RESUMEN

Introducción: el hecho de que una persona no puede acceder a un servicio de salud puede favorecer la automedicación, que es la administración de fármacos según la autopercepción del individuo sobre su posible diagnóstico y solución. Aunque es una situación considerada como problema de salud pública, por medio de la educación o futuras investigaciones que generen propuestas, se podrá erradicar las barreras al acceso de la salud oral. Objetivo: determinar la prevalencia de la automedicación en odontología en adultos de Macas, Ecuador, durante el año 2021. Material y métodos: estudio descriptivo, cuantitativo, documental, comunicacional y transversal actual, donde se trabajó sobre la población de edad adulta de Macas, Ecuador; los datos se recolectaron mediante una encuesta online, para luego ser analizados en prevalencia, frecuencia y chi cuadrado. Resultados: 49% de los encuestados respondió que se automedican, los analgésicos fueron el tipo de medicamento más consumido (44.2%); 27% de los individuos respondió que el dolor dental era una causa para tomar medicamentos sin receta, el principal motivo para automedicarse y no acudir al odontólogo fue por indicación del técnico de farmacia (26%). Conclusiones: los datos epidemiológicos obtenidos en esta investigación demuestran la marcada tendencia de las personas a consumir medicinas sin receta médica, por lo que, se deduce que existe una barrera para acceder a los servicios de salud oral; por ello, debería darse la importancia y atención oportuna (AU)

Introduction: the fact that a person cannot access a health service, may favor self-medication, which is the administration of drugs according to the individual's self-perception about their possible diagnosis and solution. Although, it is a situation considered as a public health problem, through education or future research that generates proposals, it will be possible to eradicate the barriers to oral health access. Objective: to determine the prevalence of self-medication in dentistry in adults in Macas, Ecuador, during the year 2021. Material and methods: a descriptive, quantitative, documentary, communicational and current cross-sectional study was carried out on the adult population of Macas, Ecuador; data were collected by means of an online survey and then analyzed in terms of prevalence, frequency and chi-square. Results: 49% of those surveyed responded that they self-medicate, analgesics were the most consumed type of medicine (44.2%), 27% of the individuals responded that dental pain was a cause for taking medicines without prescription, the main reason for self-medicating and not going to the dentist was because of the indication of the pharmacy technician (26%). Conclusions: the epidemiological data obtained in this investigation show us the marked tendency of people to take medicines without a medical prescription; therefore, it can be deduced that there is a barrier to accessing oral health services, and for this reason it should be given importance and timely attention (AU)

Asunto(s)

RESUMEN

Abstract Objective: To study the frequency of self-medication and knowledge about out-of-counter drugs during the COVID-19 pandemic in a group of Iranian dental students. Material and Methods: A descriptive cross-sectional study was conducted among dental undergraduates from September 2021 to November 2021 after receiving ethical clearance from the Kerman Medical University Ethical Committee. A valid and reliable questionnaire, consisting of demographic data and questions about self-medication and knowledge about out-of-counter drugs, was sent to participants via E-mail. Data was analyzed by SPSS 26 software by using a t-test. The P-value was considered at a 0.05% significant level. Results: A total of 88 students participated in the study with a mean age of 21.39±3.71 years. Prevalence of self-medication was found in 53.4%. The most common cause for self-medication was headache. Acetaminophen was the most commonly used medicine for self-medication. Females had more self-medication than males, but there was no significant differences. There was no significant differences between entering year to university and self-medication. Younger students had significantly more self-medication (p=0.007). Knowledge about out-of-counter drugs was moderate. Conclusion: Moderate self-medication as noticed. The out-of-counter drugs were the most used. Although out-of-counter drugs seem relatively safe, their improper use can cause serious side effects. Dental students need to be educated regarding appropriate safe medication and out-of-counter drugs.

Asunto(s)

RESUMEN

Global healthcare systems, including the National Health System in Brazil - one of the largest public models in the world -, continue to evolve, as well as populations' health needs, currently shaped on individuals feeling a greater desire to manage their own health. Self-care practices are part of several public policies and clinical guidelines in Brazil including the National Policy on Complementary and Integrative Practices, the National AIDS Control Program, the National Policy for Women's Health, and the Guidelines for Care of People with Chronic Diseases. There are over 100,700 community pharmacies, in the country (89.2% privately owned) employing 234,300 pharmacists, representing an important delivery point for self-care, as they are the first point of access to care for most patients. Self-medication is a common practice in Brazil (prevalence rates of self-medication ranging from 16.1% to 35.0%), especially with non-prescription/over-the-counter medicinal products (65.0%). In fact, these products represent over 25% of volume marketed of medicines, summing revenues of USD 1.9 billion per year. Studies demonstrated a positive budget impact as important savings for the National Health System due to reductions of unnecessary medical appointments and loss of working days. In addition to minor ailments management, other self-care services provided by community pharmacies that are frequently sought by Brazilian citizens (20-25% of cases) are smoking cessation and weight management (costs per service ranging from around USD 5.00-12.00). However, pharmacy services are not yet as fully integrated in Brazil to the same extent as in other countries. Barriers such as standardization of processes (from services' design, implementation, and evaluation in practice), pharmacist remuneration for the provision of services and the amount to be charged for the service are still a matter of controversy. For more rapid and sustainable advances in these practices, communication among various stakeholders, professional practice and healthcare regulations, standardization of services and financing of self-care (both publicly and privately) are urgently needed. This paper provides an overview of some self-care services provided by community pharmacies in Brazil and call attention to the ongoing challenges to move the National Health system forward.

