Medication discrepancies in a hospital in Southern Brazil: the importance of medication reconciliation for patient safety

Medication discrepancies are of great concern in hospitals because they pose risks to patients and increase health care costs. The aim of this study was to estimate the prevalence of inconsistent medication prescriptions to adult patients admitted to a hospital in southern Santa Catarina, Brazil. This was a patient safety study on patients recruited between November 2015 and June 2016. The participants were interviewed and had their medical records reviewed. Discrepant medications were considered those that did not match between the list of medicines taken at home and the prescribed drugs for treatment in a hospital setting. Of the 394 patients included, 98.5% took continuous-use medications at home, with an average of 5.5 medications per patient. Discrepancies totaled 80.2%, The independent variables associated with the discrepancies were systemic arterial hypertension, hypercholesterolemia, vascular disease, number of medications taken at home, and poor documentation of the medications in the medical record. Findings from this study allowed us to conclude there was a high rate of prescription medication misuse. Medication reconciliation is crucial in reducing these errors. Pharmacists can help reduce these medication-related errors and the associated risks and complications.

Increase of binucleated cells in the oral mucosa: a study on the use of psychotropics by students of a Brazilian institution

SUMMARY This study aimed to assess the prevalence of medical and nonmedical use of psychiatric medication among undergraduate students of health sciences from a public university in Brasil. Another objective was to determine the frequency of nuclear morphological abnormalities in the buccal mucosa of students using psychiatric drugs. A cross-sectional study based on a Web survey was carried out with 375 health sciences undergraduate students from schools of Pharmacy, Physical Education, Nutrition, and Medicine. Additionally, spontaneous genetic damages in exfoliated cells of the buccal mucosa of 41 individuals by counting micronucleus (MN) and binucleated (BN) cells frequencies were evaluated. The results showed 76 (20.3%) of students reported the use of psychotropic drugs after enrolling in university. The majority of these students were from Pharmacy and Medicine programs, females, aged between 18-25 years old, nonsmokers, alcohol addicts, and with a family history of mental illness. In addition, Medical students, individuals with high-income, who live alone and are in the last period of the program are more likely to use psychotropic drugs. Moreover, exposure to psychiatric medication was able to increase the number of binucleated cells. These results provide evidence that the use of psychoactive drugs is increased in the academic context and may be related to the failure of the cell cycle.

RESUMO O objetivo deste estudo foi avaliar a prevalência de uso médico e não médico de medicação psiquiátrica entre estudantes de graduação em Ciências da Saúde de uma universidade pública do Brasil. Outro objetivo foi determinar a frequência de anormalidades nucleares morfológicas na mucosa bucal desses estudantes. Realizou-se um estudo transversal baseado na Web com 375 estudantes de graduação em Ciências da Saúde das escolas de Farmácia, Educação Física, Nutrição e Medicina. Adicionalmente, danos genéticos espontâneos em células esfoliadas da mucosa bucal de 41 indivíduos foram analisados para estudo da frequência de micronúcleos e células binucleadas. Os resultados mostraram que 76 (20,8%) dos estudantes relataram que usaram drogas psicotrópicas após se matricularem na universidade. O uso desses medicamentos foi maior entre estudantes de cursos de Farmácia e Medicina, sexo feminino, idade entre 18 e 25 anos, não tabagistas, alcoolistas e histórico familiar de doença mental. Além disso, estudantes de Medicina, indivíduos com alta renda, que moram sozinhos e estão no último período do curso são mais propensos a usar drogas psicotrópicas. Ademais, a exposição à medicação psiquiátrica foi capaz de aumentar o número de células binucleadas. Esses resultados fornecem evidências de que o uso de drogas psicotrópicas aumenta no contexto acadêmico e pode estar relacionado à falha do ciclo celular.

