Prescrição farmacêutica: uma revisão sobre percepções e atitudes de pacientes, farmacêuticos e outros interessados / Pharmacist prescribing: a review of perceptions and attitudes of patients, pharmacists and other interested professionals

Resumo A prescrição farmacêutica é uma experiência em expansão em alguns países desenvolvidos, com diferentes sistemas de saúde. Conhecer a contribuição que essa atividade pode desempenhar no processo de assistência à saúde e investigar sua aceitação é de fundamental interesse para os países que a regularam. Este estudo de revisão de literatura, portanto, objetivou desenhar o estado da arte da investigação acadêmica sobre percepção, opiniões e atitudes no contexto da prática da prescrição farmacêutica em países que a adotaram. Para isso, realizou-se investigação nas bases de dados MEDLINE, Scopus, Embase, SciELO e LILACS, resultando na seleção de 17 estudos. Da análise dos artigos, emergiram três categorias de discussão: "compreensão da prática e benefícios percebidos"; "aceitação e adesão à prática"; "barreiras à prática". Os resultados mostraram aceitação e percepções variáveis nos diferentes públicos, dependendo, entre outras questões, do nível de conhecimento e experiência dos pacientes e dos profissionais de saúde, do perfil do farmacêutico ou da modalidade de prescrição. Este estudo aponta alguns desafios envolvidos na prática da prescrição farmacêutica e seus achados podem ser úteis para sugerir caminhos para o fortalecimento da prática.

Abstract Pharmacist prescribing is a growing reality in some developed counties, with varied health systems. Understanding the contribution that this activity can offer in the healthcare process, and investigating its acceptance is of utmost importance for the countries that implement and regulate this type of system. This literature review aimed to design a state-of-the-art academic investigation on the perception, opinions, and attitudes in the context of pharmacist prescribing practices in countries that have adopted this system. To achieve this, the present study conducted an investigation of the Medline, Scopus, Embase, SciELO, and Lilacs databases, resulting in the selection of 17 studies. From the analysis of the articles, three categories of discussion arose: "understanding of the practice and perceived benefits", "acceptance and adherence to the practice, and "hindrances to the practice". The results showed varied acceptance and perceptions among the different publics, depending, among other questions, on the level of knowledge and experience of the patients and health professionals, on the profile of the pharmacists, or on the prescribing modality. This study highlights some challenges involved in the practice of pharmacist prescribing, and its findings can be useful in suggesting a means through which to strengthen the practice.

The use of analgesics and anti-inflammatories in an oral surgery service in Medellín, Colombia, 2013-2015 / Uso de analgésicos y antiinflamatorios en un servicio de cirugía bucal en Medellín, 2013-2015

ABSTRACT Introduction: dental surgical procedures trigger an inflammatory response, for which dental practitioners prescribe analgesic and anti-inflammatory medications using pharmacological guidelines that require knowledge on the use of medicines in a given environment. The aim of the present study was to identify the analgesics and anti-inflammatory drugs most commonly prescribed at the oral surgery service of the Universidad de Antioquia School of Dentistry. Methods: this retrospective descriptive study reviewed the clinical records of the oral surgery service in the period January 2013-August 2015. A total of 1,177 records were reviewed, and 709 were selected for analysis. Results: 53.1% of the drugs prescribed were non-selective Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). Ibuprofen was formulated in 26.7% of all cases, followed by nimesulide with 24.1% and the combination of acetaminophen plus meloxicam with 10.2%. This same prescription pattern was observed in patients reporting no additional relevant medical history. In the case of gastric history, nimesulide was the drug of choice. 84% of all procedures were surgical extractions of third molars, with ibuprofen 600 mg postoperative for three days as the main therapeutic scheme. Conclusion: ibuprofen, nimesulide, and the combination acetaminophen plus meloxicam were the main analgesics and anti-inflammatory drugs prescribed in this study, according to medical and surgical records.