RESUMEN

Background: Older adults are a particularly vulnerable group to drug use and self-medication. The aim of the study was to evaluate self-medication as a factor associated with the purchase of brand-name and over-the-counter (OTC) drugs in older adults in Peru. Methods: A secondary analysis was performed using an analytical cross-sectional design of data from a nationally representative survey from 2014 to 2016. The exposure variable was self-medication, defined as the purchase of medicines without a prescription. The dependent variables were purchases of brand-name and OTC drugs, both as a dichotomous response (yes/no). Information of sociodemographic variables, health insurance, and the types of drugs purchased by the participants was collected. Crude prevalence ratios (PR) were calculated and adjusted using generalized linear models of the Poisson family, considering the complex sample of the survey. Results: In this study, 1,115 respondents were evaluated, with a mean age of 63.8 years and a male proportion of 48.2%. The prevalence of self-medication was 66.6%, while the proportions of purchases of brand-name and OTC drugs were 62.4% and 23.6%, respectively. The adjusted Poisson regression analysis revealed an association between self-medication and the purchase of brand-name drugs (adjusted PR [aPR]=1.09; 95% confidence interval [CI]: 1.01-1.19). Likewise, self-medication was associated with the purchase of OTC medications (aPR=1.97; 95%CI: 1.55-2.51). Conclusions: This study evidenced a high prevalence of self-medication in Peruvian older adults. Two-thirds of the surveyed people bought brand-name drugs, whereas one-quarter bought OTC drugs. Self-medication was associated with a greater likelihood of buying brand-name and OTC drugs.

RESUMEN

Resumen Introducción: la publicidad televisiva es una estrategia utilizada por la industria farmacéutica para ofrecer sus productos. En el caso de los medicamentos de venta libre, se tiene la responsabilidad de ajustarse a la normativa relacionada con estos productos, con el propósito de proteger al televidente de influencias negativas por posible publicidad imprecisa o engañosa. Objetivo: evaluar el cumplimiento normativo de la publicidad televisiva de medicamentos de venta libre en Colombia de agosto de 2018 en los canales nacionales Caracol y RCN. Metodología: se revisaron las grabaciones de anuncios publicitarios de medicamentos en los canales Caracol y RCN. Aleatoriamente, se seleccionaron los días 2, 4, 22 y 26 de agosto de 2018. La revisión de las grabaciones se realizó por dos evaluadores independientes. Los datos de los anuncios publicitarios se analizaron con estadística descriptiva. Resultados: se identificaron 624 anuncios publicitarios relacionados con medicamentos de venta libre: 601 pautas (96,3 %) y 23 comerciales (3,7 %). Entre los 624 anuncios emitidos, 226 (36,2 %) de 18 medicamentos no cumplieron con algunas condiciones establecidas en la normatividad. Discusión: este estudio, comparado con la publicación del 2014, mostró un incremento en la cantidad de anuncios que no cumplen con la norma, pasando de 8 % a 36,2 %. La principal situación de incumplimiento se debe al tamaño de la fuente, que puede limitar la lectura en poblaciones especiales. Conclusiones: los anuncios televisivos emitidos en los canales nacionales Caracol y RCN, en un 36,2 %, no cumplen con los requisitos definidos por la normatividad vigente.

Abstract Introduction: Advertising broadcast by mass media is a strategy used by the pharmaceutical sectors to offer their products. For of over-the-counter drugs, this sector is responsible for complying with the regulations related to these products, in order to protect the viewers from negative influences, for possible inaccurate or misleading advertising. Objective: To evaluate regulatory compliance in television advertising of over-the-counter drugs in Colombia in August 2018 on Caracol and RCN national channels. Methods: The recordings of the drug advertisements of two national television channels Caracol and RCN were reviewed. The days 2, 4, 22, 26 of august 2018 were randomly selected. Two independent evaluators reviewed the recordings. The data from the advertisements was analyzed with descriptive statistics. Results: A total of 624 commercials related to over-the-counter drugs were identified: 601 guidelines (96.3%) and 23 commercials (3.7%). Among the 624 advertisements broadcast by both national channels, 226 (36.2%) of 18 drugs did not meet some of the conditions established in the regulations. Discussion: Compared to the work done in 2014, shows that there was an increase in the number of advertisements that do not comply with the norm (from 8% to 36.2%). The main non-compliance situation presented by advertisements is related to the source size since small letters can limit the reading of special populations. Conclusion: 36.2% of the television advertisements broadcast on the national television channels Caracol and RCN do not meet the requirements defined by current regulations.

Asunto(s)

RESUMEN

Although restricting over-the-counter (OTC) antimicrobial drug sales is recommended globally, no data track its effect on antimicrobial resistance (AMR) in bacteria. We evaluated the effect of a national policy restricting OTC antimicrobial sales, put in place in November 2010, on AMR in a metropolitan region of São Paulo, Brazil. We reviewed associations between antimicrobial sales from private pharmacies and AMR in 404,558 Escherichia coli and 5,797 Streptococcus pneumoniae isolates using a dynamic regression model based on a Bayesian approach. After policy implementation, a substantial drop in AMR in both bacterial species followed decreased amoxicillin and trimethoprim/sulfamethoxazole sales. Conversely, increased ciprofloxacin sales were associated with increased ciprofloxacin resistance, and extended spectrum ß-lactamases-positive E. coli isolates and azithromycin sales increases after 2013 were associated with increased erythromycin resistance in S. pneumoniae isolates. These findings suggest that restricting OTC antimicrobial sales may influence patterns of AMR, but multifaceted approaches are needed to avoid unintended consequences.

