Legibility of USP pictograms by clients of community pharmacies in Portugal.

BACKGROUND: Effective and safe use of medicines depends on patients' good understanding of the pharmacotherapy. Pictograms are a communication tool, as complement of verbal/written information, to facilitate drug use and, avoiding errors, being useful for drug effectiveness and safety. OBJECTIVE: To assess the ability of pharmacy's clients, in understanding USP pictograms, establishing the relationship with their socio demographic profiles. SETTING: The study was developed in community pharmacies, in Lisbon region. METHODS: Cross sectional study, carried out in pharmacies in Lisbon. A structured questionnaire was used in pharmacies clients of 18 years old and above. Legibility of fifteen USP pictograms was studied using ISO and ANSI criteria. Correlation between the legibility of pictograms and pharmacies clients' demographic profile (age, gender, scholarship, frequency of medicines use) was evaluated. SPSS data base version 18 was used for descriptive analysis. MAIN OUTCOME MEASURE: Legibility of fifteen United States Pharmacopeia (USP) pictograms and, its relationship with clients' demographic data (scholarship degree, age, frequency of medicines use and, gender) was studied. RESULTS: From 751 responders, ten pictograms were legible by ISO and seven by ANSI. More than 30 % of the responders weren't able to understand five of the pictograms. It was found statistically significant relationships between some the understanding of some pictograms and clients' scholarships degree, age and frequency of medicines use. CONCLUSION: It was found that not all the fifteen tested USP pictograms were correctly comprehended by Portuguese pharmacies' clients, having found correlations with scholarship degree, daily use of medicines and age group, for some pictograms. To ensure the effectiveness of USP pictograms it is advisable to test patients' comprehension, before their use in general practice.

[Operationalization to Portugal: Beers criteria of inappropriate medication use in the elderly]. / Operacionalização para Portugal: critérios de Beers de medicamentos inapropriados nos doentes idosos.

INTRODUCTION: Elderly drug therapy needs special care considering physiopathological alterations of this age group that increase the risk of adverse drug events occurrence and due to the high number of drugs used. Several tools have been created, as tables of drugs and groups of drugs to be avoided in patients 65 years old and over. Beers Criteria of 2002 update is the most used tool. GOALS: To operationalize Beers Criteria to be used by health care professionals in Portugal. METHODS: Analysis of the drugs and therapeutic classes included into the Beers Criteria approved for market in Portugal and the identification of other approved substances included in the pharmacological classes mentioned in Beers Criteria. The two tables in the Beers criteria were adapted to substances approved in Portugal, even including other marketed active substances belonging to therapeutic classes mentioned in Beers criteria. Levels of inappropriateness and the potential effects after their use in elderly were also included. In Beers table 1, 34 included substances don't have approval in Portugal, and 4 have different denominations. In Beers table 2, three tricyclic antidepressants, 12 typical antipsychotics, 5 doses for short-action benzodiazepines, and 28 NSAIDs (being two coxibs) were included. CONCLUSIONS: The Portuguese operationalization of the Beers Criteria allows the creation of a tool that helps prescribers to choose drugs and doses for a safer prescription to the elderly. These adapted tables allow benchmarking among studies assessing inappropriateness of use of drugs in different countries using Beers Criteria.

Inappropriate drug use by Portuguese elderly outpatients--effect of the Beers criteria update.

OBJECTIVE: To characterize the use of medicines and to evaluate the inappropriateness of drugs in elderly outpatient population. SETTING: Twelve community pharmacies in different districts of Lisbon-Portugal. METHOD: Observational cross-sectional survey, in a sample of 213 elderly outpatients (age>or=65-years-old) presenting a prescription with two or more drugs, for their own use. MAIN OUTCOME MEASURES: Drug use pattern and prevalence of potentially inappropriate medication. RESULTS: We have studied 213 outpatients, who were taking a total of 1,543 drugs, with an average of 7.23 per patient. The drugs were distributed mainly in the following 3 ATC (Anatomical Therapeutic Chemical Classification) classes: C (cardiovascular system), N (nervous system) and A (alimentary tract). Using the 1997 Beers Explicit criteria, 75 occurrences of inappropriate medicines were detected in 59 patients (27.7%), while with the 2003 Beers Explicit criteria we detected 114 cases of inappropriate medication in 82 patients (38.5%). The occurrence of inappropriate medicines was significantly associated with the consumption of a high number of drugs. According to the ATC Classification, more than one half of the cases of inappropriateness were related with long acting benzodiazepines and with ticlopidine. The 2003 version detected a significantly higher prevalence of inappropriate drug use having potentially adverse outcomes of high severity. CONCLUSIONS: The application of the updated Beers criteria lead to higher rates of potentially inappropriate medication, and especially those responsible for more severe adverse outcomes. The results suggest that there is a need for interventions to improve instructions for safe drug use in the elderly patients and to decrease the number of medications whenever it is possible. This study suggests a high prevalence of potentially inappropriate drug use by the elderly patients of Lisbon region, Portugal.