RESUMEN Introducción: la realización de procedimientos quirúrgicos odontológicos desencadena una respuesta inflamatoria, por la cual el profesional prescribe medicamentos analgésicos y antiinflamatorios teniendo como apoyo guías farmacológicas cuya construcción requiere del conocimiento del uso de los medicamentos en un determinado entorno. El objetivo del presente estudio consistió en identificar los analgésicos y antiinflamatorios más prescritos en el servicio de cirugía bucal de la Facultad de Odontología de la Universidad de Antioquia. Métodos: estudio descriptivo retrospectivo en el que se revisaron las historias clínicas del servicio de cirugía bucal en el período comprendido entre enero del 2013 y agosto del 2015. De una revisión de 1.177 registros se incluyeron 709 para el análisis de la información. Resultados: el 53,1% de los medicamentos prescritos fueron AINEs no selectivos, el ibuprofeno fue formulado en el 26,7% de los casos, seguido de la nimesulida (24,1%) y la combinación acetaminofén más meloxicam (10,2%). Este mismo patrón de prescripción se apreció cuando el paciente manifestó no tener ningún antecedente médico de relevancia; en el caso de referir antecedentes gástricos, la nimesulida fue el fármaco de elección. El 84% del total de procedimientos fue la exodoncia quirúrgica de terceros molares, en el cual el ibuprofeno de 600 mg posoperatorio durante tres días fue el principal esquema terapéutico. Conclusión: el ibuprofeno, la nimesulida y la combinación acetaminofén más meloxicam fueron los principales analgésicos y antiinflamatorios prescritos en este estudio según los antecedentes médicos y el procedimiento quirúrgico.

Opilation and menstrual suppression: an 18 th century medical prescription in the new kingdom of granada / Opilación y supresión de menstruos: una receta médica del siglo XVIII en el nuevo reino de granada

ABSTRACT Objective: To present and define the context of a medical prescription dating from the eighteenth century in the New Kingdom of Granada, used for the suppression of menstruation, and to analyze it in the light of current knowledge as to whether its ingredients as a whole, may or may not achieve inhibition of menstrual bleeding. Materials and methods: Documentary search in the Historical Archives of the Octavio Arizmendi Posada Library at Universidad de La Sabana where the prescription "Opilation and menstrual suppression" was found. A review of the literature available in SciELO/proQuest databases was subsequently conducted for the period 1993-2015. Conclusions: The manuscript found describes multiple ingredients that, as a whole, and analyzed in light of current knowledge, are not valid to achieve the alleged suppressive effect. However, the components of the "liquid vitriol of Mars" could be recognized as having antianemic properties, and the potential suppressive effect of prescribing vigorous exercise in the middle of the menstrual cycle, although the recipe does not accurately describe the frequency or intensity of exercising to achieve the desired effect.

RESUMEN Objetivo: Presentar y definir el contexto de una receta médica que data del siglo XVIII en el Nuevo Reino de Granada, utilizada para la supresión de la menstruación, y analizar, a la luz de los conocimientos actuales, si sus ingredientes en conjunto podrían o no lograr la inhibición del sangrado menstrual. Materiales y métodos: Búsqueda documental en el Archivo Histórico de la Biblioteca Octavio Arizmendi Posada en la Universidad de La Sabana, donde se identifica la receta "Opilación y supresión de menstruos", y, posteriormente, se realizó una revisión de la literatura disponible en las bases de datos SciELO/proQuest en el periodo 1993-2015. Conclusiones: En la receta manuscrita hallada se describen múltiples ingredientes que, analizados a la luz de los conocimientos actuales, y en su conjunto, no tienen validez para lograr el pretendido efecto supresor. Sin embargo, se reconocen las propiedades antianémicas del "vitriolo líquido de Marte", y el posible efecto que ejercería el ejercicio excesivo formulado en medio del ciclo menstrual, aunque en la receta no se describe con exactitud la frecuencia ni la intensidad con la que este debería ser realizado para lograr una supresión del menstruo.