Asunto(s)

RESUMEN

Aim: This study analyzed the effect of whitening mouth rinses on water sorption (WS), solubility (SL), color change, and surface roughness of a nanofilled composite. Whitening perceptibility and acceptability (WID) were also studied. Methods: Forty specimens of Filtek Z350XT, shade EA2 were produced and randomly distributed (n=8) to AS ­ artificial saliva (control); LWE ­ Listerine Whitening Extreme; CLW ­ Colgate Luminous White; LCM ­ Listerine Cool Mint; and CP ­ Colgate Plax. They were immersed in the mouth rinses 2x/day, for one minute, during 28 days. The color was assessed using an Easyshade spectrophotometer (CIE-L*a*b* system). Surface roughness (Ra-µm) was measured with three parallel measures, using an RP-200 roughness meter. The WS and SL (µg/mm-3) were analyzed based on the ISO 4049 recommendations. The data were analyzed using one- and two-way ANOVA/Tukey tests (α=0.05). Results: Surface roughness significantly increased after immersion in AS and LCM, with no significant differences between the groups either before or after immersion. The ΔE* was not significantly different between the groups. All substances produced a ΔWID higher than the 50%:50% perceptibility and acceptability thresholds. The WS and SL were not significantly affected by the mouth rinses. Conclusion: Whitening mouth rinses did not affect WS, SL, surface roughness, and color stability of a nanofilled composite, regardless of the presence of ethanol in the composition

Asunto(s)

RESUMEN

O objetivo deste estudo foi caracterizar a prática da automedicação na população adulta, bem como, investigar os fatores de risco e os comportamentos individuais de saúde.Trata-se de um estudo epidemiológico,transversal, realizado na atenção primária em saúde no Brasil. Como instrumento da coleta foi utilizado um inquérito semiestruturado e dimensionado em blocos temáticos. Para estatística foram empregadas a análise bivariada e regressão logística binomial. Dos 537 entrevistados, 42,83% relataram ter feito uso de medicamentos sem prescrição no período de 15 dias. Verificaram-se associações entre a variável dependente e enxaqueca (OR=3,347); presença de dor atualmente (OR=2,189); uso do medicamento sob influência de familiares (OR=2,431); falta de leitura da bula (OR=1,682) e ausência de atividades de lazer (OR=4,335). Conclui-se que mais da metade dos usuários da atenção primária à saúde no Brasil, fez uso de medicamentos sem a prescrição.

This study characterized and measured self-medication in adult population, as well as identified possible associations between lifestyle and risk factors for the use of over-the-counter medications. This is an epidemiological, cross-sectional study, carried out in the primary health care of a city in Brazil. The data collection instrument was a semi-structured survey grouped into thematic blocks. The statistical analysis included a bivariate analysis and a binomial logistic regression provided the statistics. Of the 537 participants, 42.83% reported having used medication without a prescription in the last 15 days. There were associations between the dependent variable and migraine (OR = 3.347); current pain (OR = 2.189); use of medications under the influence of family members (OR = 2.431); not reading drugs' leaflet (OR = 1.682); and lack of leisure activities (OR = 4.335). A significant part of users of primary health care self-medicated.

RESUMEN

Purpose: The purpose of this study was to determine the prevalence and correlates of nonprescription hormone use among Brazilian trans women. Methods: This study is a cross-sectional survey of trans women in São Paulo, Brazil, recruited by respondent-driven sampling in 2017-2019. Results: Of 790 trans women, 36.8% were taking nonprescribed hormones. Nonprescribed hormone use was higher with younger age, lower education, homelessness, and using estrogen plus progesterone. Lower use was associated with accessing health care and having trans-specific health needs met. Conclusion: Marginalized Brazilian trans women exhibit high use of nonprescription hormones, which may have health consequences and requires further examination and research.

Asunto(s)

RESUMEN

BACKGROUND/OBJECTIVES: Self-medication, despite some benefits, carries many risks, especially when practiced by older adults who are polymedicated. Information addressing the prevalence and associated factors of self-medication in older age in a European context is scarce and sometimes contradictory. This paper aims to estimate the prevalence of self-medication among older adults across Europe and to identify its predictive factors. DESIGN: Cross-sectional study. SETTING: Micro-data from the European Health Interview Survey (2006-2009) was used. PARTICIPANTS: The sample comprised 31,672 community-dwelling individuals aged 65 and over living in private households in 14 European countries. MEASUREMENTS: The analyses explored the use, over the last two weeks, of any medicines, supplements, or vitamins that were not prescribed by a doctor. RESULTS: The mean self-medication prevalence was 26.3 %, being the highest in Poland (49.4 %) and the lowest in Spain (7.8 %). Greater odds of self-medication were found for women and for participants who were younger, divorced, or presented a higher educational degree. The presence of long-standing illness and physical pain or not using prescribed medication also significantly increased the possibility of self-medication. A wide variation in the odds of self-medication between countries was also observed (up to 8 times more for Poland, compared to Spain). CONCLUSION: Self-medication is a prevalent problem among older Europeans, and even though some think it is risk-free, dangers tend to be greater with advancing age. This study will help identify the groups most likely to have this behavior so that we can focus on targeted educative and preventive initiatives.

