados, aplicou-se estatística descritiva. Resultado: houve prevalência de idosos (62,3%), grande parte do sexo feminino (67,9%), com até o ensino fundamental completo (78,4%), da raça/cor branca (62,3%), aposentados/pensionistas (55,2%), predomínio de indivíduos com companheiro (58,3%) e classificados economicamente em extrato C (43,9%). Em relação aos medicamentos, 34,8% foram classificados em polifarmácia e 58,8% receberam a medicação pelo sistema público de saúde. Os remédios mais utilizados foram os do grupo do sistema cardiovascular, nervoso, digestivo e metabólico. Conclusão: através deste estudo, foi possível conhecer o perfil medicamentoso de pacientes com hipertensão, o que contribui para o acompanhamento adequado de pacientes da rede básica de assistência à saúde.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Chronic Disease , Pharmacoepidemiology , National Health Strategies , Drug Utilization , Hypertension , Primary Health Care , Cardiovascular System
19.
Medicina (Ribeiräo Preto) ; 52(3)jul.-set. 2019.
Article in Portuguese | LILACS | ID: biblio-1025540

ABSTRACT

RESUMO Modelo de estudo: Trata-se de um estudo do tipo observacional, descritivo e transversal. Objetivo: Avaliar o comportamento de adesão ao tratamento antirretroviral de pessoas convivendo com HIV/aids que participam de um Grupo de Adesão. Métodos: O questionário foi respondido por 15 pacientes maiores de 18 anos, independente do sexo, com diagnóstico confirmado de AIDS que participam de um Grupo de Adesão em um serviço de dispensação de antirretrovirais, e que após receberem informações pertinentes ao estudo, aceitaram participar voluntariamente, por meio da assinatura do Termo de Consentimento Livre e Esclarecido. Resultado: A maioria dos participantes era do sexo masculino, acima de 40 anos (73,3%) e 26,6% eram economicamente ativos. Quanto à sexualidade, 80% dos entrevistados declararam ser heterossexual. Quanto à escolaridade, 60% não havia completado o ensino médio. O tempo de diagnóstico da doença predominante foi entre 10 e 16 anos, sendo que 46,6% referiram possuir outros problemas de saúde, como toxoplasmose, herpes, tuberculose e leishmaniose. A análise do questionário de adesão mostrou que 33,3% possuía uma boa adesão ao tratamento antirretroviral. Entre as interações droga-droga identificadas, 44,4% ocorreram entre os antirretrovirais. Conclusão: A partir da realização deste estudo foi possível concluir que 66,66% dos entrevistados relataram que em algum momento houve uma descontinuidade do tratamento, revelando uma dificuldade na manutenção do uso dos antirretrovirais em indivíduos convivendo com HIV/AIDS. No contexto da farmacoepidemiologia antirretroviral, as potenciais interações medicamentosas identificadas neste estudo foram eventos que afetam a resposta terapêutica levando a toxicidade (AU)


Study design: This is an observational, descriptive, and cross-sectional study. Objective: Evaluating the adher-ence behavior to the antiretroviral treatment of people living with HIV/Aids who participate in an Adherence Group. Methods: The questionnaire was answered by 15 patients older than 18 years of age, regardless of sex, with a confirmed diagnosis of AIDS participating in an Adherence Group at an antiretroviral dispensing service, who, after receiving information related to the study, agreed to participate voluntarily, by singing the Written Informed Consent Form. Results: The majority of the participants were male, over 40 years old (73.3%) and 26.6% were economically active. Regarding sexuality, 80% of the interviewees stated that they were heterosexual. As for schooling, 60% had not finished high school. The time of diagnosis of the disease predominant was between 10 and 16 years, and 46.6% reported having other health problems, like toxoplasmosis, herpes, tuberculosis, and leishmaniasis. The analysis of the adherence questionnaire showed that 33.3% had good adherence to antiretroviral treatment. Among the drug-drug interactions identified, 44.4% occurred among antirretrovirals. Conclusion: Based on this study, it was possible to conclude that 66,66% at some point there was a discontinuation of treatment, revealing a difficulty in maintaining antiretroviral use in individuals living with HIV/aids. In the scenario of antiretroviral pharmacoepidemiology, the po-tential drug interactions identified in this study were events that affect the therapeutic response leading to toxicity (AU)


Subject(s)
Humans , Male , Female , Adult , HIV Infections , Acquired Immunodeficiency Syndrome , Pharmacoepidemiology , Anti-HIV Agents , Medication Adherence
20.
Article in Portuguese | LILACS | ID: biblio-1047218

