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<b>Purpose</b>: Palliative care is an essential part of integrated cancer treatment. This study aimed to identify general practitioner (GPs)' perceptions of palliative care and the difficulties they encounter in providing care to terminally ill cancer patients. <b>Methods</b>: Japanese GPs in a rural area where palliative care resources were inadequate were surveyed by questionnaire. Using the questionnaire, researchers visited 62 clinics in the area and carried out semi-structured interviews to identify problems and to investigate possible ways to promote the provision of palliative care by GPs. The transcripts were manually coded into descriptive and interpretive categories. <b>Results</b>: Seventy seven out of 95 responded to the questionnaire (effective response rate: 81%). Experience of pain control was inversely related to the extent of the GPs' perceived difficulties in providing palliative care. Lack of hospital support and understanding of patients and their families were also barriers to the provision by the GPs of palliative care to terminally ill cancer patients at home. The suggested solutions were: to provide seminars for doctors in the area to improve their pain control and other clinical skills; to build up good relations between the doctors in hospitals and clinics in the area; and to educate patients, families and the community at large in the necessity of palliative care. <b>Conclusion</b>: Our study indicated that building up good inter-organizational relations among physicians and educating the community were important in order to promote GPs' participation in palliative care. Palliat Care Res 2009; 4(2): 112-122
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OBJETIVO: Analisar as características das farmácias domiciliares e sua relação com a automedicação em crianças e adolescentes dos municípios de Limeira e Piracicaba (SP). MÉTODOS: Estudo descritivo tipo inquérito populacional domiciliar de uma amostra aleatória simples de ambos os municípios, constituída de 705 domicílios de setores censitários selecionados por meio de amostragem por conglomerado. Critérios de inclusão: idade ≤ 18 anos; entrevista obrigatória com um dos responsáveis; inventário da farmácia domiciliar e ter consumido pelo menos um medicamento nos 15 dias prévios à data da entrevista. Segundo o uso de medicamentos, os participantes foram divididos em dois grupos de estudo: automedicação (orientação leiga) e prescrição médica. Foram realizados testes de associação linear, análise descritiva das variáveis e regressão logística múltipla. RESULTADOS: Foram identificados 3.619 medicamentos (média = 5,1/domicílio; 79,6 por cento especialidades farmacêuticas). Os principais cômodos de estoque foram dormitórios (47,5 por cento), cozinha (29,9 por cento) e banheiros (14,6 por cento); 76,5 por cento em caixas de papelão e em locais de fácil alcance a 142 crianças com idade ≤ 6 anos. Considerando somente as especialidades farmacêuticas (n = 2.891), as mais freqüentes foram analgésicos/antipiréticos (26,8 por cento) e antibióticos sistêmicos (15,3 por cento), sendo o estoque desses medicamentos significativamente mais elevado no grupo automedicação (p < 0,01). Guardar medicamentos nos banheiros (razão de chances = 1,59) e grau de instrução dos responsáveis legais ≤ 4 anos do ensino fundamental (razão de chances = 2,40) denotaram maior risco de automedicação. CONCLUSÕES: É comum armazenar medicamentos nos domicílios, sendo importante a efetivação de campanhas visando o uso racional, a diminuição do desperdício e o estoque seguro.
OBJECTIVE: To investigate the contents of home medicine chests and their relationship with self-medication in children and adolescents in the towns of Limeira and Piracicaba, SP, Brazil. METHODS: This is a descriptive population study based on a home survey of a simple random sample from both towns, comprising 705 households from census sectors selected by means of cluster sampling. Inclusion criteria: age ≤ 18 years; an obligatory interview with at least one guardian; inventory of medicines kept at home; and having taken at least one medication during the 15 days prior to the interview. The participants were split into two groups based on medication: self-medication (lay advice) and medical prescription. Tests of linear association were performed, in addition to a descriptive analysis of the variables and multiple logistic regression. RESULTS: A total of 3,619 medicines were found (mean = 5.1/household; 79.6 percent were pharmaceutical preparations). The rooms most commonly used to store medications were bedrooms (47.5 percent), kitchens (29.9 percent), and bathrooms (14.6 percent); 76.5 percent were in cardboard boxes and within easy reach of 142 children aged ≤ 6 years. Taking the pharmaceutical preparations in isolation (n = 2,891), the most common were analgesics/antipyretics (26.8 percent) and systemic antibiotics (15.3 percent), and the self-medication group had significantly larger stocks of these medications (p < 0.01). Storing medications in the bathroom (odds ratios = 1.59) and legal guardians with ≤ 4 years of primary education (odds ratios = 2.40) indicated greater risk of self-medication. CONCLUSIONS: Keeping medicines at home is a common practice, and it is important to implement campaigns to encourage rational use, reduced waste and safe storage of medicines.