Evaluation of the effectiveness of an Internet-based continuing education program on pharmacy-based minor ailment management: a randomized controlled clinical trial

ABSTRACT The aim of this work was to evaluate the effectiveness of an internet-based continuing education (CE) program on pharmacy-based minor ailment schemes (PMASs). A controlled randomized clinical trial was conducted in community pharmacies in Brazil. Community pharmacists (CPs) were enrolled in two groups: intervention (n = 61) and control (n = 60). CPs who were enrolled to the intervention group participated in an Internet-based CE program. CPs in the control group received no educational intervention. We evaluated participant perception, learning outcomes, and practice performance. Learner satisfaction with the CE program was high for every point evaluated (mean ± standard deviation = 4.2 ± 0.4). Posttest learner outcome scores and practice performance in the intervention group after the conclusion of the CE program significantly improved compared with pretest scores (p < 0.001) and were significantly better compared with the control group (p < 0.001). The present Internet-based CE program is a viable educational strategy for improving participant perception, learning outcomes, and practice performance in PMASs.

RESUMO O objetivo desse trabalho foi avaliar a efetividade de um programa de educação continuada (EC) à distância, relacionado ao gerenciamento clínico de problemas autolimitados de saúde em farmácias comunitárias. Realizou-se um ensaio clínico controlado randomizado em farmácias comunitárias no Brasil. Os farmacêuticos comunitários foram alocados em dois grupos: intervenção (n = 61) e controle (n = 60). Os farmacêuticos comunitários do grupo intervenção participaram de um programa de EC à distância. Os farmacêuticos comunitários do grupo controle não receberam intervenção educativa. A percepção dos participantes, os resultados de aprendizagem e hábitos de prática foram avaliados. A satisfação dos estudantes com o programa de CE foi elevada em todos os momentos avaliados (média ± desvio padrão = 4,2 ± 0,4). Os escores de aprendizagem e prática aumentaram significativamente ao final do estudo em relação ao início do estudo (p < 0,001) e foram significativamente melhores que os do grupo controle (p < 0,001). O presente programa de EC à distância é uma estratégia educacional viável para melhorar a percepção dos participantes, os resultados da aprendizagem e hábitos de prática relacionados ao gerenciamento clínico de problemas autolimitados de saúde em farmácias comunitárias.

Mercado farmacéutico en México: tamaño, valor y concentración / The pharmaceutical market in Mexico: size, value, and concentration

OBJETIVO: Caracterizar el mercado de medicamentos de México en cuanto a su tamaño, organización, poder de mercado de las empresas y capacidad de negociación de los consumidores. MÉTODOS: Estudio descriptivo a partir de los datos de los Censos Económicos de 2004 y los informes de Intercontinental Marketing Services. Se obtuvieron los montos y volúmenes de ventas de las empresas del sector farmacéutico mexicano de 2002 a 2005 y se calcularon el índice de Herfindahl-Hirschman (IHH) y su inverso como indicadores del grado de concentración del mercado, así como la elasticidad del precio por un producto índice. RESULTADOS: El valor total de los productos elaborados por el sector farmacéutico fue de 115 mil millones en pesos de 2006, de los que 99,0 por ciento correspondió a las empresas clasificadas como grandes. Este monto representó 1,2 por ciento del producto interno bruto nacional de ese año (20,0 por ciento de la participación del sector salud, estimada en 6,0 por ciento) y 3,9 por ciento del valor de los productos de manufactura. El IHH del mercado farmacéutico mexicano en el período analizado fue de alrededor de 0,04, aunque con una reducción sostenida, y su inverso se redujo de 23 a 26. La elasticidad del precio de los productos farmacéuticos entre 2003 y 2005 fue mínima (0,007, 0,003 y -0,002). CONCLUSIONES: Este trabajo constituye una primera caracterización del mercado farmacéutico mexicano, uno de los sectores más dinámicos de la economía nacional. Se comprobó que se trata de un mercado oligopólico e inelástico, por lo que se justifica la creación de mecanismos regulatorios más sólidos que reduzcan el poder de los productores en favor de los consumidores.

OBJECTIVES: To describe the pharmaceutical drug market in Mexico in terms of its size, structure, business' market power, and consumer negotiating power. METHODS: A descriptive study based on data from the 2004 Economics Census and the reports of IMS Health, Inc. (Norwalk, Connecticut, United States of America). Sales amounts and volumes of Mexico's pharmaceutical companies from 2002-2005 were obtained and the Herfindahl-Hirschman Index (HHI) and its inverse were calculated as indicators of the market's degree of concentration; also, price elasticity was determined by a product index. RESULTS: The total value of the products manufactured by the pharmaceutical sector was 115 billion in 2006 Mexican pesos, of which 99 percent pertained to companies categorized as large. This amount constituted 1.2 percent of the national gross domestic product that year (20.0 percent of the health sector's portion, estimated to be 6.0 percent) and 3.9 percent of the total value of manufactured goods. The HHI of Mexico's pharmaceutical market during the study period was about 0.04, albeit with a steady decline, and its inverse decreased from 23 to 26. The price elasticity of pharmaceutical products was minimal (0.007, 0.003, and -0.002). CONCLUSIONS: This study constitutes a preliminary description of Mexico's pharmaceutical market, one of the country's most dynamic economic sectors. It confirmed that the market is a rigid oligopoly, and thus supports enactment of firmer regulatory tools to reduce the power of the manufacturers in favor of that of the consumers.

Drug Use in the Elderly / 기본간호학회지

PURPOSE: This study was conducted to identify drug use by elders. METHOD: There were 304 participants age 65 or older included in this study. Data were collected using a questionnaire about drug use in the past 4 weeks. The questionnaire, a modification of Uhm's (2005), Lee's (2001), and Ellor and Kurz's (1982) tools, consisted of 17 questions on general and health characteristics, 17 on drug usage and 9 on behaviors related to drug misuse. RESULTS: 85.5% of participants reported taking at least one type of prescription or non-prescription drug. 26.0% of participants reported taking only prescription drugs, 3.9% reported taking only non-prescription drugs, and 55.6% reported taking both prescription and non-prescription drugs. 17.1% of participants reported side effects from the drugs. The mean score for behaviors related to drug misuse was 7.53. Elders taking only non-prescription drugs showed more drug misuse than elders taking only prescription drugs or both. Women used more prescription, non-prescription drugs or both than man. Elders in rural areas used more non-prescription drugs than those in urban areas. CONCLUSION: Even though pharmacies were separated from medical practices in 2000, most older adults continue to use and misuse prescription and non-prescription drugs.