Use of antibiotics by adults: a population-based cross-sectional study

ABSTRACT BACKGROUND: The consumption of antibiotics has been widely discussed, mainly because of antibacterial resistance, which has become a worldwide concern. In Brazil, sale of antibiotics is currently ruled by Agência Nacional de Vigilância Sanitária (ANVISA) regulation RDC 20/2011, which restricts sales to those made under medical prescription. The aims of this study were to evaluate antibiotic use and associated factors among adults in the Metropolitan Region of Manaus, Amazonas, Brazil, and to assess the proportion of self-medication from this use. DESIGN AND SETTING: Population-based cross-sectional study conducted in the Metropolitan Region of Manaus between May and August 2015. METHODS: Adults aged ≥ 18 years were selected through probabilistic sampling in three stages. Trained interviewers collected data from the participants in their homes. Antibiotic consumption over the last 15 days was reported. Bivariate analysis was used to calculate the prevalence ratio (PR) of antibiotic usage, with 95% confidence interval (95% CI). A multivariate model adjusted according to significant variables at P ≤ 0.20 using Poisson regression with robust variance was constructed. RESULTS: The prevalence of antibiotic use was 3.4% (95% CI 2.8-4.0%). Adjusted analysis showed that consumption was higher among women than among men (PR 1.58; 95% CI 1.11-2.24) and among people with fair health status than among those with good health (PR 1.52; 95% CI 1.08-2.15). The prevalence of self-medication was 19.0%; amoxicillin was the most self-medicated antibiotic (10/26). CONCLUSION: Antibiotic use was associated with women and individuals with fair health status. One fifth of the antibiotics were consumed through self-medication, contrary to the current Brazilian legislation.

Estado nutricional, imagem corporal e associação com comportamentos extremos para controle de peso em adolescentes brasileiros, Pesquisa Nacional de Saúde do Escolar de 2015 / Nutritional status, body image, and their association with extreme weight control behaviors among Brazilian adolescents, National Adolescent Student Health Survey 2015

RESUMO: Introdução: Este estudo objetivou analisar a associação entre estado nutricional, percepção da imagem corporal e comportamentos extremos para controle de peso nos adolescentes. Metodologia: Estudo transversal analítico, realizado no Brasil a partir da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015, com adolescentes de 13 a 17 anos. Estado nutricional e percepção da imagem corporal foram as variáveis independentes. As dependentes foram vômito ou uso de laxantes e uso de remédios e outras fórmulas para controle de peso nos últimos 30 dias. Modelos de regressão de Poisson foram empregados para associação, com uso de variáveis demográficas para controle. Resultados: 7,4% dos adolescentes (IC95% 6,7 - 8,2) relataram vômito ou uso de laxantes, sem diferença entre os sexos. A prevalência de uso de remédio e fórmulas foi maior entre meninos (7,8%; IC95% 6,6 - 8,9). A associação entre estado nutricional e comportamentos extremos não foi significativa; entretanto, a prevalência de vômito ou uso de laxantes foi 2,3 (IC95% 1,1 - 4,7) vezes maior em meninos e 5,3 (IC95% 3,3 - 8,6) vezes maior em meninas que se sentiam muito gordos(as), ao passo que uso de remédios e fórmulas foi 4,0 vezes (IC95% 2,3 - 7,1) maior em meninas que sentiam muito gordas. Conclusão: A percepção da imagem corporal parece ter maior influência na prática dos comportamentos extremos do que o estado nutricional. Estratégias envolvendo serviços de saúde e escolas têm grande potencialidade para ações que impactem positivamente na autoestima e na saúde dos estudantes.

ABSTRACT: Introduction: This study aimed to analyze the association between nutritional status, body image perception, and extreme weight control behaviors among adolescents. Methods: This is an analytical cross-sectional study conducted in Brazil based on the National Adolescent Student Health Survey (Pesquisa Nacional de Saúde do Escolar - PeNSE) of 2015, with adolescents aged 13 to 17 years. Nutritional status and body image perception were the independent variables. The two dependent variables were vomiting or laxative use and use of medicines and other formulas for weight control in the 30 days prior to data collection. We used Poisson regression models for association, with demographic variables for control. Results: 7.4% of adolescents (95%CI 6.7 - 8.2) reported vomiting or using laxatives, with no difference between genders. The prevalence of use of medicines and formulas was higher among boys (7.8%; 95%CI 6.6 - 8.9). The association between nutritional status and extreme behaviors was not significant. However, the prevalence of vomiting or laxative use for adolescents who considered themselves very fat was 2.3 (95%CI 1.1 - 4.7) times higher for boys and 5.3 (95%CI 3.3 - 8.6) times higher for girls, while the use of medicines and formulas was 4.0 (95%CI 2.3 - 7.1) times higher for girls who considered themselves very fat. Conclusion: Body image perception seems to have a greater influence on extreme behaviors than nutritional status. Strategies involving health services and schools have great potential to impact the self-esteem and health of students positively.