ABSTRACT

Introdução: Imunossupressores apresentam alta toxicidade associada à estreita faixa terapêutica, devendo-se ter controle de níveis séricos. Assim, é necessário o estudo de utilização de medicamentos em clínicas que os utilizam, fornecendo uma visão geral de seu consumo e uso racional em uma dada população. Objetivo: Identificar o perfil de utilização de imunossupressores para profilaxia de doença enxerto versus hospedeiro em pacientes submetidos a transplante de células-tronco hematopoiéticas, em um centro de transplante de medula óssea. Método: Trata-se de um estudo transversal realizado em um centro de transplante de medula óssea brasileiro. Os imunossupressores utilizados em 2017 foram classificados segundo um sistema de classificação internacional; seu consumo, expresso em dose diária definida; e seus protocolos, analisados segundo as Diretrizes para profilaxia de doença do enxerto contra hospedeiro do Consenso da Sociedade Brasileira de Transplante de Medula Óssea de 2015. Resultados: O regime de condicionamento mieloablativo foi o mais frequente (51,7%). O protocolo de imunossupressão mais prescrito foi ciclosporina com metotrexato (37,9%). Dos 29 pacientes elegíveis, 23 (79,3%) tiveram protocolos seguindo as recomendações do Consenso de 2015. Metotrexato, ciclosporina intravenosa e micofenolato foram responsáveis por 85,64% do consumo. Conclusão: Neste trabalho, só foi possível identificar um perfil de uso de imunossupressores e realizar comparações dentro da instituição, em virtude da escassez de estudos de utilização desses medicamentos. Portanto, novos estudos devem ser realizados, a fim de promover seu uso racional e elaborar políticas públicas com acesso a esses medicamentos.


Introduction: Immunosuppressants have high toxicity associated to a narrow therapeutic range, and serum levels should be controlled. Thus, it is necessary to study the use of drugs in clinics that use them, providing an overview of their intake and rational use in a given population. Objective: Identify the profile of the use of immunosuppressants for prophylaxis of graft versus host disease in patients submitted to hematopoietic stem cell transplantation in a bone marrow transplant center. Method: It is a cross-sectional study performed at a Brazilian bone marrow transplant facility. The immunosuppressants used in 2017 were classified according to an international classification system, their intake expressed in defined daily dose and their protocols analyzed according to the "Consenso da Sociedade Brasileira de Transplante de Medula Óssea" of 2015. Results:The myeloablative conditioning regimen was the most frequent (51.7%). The most prescribed immunosuppressive protocol was cyclosporine with methotrexate (37.9%). Of the 29 eligible patients, 23 (79.3%) had protocols following the 2015 "Consenso" recommendations. Methotrexate, intravenous cyclosporine and mycophenolate were responsible for 85.64% of the intake. Conclusion: In this study, it was only possible to identify a profile of use of immunosuppressants and compare within the institution due to the scarcity of studies about the use of these drugs. Therefore, new studies should be conducted to promote their rational use and to develop public policies with access to these drugs.


Introducción: Inmunosupresores presentan una alta toxicidad asociada a la estrecha banda terapéutica, debiendo tener control de niveles séricos y alta vigilancia en cuanto a toxicidad y efectividad. Así, es necesario el estudio de uso de medicamentos en clínicas que los utilizan, proporcionando una visión general de su consumo en una determinada población. Objetivo: Identificar el perfil de uso de Inmunosupresores para profilaxia de enfermedad injerto contra huésped en pacientes sometidos al trasplante de células madre hematopoyéticas en un centro de trasplante de médula ósea. Método: Se trata de un estudio transversal realizado en un centro brasileño de trasplante de médula ósea. Los Inmunosupresores utilizados en 2017 se clasificaron según un sistema de clasificación internacional, su consumo expresado en Dosis Diaria Definida y sus protocolos analizados según el consenso de la sociedad brasileña de trasplante de médula ósea de 2015. Resultados: El régimen de condicionamiento mieloablativo fue el más frecuente (51,7%). El protocolo de inmunosupresión más prescrito fue ciclosporina con metotrexato (37,9%). De 29 pacientes elegibles, 23 (79,3%) tuvieron protocolos siguiendo recomendaciones del consenso de 2015. Metotrexato, ciclosporina intravenosa y micofenolato fueron responsables del 85,64% del consumo. Conclusión: En este trabajo, sólo fue posible identificar un perfil de uso de Inmunosupresores y realizar comparaciones dentro de la institución debido a la escasez de estudios de utilización de esos medicamentos. Por lo tanto, nuevos estudios deben ser realizados a fin de promover su uso racional y elaborar políticas públicas con acceso a esos medicamentos.


Subject(s)
Humans , Drug Utilization , Graft vs Host Disease/drug therapy , Immunosuppressive Agents , Pharmacoepidemiology , Hematopoietic Stem Cell Transplantation
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