RESUMEN
OBJECTIVE: To characterize prescription and other medication use in a geographically and ethnically diverse cohort of women in their first pregnancy. METHODS: In a prospective, longitudinal cohort study of nulliparous women followed through pregnancy from the first trimester, medication use was chronicled longitudinally throughout pregnancy. Structured questions and aids were used to capture all medications taken as well as reasons they were taken. Total counts of all medications taken including number in each category and class were captured. Additionally, reasons the medications were taken were recorded. Trends in medications taken across pregnancy and in the first trimester were determined. RESULTS: Of the 9,546 study participants, 9,272 (97.1%) women took at least one medication during pregnancy with 9,139 (95.7%) taking a medication in the first trimester. Polypharmacy, defined as taking at least five medications, occurred in 2,915 (30.5%) women. Excluding vitamins, supplements, and vaccines, 73.4% of women took a medication during pregnancy with 55.1% taking one in the first trimester. The categories of drugs taken in pregnancy and in the first trimester include the following: gastrointestinal or antiemetic agents (34.3%, 19.5%), antibiotics (25.5%, 12.6%), and analgesics (23.7%, 15.6%, which includes 3.6%; 1.4% taking an opioid pain medication). CONCLUSION: In this geographically and ethnically diverse cohort of nulliparous pregnant women, medication use was nearly universal and polypharmacy was common. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01322529.
Asunto(s)
Medicamentos sin Prescripción/uso terapéutico , Polifarmacia , Complicaciones del Embarazo/tratamiento farmacológico , Medicamentos bajo Prescripción/uso terapéutico , Adulto , Etnicidad , Femenino , Humanos , Estudios Longitudinales , Medicamentos sin Prescripción/clasificación , Paridad , Embarazo , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo/epidemiología , Primer Trimestre del Embarazo , Medicamentos bajo Prescripción/clasificación , Estudios Prospectivos , Estados Unidos/epidemiologíaRESUMEN
The objective of this study was to describe patterns of medication use among homeless adults from the city of Porto, Portugal. We recruited 146 homeless participants in four social services institutions. Data on the use of medicines in the previous week were collected using face-to-face interviews. We described the prevalence and main correlates of use of medicines from different Anatomical Therapeutic Chemical classification (ATC) groups. A total of 56.8% of the homeless reported to have used at least one medicine in the previous week. The most frequently reported were benzodiazepines (21.9%) and antipsychotics (15.1%); socio-demographic characteristics, lifestyle variables and use of health care were not found to be significantly associated with their use. The prevalence was 1.4% for anti-inflammatory and antirheumatic products, and 6.2% for antihypertensives, diuretics and beta-blocking agents. Medicines pertaining to the nervous system ATC group were by far the most frequently used, while those for the treatment of other common chronic and acute conditions seem to be underused.
Asunto(s)
Personas con Mala Vivienda/estadística & datos numéricos , Medicamentos sin Prescripción , Automedicación/estadística & datos numéricos , Adolescente , Adulto , Anciano , Utilización de Medicamentos/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medicamentos sin Prescripción/clasificación , Portugal , Prevalencia , Automedicación/clasificación , Factores Socioeconómicos , Población Urbana , Adulto JovenRESUMEN
OBJECTIVE: This study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients' use of both homemade preparations and manufactured products before seeking specialized care. MATERIALS AND METHODS: We conducted a cross-sectional analytic survey of consecutive patients seen in the ophthalmology emergency room of a teaching hospital. RESULTS: The sample included 561 subjects, 51.3% males and 48.7% females, with a mean age of 39.8 years. Prior to seeking emergency care, 40.5% reported self-medicating; 29.4% used a homemade preparation (13.9% referred to an industrialized product like boric acid as a homemade preparation), and 11.1% used a manufactured product. The most frequently used products included a boric acid solution (53.3%), a normal saline solution (35.7%), herbal infusions (6.1%) and breast milk (4.8%). Viral conjunctivitis was the most frequent diagnosis (24.4%), followed by the presence of a corneal foreign body (7.4%). No significant differences were found in the self-treatment of ocular injuries according to gender (p = 0.95), level of education (p = 0.21) or age (p = 0.14). In addition, self-medication practices were not related to the medically judged severity of the condition. CONCLUSION: Patients often attempt to treat conditions that require ophthalmologic emergency care by self-medicating with homemade or manufactured products. The most widely used products include boric acid, normal saline, leaf infusions and breast milk. This behavior occurs independently of educational level, gender, age or the nature of the ocular condition. Self-medication is a culturally driven practice that is used even in cases of acute ocular injuries.