RESUMEN

Objetivo: Analisar o uso de medicamentos por automedicação em pacientes renais crônicos hemodialíticos. Métodos: Estudo quantitativo, descritivo e transversal, realizado em um centro de tratamento hemodialítico, na região Sudoeste da Bahia, em março de 2015, por meio da aplicação de formulário contendo variáveis sociodemográficas, clínicas e farmacoterapêuticas de 170 pacientes. A amostra compôs-se de pacientes em tratamento hemodialítico crônico há mais de um ano, com idade maior ou igual a 18 anos. Utilizou-se o Epidata 3.1 como banco de dados. Realizou-se análise descritiva e empregou-se o método de regressão logística binária, usado para avaliar a associação entre automedicação e variáveis independentes, utilizando o programa SPSS, versão 21.0. Resultados: Dos participantes, 64,1% (109) eram homens, com idade média de 50,5 anos (± 14,9); 57% (98) possuíam renda menor que um salário mínimo; 20% (34) nunca estudaram; 48,2% (82) estavam dialisando em período de um a cinco anos e 92,9% (158) não possuíam plano de saúde. Contabilizaram-se 104 medicamentos utilizados por automedicação, com destaque para o calcitriol (9,6%) e a clonidina (6,7%). Verificou-se que pacientes com maior escolaridade (OR=1,32; IC95%=1,32-28,72) e que usam sobra de medicamentos em casa (OR=22,48; IC95%=6,53-77,38) têm mais chances de se automedicar. Conclusão: Há baixa frequência de automedicação na população de renais crônicos investigada, sendo associada ao uso de medicamentos guardados em casa e à baixa escolaridade.

Objective: To analyze self-medication in chronic kidney disease patients on hemodialysis. Methods: A quantitative descriptive cross-sectional study was conducted at a hemodialysis center in Southwestern Bahia in March 2015 using a form to collect sociodemographic, clinical and drug therapy data from 170 patients in March 2015. The sample comprised patients undergoing chronic hemodialysis treatment for over one year aged 18 years or older. Epidata 3.1 was used as a database. Descriptive analysis was performed and binary logistic regression was used to check for associations between self-medication and independent variables using the SPSS software version 21.0. Results: In all, 64.1% (109) of the participants were men and the mean age was 50.5 years (±14.9). 57% (98) of the participants earned less than one minimum wage, 20% (34) had never studied, 48.2% (82) had been on dialysis for one to five years, and 92.9% (158) had no health insurance. We confirmed self-medication of 104 drugs, particularly calcitriol (9.6%) and clonidine (6.7%). Patients with higher levels of education (OR=1.32; 95%CI=1.32-28.72) and those who use leftover drugs at home (OR=22.48; 95%CI=6.53-77.38) were more likely to self-medicate. Conclusion: The rate of self-medication in chronic kidney disease patients is low and it is associated with the use of drugs stored at home and low levels of education.

Objetivo: Analizar el uso de medicamentos por automedicación de pacientes renales crónicos en hemodiálisis. Métodos: Estudio cuantitativo, descriptivo y transversal realizado en un centro de tratamiento de hemodiálisis de la región Sudoeste de Bahía en marzo de 2015 a través de la aplicación de un formulario con variables sociodemográficas, clínicas y de tratamiento farmacológico de 170 pacientes. La muestra ha sido de pacientes en tratamiento de hemodiálisis desde hace más de un año con edad mayor o igual a 18 años. Se utilizó el Epidata 3.1 para el banco de datos. Se realizó un análisis descriptivo y se utilizó el método de regresión logística binaria para evaluar la asociación entre la automedicación y las variables independientes con el programa SPSS, versión 21.0. Resultados: Entre los participantes, el 64,1% (109) era hombres con edad media de 50,5 años (± 14,9); el 57% (98) tenía renta de menos de un sueldo mínimo; el 20% (34) nunca ha estudiado; el 48,2% (82) realizaba la hemodiálisis desde el periodo entre uno y cinco años y el 92,9% (158) no tenía seguro de salud. Se ha contabilizado 104 medicamentos utilizados por la automedicación con énfasis para el calcitriol (9,6%) y la clonidina (6,7%). Se verificó que los pacientes con mayor escolaridad (OR=1,32; IC95%=1,32-28,72) y los que usan lo que queda de los medicamentos que tienen en casa (OR=22,48; IC95%=6,53-77,38) tienen más oportunidades para la automedicación. Conclusión: Hay baja frecuencia de automedicación en la población de renales crónicos investigados y la misma se asoció con el uso de medicamentos almacenados en casa y las personas de baja escolaridad.

Asunto(s)

RESUMEN

Regardless of the extensive availability of mouth rinses that claim to whiten teeth, evidence of achievement of such effect is still missing. Aim: Therefore, this study assessed in vitro the whitening effectiveness of whitening mouth rinses. Methods: Sixty intact bovine incisors were embedded in acrylic resin and had their buccal surface flattened and polished. Then, the specimens were randomly allocated to three conventional (Colgate Plax, Cepacol and Listerine Cool Mint) and three whitening mouth rinse groups (Colgate Luminous White, Cepacol Whitening and Listerine Whitening Extreme) (n=10). Following, the specimens were immersed twice a day in the mouth rinses for one minute for 28 days. In between each immersion period, the specimens remained in artificial saliva at 37oC. Color was measured at baseline, 7, 14, 21, and 28 days using a portable spectrophotometer (Easyshade, Vita Zahnfabrik, Germany) with a 6 mm of diameter probe. Color change was analyzed considering the parameters of ∆L*, ∆a*, ∆b* and, ultimately, ∆E*. The whitening efficacy of the mouth rinses was analyzed using the Whiteness Index for Dentistry (WID). Data of ∆s was analyzed using two-way ANOVA and Tukey's test (α=0.05). Results: The type of mouth rinse affected significantly all the ∆ parameters (p<0.05). A non-whitening (conventional) mouth rinse produced the highest ΔE*, followed by the three whitening mouth rinses. The application time also affected ΔE* (p<0.05), with emphasis on the third week of treatment. Only the hydrogen peroxide-containing mouth rinse (Listerine Whitening Extreme) presented a whitening effect, with an increasing trend over time. Conclusion: Although the overall color change was not different when comparing conventional and whitening mouth rinses, the hydrogen peroxide-containing whitening mouth rinse produces an increasing whitening trend over time. Not every mouth rinse that claims to whiten teeth produces the desired effect

Asunto(s)