Prevalência da automedicação na população urbana portuguesa / Self-medication prevalence in a Portuguese urban area

Este estudo transversal teve como objetivo principal determinar a prevalência da automedicação em meio urbano. Decorreu nas cidades de Lisboa e Porto, respectivamente em 11 e 15 farmácias, no período de Novembro de 1995 a Setembro de 1996. A recolha de informação dividiu-se em 6 fases de 10 dias cada. A prevalência da automedicação encontrada foi de 26,2 por cento. Encontraram-se diferenças estatisticamente significativas no que respeita às prevalências da automedicação por sexo, idade, nível educacional e atividade profissional. Em 50 por cento dos casos, os voluntários que adquiriram medicamentos em automedicação fizeram-no sob aconselhamento do farmacêutico. Os grupos terapêuticos mais utilizados em automedicação foram as preparações nasais e sistêmicas para a constipação e tosse (23,0 por cento) e os analgésicos (13,6 por cento)...

Revisão técnica de livros sobre diagnósticos de enfermagem: percepções de enfermeiras do sul do Brasil / Technical proofreading of books about nursing diagnosis: perceptions of nurses from the south of Brazil

A temática desenvolvida no presente estudo aborda o relato de experiência de enfermeiras do sul do Brasil como revisoras técnicas de livros sobre diagnóstico de enfermagem. Busca-se contribuir com colegas que venham realizar tarefa semelhante lançando alguns aspectos para discussão. É situado o desenvolvimento do diagnóstico de enfermagem no Brasil. São identificadas as principais etapas de produção de livros traduzidos e citadas as atribuições de revisores técnicos. Comentam-se os pontos positivos e as dificuldades encontradas na atividade de revisão técnica. Sugerem-se alternativas para manter a qualidade final da obra e ampliar a oferta de textos especializados o mais fiel possível aos seus originais.

Self-medication in a Portuguese urban population: a prevalence study.

PURPOSE: To determine the prevalence of self-medication in a Portuguese urban population. To assess the feasibility of performing these studies in community pharmacies. METHODS: A cross-sectional study was chosen to collect information about demography, use of health services and drug utilization in a sample of pharmacy user-purchasers in a pre-determined period of time. RESULTS: The proportion of pharmacies which participated in the study was 18.3% (11 from 60 invited) in Lisbon and 37.5% (15 of 40 invited) in Porto. Among the 3312 selected patients, only 2.6% (n = 114) refused to participate. The prevalence of self-medication was found to be 26.2%. The distribution of self-medication by gender was 28.4% for males and 25.2% for females. Use of self-medication was statistically significantly higher (p < 0.001) among individuals aged between 10 and 49 years. The main therapeutic groups used for self-medication, according to the ATC classification, were throat preparations, cough and cold preparations, stomatological preparations (antiinfectives and corticosteroides for local oral treatment), laxatives, analgesics, dermatological preparations, vitamins, mineral supplements and other alimentary tract and metabolism products. CONCLUSIONS: In the urban areas under study the overall prevalence of self-medication was 26.2%. Predictive factors for self-medication seem to be, a high level of education, professional status and length of waiting times for a medical consultation in cases of a severe health problem. Further research on this subject is needed to confirm the reproducibility of these results, since potential selection bias could have been introduced due to the method used for patient selection. Pharmacoepidemiologic research is feasible in Portuguese community pharmacies.

[Technical proofreading of nursing diagnosis books: perceptions of nurses from the south of Brazil]. / Revisão técnica de livros sobre diagnósticos de enfermagem: percepções de enfermeiras do sul do Brasil.

The present study is a report of an experience of nurses from the South of Brazil as technical proofreaders of books about nursing diagnosis. It aims at contributing with colleagues who might do similar task arousing some aspects for discussion. The development of nursing diagnosis in Brazil is presented. The main steps of a translated book production are identified and the attributions of technical proofreaders are cited. The positive aspects and the difficulties found in this activity are commented. Alternatives are given in order to maintain the final quality of the work and to enlarge the availability of specialized texts as faithful to the original as possible.

Diagnóstico de enfermagem e intervençöes em um paciente com falência de múltiplos órgäos: estudo de caso / Nursing diagnosis and interventions in a patient with multiple organs failure: case study

O presente trabalho objetiva identificar Diagnosticos e Intervençöes de Enfermagem, em um paciente em estado crítico de saúde, que apresenta falência de múltiplos órgäos, internado na Unidade de Tratamento Intensivo de uma Instituiçäo Hospitalar na cidade de Porto Alegre...