Asunto(s)
Conjuntivitis Viral/tratamiento farmacológico , Cuerpos Extraños en el Ojo/tratamiento farmacológico , Automedicación , Adolescente , Adulto , Ácidos Bóricos/uso terapéutico , Brasil/epidemiología , Niño , Preescolar , Conjuntivitis Viral/epidemiología , Estudios Transversales , Servicio de Urgencia en Hospital , Cuerpos Extraños en el Ojo/epidemiología , Femenino , Atención Domiciliaria de Salud/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Leche Humana , Medicamentos sin Prescripción/clasificación , Medicamentos sin Prescripción/uso terapéutico , Oftalmología , Extractos Vegetales/uso terapéutico , Automedicación/clasificación , Automedicación/estadística & datos numéricos , Cloruro de Sodio/uso terapéutico , Adulto JovenRESUMEN
OBJECTIVE: This study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients' use of both homemade preparations and manufactured products before seeking specialized care. MATERIALS AND METHODS: We conducted a cross-sectional analytic survey of consecutive patients seen in the ophthalmology emergency room of a teaching hospital. RESULTS: The sample included 561 subjects, 51.3 percent males and 48.7 percent females, with a mean age of 39.8 years. Prior to seeking emergency care, 40.5 percent reported self-medicating; 29.4 percent used a homemade preparation (13.9 percent referred to an industrialized product like boric acid as a homemade preparation), and 11.1 percent used a manufactured product. The most frequently used products included a boric acid solution (53.3 percent), a normal saline solution (35.7 percent), herbal infusions (6.1 percent) and breast milk (4.8 percent). Viral conjunctivitis was the most frequent diagnosis (24.4 percent), followed by the presence of a corneal foreign body (7.4 percent). No significant differences were found in the self-treatment of ocular injuries according to gender (p = 0.95), level of education (p = 0.21) or age (p = 0.14). In addition, self-medication practices were not related to the medically judged severity of the condition. CONCLUSION: Patients often attempt to treat conditions that require ophthalmologic emergency care by self-medicating with homemade or manufactured products. The most widely used products include boric acid, normal saline, leaf infusions and breast milk. This behavior occurs independently of educational level, gender, age or the nature of the ocular condition. Self-medication is a culturally driven practice that is used even in cases of acute ocular injuries.
Asunto(s)
Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Adulto Joven , Conjuntivitis Viral/tratamiento farmacológico , Cuerpos Extraños en el Ojo/tratamiento farmacológico , Automedicación , Ácidos Bóricos/uso terapéutico , Brasil/epidemiología , Estudios Transversales , Conjuntivitis Viral/epidemiología , Servicio de Urgencia en Hospital , Cuerpos Extraños en el Ojo/epidemiología , Atención Domiciliaria de Salud/estadística & datos numéricos , Leche Humana , Medicamentos sin Prescripción/clasificación , Medicamentos sin Prescripción/uso terapéutico , Oftalmología , Extractos Vegetales/uso terapéutico , Automedicación/clasificación , Automedicación/estadística & datos numéricos , Cloruro de Sodio/uso terapéutico , Adulto JovenRESUMEN
The use of multiple medicines is frequent among the elderly. Although such practice is usually necessary, it predisposes to risks of adverse events and drug interaction. The present study was intended to verify the characteristics of medication among the elderly in relation to socio-demographic profile, the most commonly used drug classes, and treatment adherence. This was a descriptive study that included 301 elderly in the coverage area of a Family Health Program, using a previously structure home interview. The sample was predominantly female, with a high illiteracy rate and alterations in cognitive status and various forms of dependency. The subjects showed an average of 2.5 diagnoses and used 2.9 drugs per individual. Some of the drugs are classified as high-risk for the age bracket. Treatment adherence data showed dependence on others for administration, self-medication, forgetfulness in relation to medication, and insufficient knowledge of the drugs taken. Systematic follow-up is needed for elderly persons using multiple medicines, in addition to encouragement for non-pharmaceutical measures and an emphasis on educational measures for lifestyle change, backed by a multidisciplinary team.
Asunto(s)
Salud de la Familia , Cumplimiento de la Medicación/estadística & datos numéricos , Programas Nacionales de Salud , Polifarmacia , Anciano , Anciano de 80 o más Años , Brasil , Estudios Transversales , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medicamentos sin Prescripción/clasificación , Medicamentos sin Prescripción/uso terapéutico , Medicamentos bajo Prescripción/clasificación , Medicamentos bajo Prescripción/uso terapéutico , Automedicación/estadística & datos numéricos , Factores SocioeconómicosRESUMEN
This paper describes the ethnopharmacological knowledge of women in an urban Mexican migrant community in Athens, GA, USA. Data were collected using free-list, pile-sort and semi-structured interviews. The pharmacopoeia of this community includes herbal remedies, over-the-counter medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and prescription medicines. Multi-dimensional scaling analysis of pile-sort data revealed that Mexican women living in Athens classify medicines into four categories: herbal remedies, salves, pastillas (pills-both prescription and non-prescription) and other commercial preparations. Herbal remedies are viewed as natural and safe while pastillas are thought to be dangerous and potentially addictive. Comparisons of Mexican explanations for the actions of five medicines (Matricaria recutita L. [Asteraceae], Mentha spp. L. [Lamiaceae], Ruta spp. L. [Rutaceae], Ocimum basilicum L. [Lamiaceae] and paracetemol) with the pharmacological literature show several similarities and confirm that migrant women use these medicines effectively. Mexican migrant women use medicinal plants in combination with commercially produced medicines, but most have a strong preference for the herbal remedies that they make themselves, over drugs prescribed by physicians. Some of their descriptions of the actions of medicines are supported by the pharmacological literature, but ethnopharmacologists have not fully investigated all of the attributes that migrant women ascribe to them.