RESUMEN

BACKGROUND: The consumption of psychotropic drugs without a medical prescription is a growing public health problem worldwide. Misuse or indiscriminate use involves several risks. OBJECTIVE: To determine sociodemographic factors and behaviors associated with the consumption of psychotropic drugs without prescription in Chile. METHODS: This is a descriptive study based on the data of the XI National Study of Drugs in the General Population in Chile, carried out in the population between 12 and 64 years old (n = 19 512) during 2014. Prevalence was estimated, and a multivariate logistic regression model was adjusted. Also, a multiple correspondence analysis was performed. RESULTS: The prevalence of psychotropic drug use was 2.3%. In the studied population, associated risk factors are female sex (odds ratio: 1.4; 95% confidence interval: 1.16 to 1.77); ages between 20-29 (odds ratio: 1.4; 95% confidence interval: 0.98 to 2.26) and 40-49 (odds ratio: 1.8; 95% confidence interval: 1.19 to 2.75); consumption of marijuana (odds ratio: 3.0; 95% confidence interval: 3.32 to 3.97), cocaine or crack (odds ratio: 3.7; 95% confidence interval: 2.45 to 5.70); tobacco (odds ratio: 1.4; 95% confidence interval: 1.17 to 1.78); alcohol (odds ratio: 1.3; 95% confidence interval: 1.11 to 1.73); and poor health perception (odds ratio: 1.8; 95% confidence interval: 1.51 to 2.28). Military personnel used more pain and cough medication; young women between 19 to 25 years old used stimulants; the population between 45 to 64 years had a bad perception of health associated with the use of tranquilizers; and men between 12 and 18 years used illicit drugs. CONCLUSIONS: The prevalence found in the different groups is consistent with data reported in Latin America, showing the relationship between the use of non-prescription psychotropic drugs with sociodemographic factors, risk behaviors, and the identification of consumption profiles.

ANTECEDENTES: El consumo de psicofármacos sin receta médica es un problema creciente de salud pública en todo el mundo, su uso indebido implica una serie de riesgos. OBJETIVO: Determinar factores sociodemográficos y conductas asociadas al consumo de psicofármacos sin receta en Chile. MÉTODOS: Estudio descriptivo a partir de los datos del XI Estudio Nacional de Drogas en Población General en Chile, año 2014, realizado en población entre 12 y 64 años (n = 19 512). Se estimó la prevalencia y se ajustó un modelo multivariado de regresión logística. Además, se realizó análisis de correspondencia múltiple. RESULTADOS: La prevalencia de consumo de psicofármacos fue 2,3%. En población estudiada, los factores asociados son sexo femenino (Odds ratio: 1,4; intervalo de confianza 95%: 1,16 a 1,77), edades entre 20 y 29 (Odds ratio: 1,4; intervalo de confianza 95%: 0,98 a 2,26) y 40 y 49 años (Odds ratio: 1,8; intervalo de confianza 95%: 1,19 a 2,75), consumo de: marihuana (Odds ratio: 3,0; intervalo de confianza 95%: 3,32 a 3,97), cocaína o pasta base (Odds ratio: 3,7; intervalo de confianza 95%: 2,45 a 5,70), tabaco (Odds ratio: 1,4; intervalo de confianza 95%: 1,17 a 1,78), alcohol (Odds ratio: 1,3; intervalo de confianza 95%: 1,11 a 1,73) y mala percepción de salud (Odds ratio: 1,8; intervalo de confianza 95%: 1,51 a 2,28). De los perfiles, se vinculó a población de fuerzas armadas con consumo de analgésicos y antitusivos, a jóvenes de 19 a 25 años con consumo de estimulantes, a población de 45 a 64 años con mala percepción de salud asociada al consumo de tranquilizantes y a hombres de 12 a 18 años con uso de sustancias psicoactivas. CONCLUSIÓN: Las prevalencias halladas concuerdan con datos en Latinoamérica, permitiendo evidenciar la relación que existe entre el consumo de psicofármacos con factores sociodemográficos, conductas de riesgo e identificación de perfiles de consumo.

Asunto(s)

RESUMEN

Atualmente a automedicação é considerada um fenômeno crescente na população brasileira, que busca na representação dos fármacos, alívios instantâneos de dores e desconfortos autopercebidos, sem a prescrição e supervisão de um profissional habilitado. Neste sentido, com a facilidade do acesso na obtenção de medicamentos, associada a desenfreada difusão midiática dessas substâncias, com vinculação descabida as propriedades farmacodinâmicas, influenciam à população condicionada à dor, a obtenção e uso imprudente desses medicamentos. O objetivo do estudo foi relatar um caso de automedicação, e por meio dessa representação, elucidar os principais fatores associados ao uso irracional dos fármacos. Verificou por meio do presente estudo que, a criação de políticas públicas e adoção de estratégias educativas, são essenciais, controlando o uso imoderado dos fármacos, principalmente dos antibióticos, reduzindo as doenças infecciosas, além de permitir orientar os indivíduos quanto o prejuízo dessa prática autoinfligida. Por meio do estudo, ficou evidente a influência socioeducacional e cultural estão intrinsicamente ligados à prática da automedicação e do uso descomedido dos fármacos(AU)

Currently, self-medication is considered a growing phenomenon in the Brazilian population, which seeks to represent drugs, instant relief of self-perceived pain and discomfort, without the prescription and supervision of a qualified professional. In this sense, with the ease of access in drug procurement, associated with the rampant media diffusion of these substances, with inappropriate linkage to the pharmacodynamics properties, influence the population conditioned to pain, obtaining and reckless use of these drugs. The objective of the study was to report a case of self-medication, and through this representation, elucidate the main factors associated with the irrational use of the drugs. Through the present study, it was verified that the creation of public policies and the adoption of educational strategies are essential, controlling the immoderate use of drugs, especially antibiotics, reducing infectious diseases, as well as guiding individuals regarding the damage of this self-practice inflicted. Through the study, it became clear that socio-educational and cultural influences are intrinsically linked to the practice of self-medication and overuse of drugs(AU)

