RESUMO
RATIONALE, AIMS, AND OBJECTIVES: Misunderstanding medication dosage regimen instructions can lead to unintentional misuse of a prescribed medicine, non-adherence to providers' instructions, and other treatment-related issues. We aimed to evaluate the frequency of and factors associated with older patients' misunderstanding of medication dosage regimen instructions after consultation with a general practitioner. METHOD: This cross-sectional study was conducted in 22 primary-care facilities in Brazil. Data were collected from September 2016 to December 2017 using a multidimensional questionnaire. Patients who were 60 years old or older who visited primary care units were included in the study (n = 416). RESULTS: Of the older patients interviewed, 38.2% had a misunderstanding of medication dosage regimen instructions; being female was a protective factor against the misunderstanding of medication dosage regimen instructions (prevalence ratio [PR] = 0.63; 95% confidence interval [CI] = 0.45-0.89). In relation to other factors with an important association, misunderstanding medication dosage regimen instructions was 71% higher among illiterate participants (PR = 1.71; 95% CI = 1.25-2.35), 39% higher among people who considered their memory to be poor (PR = 1.39; 95% CI = 1.01-1.91), 49% higher in those who did not have a job at the time of the interview (PR = 1.49; 95% CI = 1.01-2.19), and 50% higher in patients who had been prescribed five or more medications (PR = 1.50; 95% CI = 1.02-2.20). CONCLUSIONS: The results showed that older people's misunderstandings of medication dosage regimen instructions after consultation with a general practitioner was greater than expected due to a range of factors, especially polypharmacy, poor literacy, poor memory, and having a job at the time of the interview. Health services and professionals should implement strategies to increase the quality of the guidance given to elderly individuals and to ensure their adherence to the regimen instructions of their medications.
Assuntos
Polimedicação , Atenção Primária à Saúde , Idoso , Brasil , Estudos Transversais , Feminino , Humanos , Adesão à Medicação , Pessoa de Meia-Idade , Encaminhamento e ConsultaRESUMO
BACKGROUND: Mite allergens have been involved in airway sensitization and allergic diseases. Immunoassays for the identification and quantifiction of house dust mite (HDM) allergens are useful to improve the knowledge of regional mite fauna and the remediation of mite allergens in allergic diseases. The present study analyzed the association between levels of HDM allergen and results of mite identification or skin prick test (SPT) in two different areas of Bahia, Brazil. METHODS: Forty-two asthmatic subjects from a rural area (group I; n = 21) and a slum (group II; n = 21) were evaluated through SPT with HDM allergens and had dust samples collected at their homes for mite identification and allergen measurements. RESULTS: Positive SPT to Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis allergens were observed in 42.9, 38.0 and 42.9% subjects from group I and in 47.6, 19.0 and 33.3% subjects from group II, respectively. D. pteronyssinus and B. tropicalis were identified in approximately 76 and 50% of samples from both groups, respectively. D. farinae was identified in 38.0 and 9.5% of samples from groups I and II, respectively (p < 0.005). Der p 1, Der f 1 and Blo t 5 detection were associated with mite identification (p < 0.05). Association between HDM allergen levels over 2 microg/g of dust and positive SPT occurred only with D. pteronyssinus (p < 0.0001). CONCLUSIONS: D. pteronyssinus was the most prevalent mite species in this study followed by B. tropicalis and D. farinae. Immunoassays done to measure mite allergens were associated with mite-species identification. We conclude that these three mite species must be included on panels for the diagnosis of allergic airway diseases in subjects living in such regions.