Asunto(s)
Etnofarmacología/métodos , Migrantes , Actitud Frente a la Salud/etnología , Bebidas , Femenino , Georgia , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Lamiaceae , Matricaria , México/etnología , Medicamentos sin Prescripción/clasificación , Medicamentos sin Prescripción/uso terapéutico , Dolor/tratamiento farmacológico , Preparaciones Farmacéuticas/administración & dosificación , Preparaciones Farmacéuticas/clasificación , Farmacopeas como Asunto , Preparaciones de Plantas/clasificación , Preparaciones de Plantas/uso terapéutico , Ruta , Gastropatías/tratamiento farmacológico , Comprimidos , Población Urbana/estadística & datos numéricosRESUMEN
En el presente estudio se analizaron los 100 productos del mercado farmacéutico popular (de venta libre) más vendidos en el Brasil, en el período comprendido entre junio de 1992 y junio de 1993. Se excluyeron 23 productos alimentarios clasificados como medicamentos. La muestra, formada por 77 medicamentos, representaba aproximadamente 67 por ciento del consumo en valores y 76,8 por ciento del consumo en unidades de las especialidades vendidas en el mercado popular. Para la clasificación de los medicamentos, se utilizó el sistema anatómico-terapéutico-químico (ATC). Las especialidades también se clasificaron con la metodología del valor intrínseco, que considera la eficacia y los riesgos de las mismas. La mayoría de las especialidades (91 por ciento) mostraron "poco valor intrínseco" (dudoso/nulo, relativo, inaceptable), y 70 por ciento correspondieron a combinaciones en dosis fijas. Solo 10 especialidades pertenecían a la Relación Nacional de Medicamentos, producida por el Ministerio de Salud, y cuatro a la lista de medicamentos esenciales de la OMS. Los grupos terapéuticos a los que pertenecían las especialidades fueron, en orden de mayor a menor frecuencia, el aparato digestivo, la piel, el aparato genitourinario, el aparato musculosquelético, el sistema nervioso central, los antiparasitarios, el aparato respiratorio y los órganos de los sentidos. El subgrupo terapéutico de mayor venta fue el de preparaciones para la garganta, mientras que el que representó el mayor valor en ventas fue el de los analgésicos no opiáceos y antipiréticos. Los resultados que confirman la hipótesis planteada de que los medicamentos de venta libre en el Brasil presentan mala calidad terapéutica y de que el consumo de muchas de estas especialidades farmacéuticas representa gastos innecesarios para la población. Se puede afirmar también que algunos de esos medicamentos no deberían estar disponibles para una población que no está al corriente de las complicaciones asociadas con su utilización, puesto que 25 por ciento de las intoxicaciones registradas en el país se deben a la automedicación. Una estrategia para mejorar la utilización de medicamentos a largo plazo es modificar la percepción que tiene la población en general con respecto a la necesidad y uso de los medicamentos para curar sus dolencias
In this study we examined the 100 over-the-counter drugs that were most widely sold in Brazil from June 1992 to June 1993. We excluded 23 food products that were classified as medicinal. The sample, which included 77 drugs, was representative of about 67% of all sales in monetary value, and 76.8% of all units sold of the different classes of over-the-counter drugs. The anatomical-therapeutic-chemical (ATC) system was used to classify the various drugs; each class of drugs was also graded according to a scale of its intrinsic value, taking into account effectiveness and risks. Most classes of drugs (91%) showed "little intrinsic value" (that is, were of questionable or no value, of relative value, or unacceptable), and 70% were fixed-dose combinations. Only 10 classes of drugs were included in the Ministry of Health's National Drug List, and four appeared in WHO's list of essential drugs. The therapeutic classes to which the drugs belonged were, in descending order of frequency, for the digestive tract, skin, genitourinary system, musculo-skeletal system, central nervous system, parasitic diseases, respiratory tract, and sensory system. The therapeutic subgroup that commanded the highest sales was that of the non-opiate analgesics and antipyretics. Our results confirm the hypothesis that over-the-counter drugs in Brazil are of poor therapeutic quality and that the use of many such drugs is a source of unnecessary expense for the population. Some of them should not be accessible to individuals who lack current knowledge of their side effects, since 25% of all cases of poisoning in the country are related to self-medication. Modifying the public's perception of the need for taking drugs to relieve their ailments is one approach that may improve their use of medications in the long term.