Actualmente la automedicación es considerada un fenómeno creciente en la población brasileña, que busca en la representación de los fármacos, alivios instantáneos de dolores y incomodidades auto percibidos, sin la prescripción y supervisión de un profesional habilitado. En este sentido, con la facilidad de acceso en la obtención de medicamentos, asociada a la desenfrenada difusión mediática de esas sustancias, con vinculación descabida las propiedades farmacodinámicas, influencian a la población condicionada al dolor, la obtención y uso imprudente de esos medicamentos. El objetivo del estudio fue relatar un caso de automedicación, y por medio de esa representación, elucidar los principales factores asociados al uso irracional de los fármacos. En el presente estudio se verificó por medio del presente estudio que, la creación de políticas públicas y la adopción de estrategias educativas, son esenciales, controlando el uso inmoderado de los fármacos, principalmente de los antibióticos, reduciendo las enfermedades infecciosas, además de permitir orientar a los individuos como el perjuicio de esa práctica auto infligido. Por medio del estudio, quedó evidente la influencia socioeducativa y cultural están intrínsecamente ligados a la práctica de la automedicación y del uso desmedido de los fármacos(AU)

Asunto(s)

RESUMEN

Introdução: a polifarmácia e a automedicação estão presentes na população brasileira, sendo frequente sua ocorrência com medicamentos isentos de prescrição. Ademais, a lactose é utilizada como excipiente em formas farmacêuticas sólidas. Objetivo: o presente estudo constitui uma pesquisa sobre lactose, na condição de excipiente, em medicamentos isentos de prescrição (MIPs). Metodologia: em 391 MIPs presentes em cinco formas farmacêuticas sólidas e analisadas por classes, categorias e marcas, foram coletadas, nos meses de abril e maio de 2018, informações quanto à presença de lactose em bulas disponíveis nos sites da Agência Nacional de Vigilância Sanitária e da indústria farmacêutica no Brasil. Resultados: constatou-se que a lactose está presente em 43,48% dos MIPs, sendo mais frequente nos comprimidos e comprimidos revestidos, nas proporções de 42,94% e 36,47%, respectivamente. Ela foi encontrada, predominantemente, em medicamentos similares, principalmente antialérgicos, analgésicos não opioides e anti-inflamatórios não esteroides, bem como na totalidade dos antidiarreicos e laxantes. Das 88 marcas analisadas, 30 apresentaram mais de 50% dos produtos com lactose. Identificou-se um percentual expressivo de medicamentos utilizados no controle dos sintomas de intolerância à lactose que continham esse carboidrato como excipiente. Conclusão: nas formas farmacêuticas analisadas, a presença de lactose nos MIPs é superior a 40%. A lactose presente pode ser agravante de sintomas gastrintestinais. Portanto, é essencial incluir, na embalagem dos medicamentos, a frase de alerta sobre a presença desse açúcar, visando à sua ampla divulgação, particularmente dirigida aos indivíduos com restrição de uso dessa substância.

Introduction: polypharmacy and self-medication are present in Brazilian population, frequently occurring for prescription-free medicines. In addition, lactose is used as an excipient in solid dosage forms of prescription-free medicines. Objective: the present study constitutes a research on lactose, as an excipient, in prescription-free medicines (MIPs). Methodology: in 391 MIPs present in five solid dosage pharmaceutical forms and analyzed by classes, categories and brands, in April and May 2018, information was collected on the presence of lactose in the package inserts available on the websites of the National Sanitary Surveillance Agency and on the pharmaceutical industry websites in Brazil. Results: it was found that lactose is present in 43.48% of the MIPs, being more frequent in tablets and coated tablets, in the proportions of 42.94% and 36.47%, respectively. It has been found predominantly in similar drugs, mainly antiallergics, non-opioid analgesics and non-steroidal anti-inflammatory drugs, as well as in all antidiarrheals and laxatives. Of the 88 brands analyzed, 30 presented over 50% of lactose products. An expressive percentage of drugs used to control the symptoms of lactose intolerance that contained this carbohydrate as an excipient were identified. Conclusion: in the pharmaceutical forms analyzed, the presence of lactose in the MIPs is higher than 40%. The lactose present may be aggravating gastrointestinal symptoms. It is therefore essential to include a warning on the presence of this sugar on the packaging of medicinal products, with a view to their wide dissemination, particularly for those who have a restricted use of that substance.

Asunto(s)