WANG Dao-kun's Experience in Application of Dunhuang Ancient Medical Prescription Dabupi Decoction into the Treatment of Gastric Stuffiness / 中国中医药信息杂志

Dunhuang medicine is a branch of Dunhuang studies, including the characteristics of Dunhuang ancient medical prescriptions and treatment technique.Dunhuang Dabupi Decoction has good efficacy in nourishing vitality and yin and promoting the production of body fluid. Professor WANG Dao-kun used the prescription to treat gastric stuffiness, gaining significant curative effect. This article summaried cases of using this prescription, to show the advantages of Dunhuang ancient medical prescription Dabupi Decoction for present use.

The Associating Rules of Mongolian Medical Prescriptions Based on Reduced Binary Matrix / 世界科学技术-中医药现代化

The associating rules have been widely used in traditional Chinese medical (TCM) prescription data mining research work,while Mongolian medical prescription data mining work hardly carried out.In this study,Apriori algorithm based on reduced binary matrix was adopted for the data mining of Mongolian medical prescriptions with the provision of the decision support for research and development of new drugs.Twenty-seven Mongolian medical prescriptions for He Yi disease were involved in the data mining with Apriori algorithm based on reduced binary matrix.It was found that Aquilaria agallocha,Myristica fragrans,Zhen He Yi,or Aquilaria agallocha combined with Myristica fragrans,or Zhen He Yi combined with Myristica fragrans were determined as the Mongolian drugs frequently used in He Yi disease,with 80％ confidence level and 60％ support,and two algorithms were output,[Myristica fragrans--＞Zhen He Yi,0.83] and [Aquilaria agallocha--＞Myristica fragrans,1.00].In conclusion,some potential associating rules and drugs with high frequency in the Mongolian medical prescriptions can be fast mined using Apriori algorithm based on reduced binary matrix,providing a new way for unveiling the medication rules of Mongolian medical prescriptions.

Análise de prescrições medicamentosas dispensadas na farmácia de uma unidade básica de saúde de Porto Alegre - RS / Analysis of drug prescriptions dispensed by a pharmacy in a basic health unit in Porto Alegre, Brazil

Objetivo: Avaliar os erros nas prescrições atendidas e o percentual de retirada efetiva de medicamentos, permitindo uma compreensão de como o medicamento contribui para a orientação da assistência farmacêutica na Unidade Básica de Saúde (UBS) Hospital de Clínicas de Porto Alegre (HCPA) - Santa Cecília. Métodos: Estudo longitudinal retrospectivo a partir de prescrições dispensadas em uma Unidade Básica de Saúde em Porto Alegre-RS, durante o período de um mês, incluindo todas as prescrições que tiveram no mínimo um item dispensado. Parâmetros analisados: 1) procedência da prescrição médica; 2) demanda não-atendida; 3) utilização do nome comercial; 4) posologia; 5) data; 6) dados de identificação do paciente; 7) dados de identificação do prescritor; 8) legibilidade da receita. Resultados: Foram avaliadas 3.701 prescrições medicamentosas. Quanto à procedência, 24,2% (894) das prescrições foram oriundas do HCPA; 49,3% (1.824), da UBS HCPA-Santa Cecília; 9,6% (357), de outros postos de saúde; 9,1% (338), de convênios/particulares; 7,6% (280), de outros hospitais; 0,2% (7) não apresentavam identificação de procedência. Na totalidade das prescrições, 10.189 medicamentos foram prescritos, o que corresponde a uma média de 2,75 (±1) medicamentos por prescrição. Os medicamentos dispensados pela farmácia da UBS HCPA-Santa Cecília corresponderam a 67,1% deste total. Do total de medicamentos que não foram dispensados, 74,7% pertenciam à Relação Municipal de Medicamentos. Das 3.701 prescrições analisadas, 18% apresentavam algum tipo de erro. Foram encontrados 3.519 erros somatórios, considerando que uma mesma prescrição apresentou mais de um erro. A média de erro por prescrição foi de 5,3 (±2). Conclusão: Para alcançarmos resultados positivos na terapêutica, a educação permanente sobre a importância da prescrição de medicamentos para os profissionais da saúde torna-se necessária, evitando os erros de prescrição e, em muitos casos, de demanda não-atendida