RESUMEN

ANTECEDENTES Y OBJETIVO El acceso a medicamentos es un elemento fundamental para avanzar en la cobertura universal de la salud. En este ámbito, el precio es un elemento esencial para mejorar el acceso a medicamentos, lo que podría lograrse a través del aumento de la competencia dentro del mercado farmacéutico. Con el objetivo de reducir los precios de los medicamentos e introducir competencia en este mercado, el Ministerio de Salud está intentando impulsar una política para permitir que fármacos sin necesidad de una prescripción médica, puedan ser comercializados en establecimientos diferentes a una farmacia. En este contexto el departamento de políticas Farmacéuticas y Profesiones Médicas solicita esta síntesis de evidencia con el objetivo de aportar con la evidencia disponible que sobre este tipo de intervenciones. METODOLOGÍA Se formuló una estrategia de búsqueda para ser utilizada en 4 bases de datos, con el objetivo de identificar revisiones sistemáticas que abordaran la pregunta formulada. Al no encontrarse revisiones que abordaran las comparaciones deseadas, se realizó una búsqueda de estudios primarios en PubMed y CENTRAL. Se utiliza la metodología de certeza de la evidencia GRADE. Se incluyeron todos los estudios que evaluaran el impacto de este tipo de medidas en cualquier país. Se excluyeron estudios que evaluaran el impacto de cambiar medicamentos en cuanto a su obligatoriedad de ser comercializados con prescripción, así como también la venta de medicamentos que no están autorizados a venderse sin prescripción. RESULTADOS Se utilizan 3 estudios primarios -Un estudio realizado en Corea, muestra que la venta de medicamentos fuera de farmacias podría reducir la tasa de consultas ambulatorias para migrañas. Este mismo estudio muestra un efecto sutil sobre la dispepsia, y sin resultados en infecciones respiratorias. -Otro estudio realizado en Noruega, muestra que esta intervención reduciría levemente el consumo de analgésicos en la población. -Muchos países han implementado políticas similares, tales como Islandia, Noruega, Israel, Reino Unido y Corea. Sin embargo, no se encontró evidencia de evaluaciones de cada uno de estos países. ­Es necesario monitorear la publicación de nueva evidencia sobre el impacto de esta interven ción, de manera de contar con una respuesta más robusta.

Asunto(s)

RESUMEN

The advertisement has a great influence on the public and, in over the counter medicines (OTC), it can generate health risks on the population if it is misregulated. The aim of this work is to analyze and disclose strategic viable actions emerged from a forum debate during an online course for fostering the pharmacist's compromise related to OTC advertisement. Methods: A content analysis was carried on, grouping by themes and categories the opinions of community pharmacists participating in a forum debate about OTC advertisement. Two audiovisual advertisement pieces were analyzed as triggers of discussion. Results: Sixty-five professionals participated in 3 groups of debate, and 103 opinions were collected. Among individual strategies, to guarantee the attention by a pharmacist was highlighted when health conditions or the use of medicines are consulted about. Other strategies include denouncing to the ANMAT the advertisements that do not comply with the norms, procuring a better regulation and assuming a critical posture. Within the collective strategies, including pharmacists in the evaluation committee of advertisement of ANMAT and furthering norms to reassess the role of the pharmacist and the community pharmacy in minor illnesses were stressed. Conclusion: The contribution of the community pharmacists allows disposing a set of professional strategies, both individuals and collectives, to promote a rational use of OTC for the patients and the community.

INTRODUCCIÓN: la publicidad ejerce una influencia muy importante sobre el público y, en el caso de los medicamentos de venta libre (MVL), puede generar riesgos en la salud de la población si no es adecuadamente fiscalizada. OBJETIVO: El objetivo de este trabajo es analizar y divulgar acciones estratégicas viables surgidas de la discusión en un foro de debate de un curso online, para fomentar el compromiso del farmacéutico ante la publicidad de MVL. MÉTODO: se realizó un análisis de contenido, agrupando por temas y categorías los aportes de los farmacéuticos comunitarios participantes en un foro de debate sobre publicidad de MVL. Como elemento disparador del debate, se analizaron 2 piezas publicitarias audiovisuales. RESULTADOS: participaron 65 profesionales en 3 grupos de debate y se efectuaron 103 aportes. Dentro de las estrategias individuales se destacan la de garantizar la atención por un farmacéutico ante consultas sobre problemas de salud o sobre el uso de estos medicamentos. Otras estrategias incluyen denunciar ante la ANMAT las publicidades que no cumplan con las normativas vigentes, solicitar mejor fiscalización y asumir una postura crítica. Dentro de las estrategias colectivas se destacan: incluir a farmacéuticos en la comisión evaluadora de publicidad de la ANMAT e impulsar normativas para revalorizar el rol del farmacéutico y la farmacia comunitaria frente a los trastornos menores.C CONCLUSIONES: la contribución de los farmacéuticos comunitarios permite disponer de un set de estrategias profesionales individuales y colectivas para promover un uso más racional de los MVL por parte de los pacientes y la comunidad.

Asunto(s)

RESUMEN

Introduction: The Disposición ANMAT 753/2012 states definitions and guidelines about the information that inserts and labels must include in nonprescription drugs (also known as over-the-counter or OTC drugs). aim: Aims: to analyze the adequacy to the norm in a sample of OTC drugs; promote and disseminate strategic viable actions for being developed by pharmacists to improve the patient's information. formulated. Methods: During a course destined to community pharmacists, a practical activity and an on-line forum about the adequacy to the Disposición ANMAT 753/2012 were developed. The compliance of 17 requirements of the norm, in a sample of 66 OTC drugs, was registered. Forum duration: 2 weeks. A content analysis related to the strategies proposed by the participants was conducted. Results: From the sample, 87.9% of the medicines do not accomplish to at least 1 of the requirements. The major noncompliances were: inappropriately described composition, lack of telephone number for consultations, uncomprehensible therapeutic action, and package requirements. Strategies to develop by pharmacies individually, grouped, or through professional associations were Conclusions: A high level of noncompliance in the analyzed aspects of the norm was observed. The strategies proposed are oriented to patient empowerment by health education about OTC drugs and access to reliable information resources, comprehensible for consumers. It is necessary to reinforce the control procedures for the information the OTC drugs must include, and to encourage both the participation and commitment of the pharmacist.

Introducción: La Disposición ANMAT 753/2012: establece definiciones y lineamientos generales sobre la información que deben contener prospectos, etiquetas y rótulos de medicamentos de venta libre (MVL). Objetivos: analizar la adecuación a la normativa de una muestra de MVL; promover y divulgar acciones estratégicas viables a desarrollar por los farmacéuticos a fin de mejorar la información para los pacientes. Métodos: En un curso, dirigido a farmacéuticos comunitarios, se desarrollaron una actividad práctica y un foro de debate sobre la adecuación a la Disposición ANMAT 753/2012. Se registró el cumplimiento de 17 pautas de la normativa en una muestra de 66 MVL. Duración del foro: 2 semanas. Se realizó un análisis de contenido sobre las estrategias aportadas por los participantes. Resultados: El 87,9% de los medicamentos de la muestra incumple con al menos 1 de las pautas analizadas. Los mayores incumplimientos se relacionaron a composición inadecuadamente descripta, ausencia de número telefónico para consultas, acción terapéutica incomprensible y requerimientos del envase. Se plantearon estrategias a desarrollar en farmacias individualmente, agrupadas o a través de los colegios profesionales. Conclusión: Se observó un alto incumplimiento en las pautas analizadas de la normativa. Las estrategias planteadas se encaminan a conseguir el empoderamiento del paciente a través de educación sanitaria sobre el uso de MVL y el acceso a fuentes de información confiables que sean comprensibles para el usuario. Es necesario fortalecer los circuitos de control de la información que deben contener los MVL y promover la participación y el compromiso del farmacéutico.

Asunto(s)

RESUMEN

Background: Low availability of medicines in health services, self-medication, inadequate use of medicines, and inadequate dispensing practices in pharmacies are frequent problems in Peru. We aimed to evaluate how frequent the purchase of medications without medical prescription is in Peru, and which factors are associated with this practice. Methods: We conducted a secondary analysis of the 2016 ENSUSALUD national survey data. Purchase of one or more medicines that require a prescription was measured as a dichotomous variable. Crude and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI) were calculated using Poisson regressions model with robust variance to assess the association of purchasing of medicines that require prescriptions with sociodemographic factors. Results: There were 3858 participants in the dataset. The prevalence of purchasing medications without prescriptions was 47.2%. History of having previously consumed the same medication (31.6%), and the delay in receiving an appointment at health facilities (26.9%) were the main reasons to buy medications without a prescription. Regarding the recommendation of the medication purchased, the advice of the pharmacy, and remembering a previous old prescription, were the most frequent reasons (38.3%, and 25.9%, respectively). On the multivariable analysis, users that buy medications without prescription were more likely to be of aged 25-44; reside in the Jungle  and Highlands regions; and self-consumption of the purchase. Individuals with Seguro Integral de Salud (Comprehensive Health Insurance) were less likely to buy medications without prescription. Conclusions: There is a high prevalence of prescription requiring medication being bought without one from pharmacies in Peru. It is necessary to include the evaluation of consumer patterns to develop strategies with the aim to regulate the consumption of prescription drugs in the Peruvian population.

Asunto(s)

RESUMEN

OBJETIVO: El objetivo del presente estudio fue determinar la frecuencia de prescripción, consumo y prevalencia de automedicación de los inhibidores de la bomba de protones en pacientes atendidos en los Centros de Salud de Ludo y Cuchil, pertenecientes al cantón Sigsig ­ Azuay ­ Ecuador, durante el año 2016. MÉTODO: Estudio descriptivo transversal realizado con todos los pacientes quienes a la fecha de la consulta médica se encontraban consumiendo o tuvieron prescripción de inhibidores de la bomba de protones (IBPs). Se estudiaron las características socio-demográficas de la población, fármaco utilizado, indicaciones para su prescripción, prevalencia de automedicación y su relación con el género, edad, escolaridad y auto identificación étnica. RESULTADOS: Se revisaron 4758 pacientes, 228 pacientes ingresaron al estudio (4.79 %). La edad media fue de 48 ±20 años, las mujeres representaron el 73.25 %. El Omeprazol fue utilizado en el 96 % de los casos. La prevención de lesiones por AINES fue la principal indicación para el uso del medicamento. La prevalencia de automedicación fue de 31.58 %, existiendo relación con la edad mayor a 60 años (RP: 4.13; IC-95 %: 2.68-6.38) y la escolaridad primaria o inferior (RP: 4.87; IC-95 %: 2.22-10.68). CONCLUSIÓN: La frecuencia de prescripción y consumo de inhibidores de la bomba de protones fue de alrededor del 5 % de los pacientes estudiados. El Omeprazol fue el IPB de uso más frecuente. Existe una relación de riesgo y asociación entre la edad superior a 60 años y el nivel de escolaridad (primario o inferior) con la frecuencia de automedicación.(au)

OBJECTIVE: To determine the frequency of prescription, consumption and prevalence of self-medication of proton pump inhibitors in patients who attended to Ludo and Cuchil Health Centers during 2016. METHOD: A cross-sectional descriptive study performed with all the patients who were consuming or had a proton pump inhibitors (PPIs) prescription at the time of the medical attention. Socio-demographic characteristics of the population, used drug, prescription indications, self-medication prevalence and its relation with gender, age, schooling and ethnic self-identification were studied. RESULTS: Were reviewed 4758 patients, and 228 patients entered in this study (4.79 %). Average age was 48 ±20 years, 73.25 % of patients were female. Omeprazole was used in 96 % of the cases. Prevention of NSAID lesions was the main indication to use the drug. Self-medication prevalence reached 31.58 % and had a relation with age over 60 years (PR: 4.13; 95 %-CI: 2.68-6.38) and primary or lower scholarship (RP: 4.87; 95 %-CI: 2.22-10.68). CONCLUSION: Frequency of prescription and consumption of PPIs was around 5 % of students patients. Omeprazole was the most used PPI. There is an association and a risk relation between self-medication frequency and age over 60 years and lower scholarship level.(au)

Asunto(s)