Objective: To evaluate errors in prescriptions and percentage of drugs effectively collected, allowing a better understanding of how drugs contribute to the orientation of pharmaceutical assistance in the Basic Health Unit (BHU) Hospital de Clínicas de Porto Alegre (HCPA) Santa Cecília. Methods: This was a longitudinal, retrospective study of dispensed prescriptions in a BHU in Porto Alegre, Brazil, over a 1-month period including all prescriptions that had at least one dispensed item. Parameters to be analyzed: 1) origin of medical prescription; 2) unsatisfied demand; 3) use of commercial name; 4) dosage; 5) date; 6) patient’s identification data; 7) prescriber’s identification data;8) prescription’s legibility. Results: A total of 3,701 drug prescriptions were evaluated. As to origin, 24.2% (894) of prescriptions came from HCPA; 49.3% (1,824) from UBS HCPA-Santa Cecília; 9.6% (357) from other health units; 9.1% (338) from health plans/private; 7.6% (280) from other hospitals; and 0.2% (seven) had no origin identification. With regard to all prescriptions, 10,189 drugs were prescribed, corresponding to an average of 2.75 (±1) drugs per prescription. Drugs dispensed by the pharmacy at UBS HCPA-Santa Cecília corresponded to 67.1% of that amount. Of the total drugs that were not dispensed, 74.7% belonged to the Municipal List of Drugs. Of 3,701 prescriptions analyzed, 18% showed some type of error. There were 3,519 somatic errors, considering that a single prescription had more than one error. Mean number of errors per prescription was 5.3 (±2). Conclusion: To reach positive results in therapeutics, it is necessary to have a permanent education on the importance of drug prescription for health professionals, avoiding prescription errors and, in many cases, unsatisfied demands

Classified Collection of Medical Prescriptions / 의사학

In this study, the career and official ranks of the authors of the Sejong text(1443-1445), Sejo text(1451-1464), and Seongjong text(1475-1477) of {Classified Collection of Medical Prescriptions} were investigated. In the completion of Sejong text, Kim Rye-mong(1406-1469), Ryu Seong-won(?-1456), and Min Bo-hua(?) collected and arranged all medical books inside and outside of Choseon; Kim Moon(?-1448), Shin Seok-jo(1407-1459), Lee Ye(1419-1480), Kim Soo-on(1410-1481), Jeon Soon-eui(?), Choi Yun(?), and Kim Yu-ji(?-1469) took part in the edition; Lee Yong(1418-1453), Lee Sa-cheol(1405-1456), Lee Sa-soon(?-1455), and Rho Joong-rye(?-1452) participated in the editorial supervision. Ryang Seong-ji(1415-1482), Son So(1433-1484), Ryu Yo(?), Han Chi-ryang(?), An Geuk-sang(?), Han Kye-mi(1421-1471), Choi Young-rin(?) took part in the completion of Sejo text. Han Kye-heui(1423-1482), Rym Won-joon(1423-1500), Kueon Chan(1430-1487), Ryu Seo(?), and Baek Soo-heui(?) participated in the completion of Seongjong text. All 96 persons participated in the completion of draft text, revision text, and first-publication text of {Classified Collection of Medical Prescriptions}. 14 persons (14.58 %) participated in the completion of draft text. 77 persons (80.21%) participated in revision text, and 5 persons (5.21%) participated in first-publication text. Even though {Classified Collection of Medical Prescriptions} is a medical book, civil officials participated in its completion together with medical officials. The scholars of Jiphyeonjeon(The Jade Hall of Scholars) who led the academy at those days and famous medical officials were ordered to complete it by Sejong(1419-1450), Sejo(1455-1468), and Seongjong(1470-1494) who showed special interest in thier own heath and the health of common people.