RESUMO
Widespread availability of antibiotics without prescription potentially facilitates overuse and contributes to selection pressure for antimicrobial resistant bacteria. Prior to this study, anecdotal observations in Guatemala identified corner stores as primary antibiotic dispensaries, where people purchase antibiotics without prescriptions. We carried out a cross sectional study to document the number and types of antibiotics available in corner stores, in four study areas in Guatemala. A total of 443 corner stores were surveyed, of which 295 (67%) sold antibiotics. The most commonly available antibiotics were amoxicillin, found in 246/295 (83%) stores, and tetracycline, found in 195/295 (66%) stores. Over the counter sales result from laissez-faire enforcement of antibiotic dispensing regulations in Guatemala combined with patient demand. This study serves as a baseline to document changes in the availability of antibiotics in informal establishments in light of new pharmacy regulations for antibiotic dispensing, which were adopted after this study was completed.
Assuntos
Antibacterianos/provisão & distribuição , Uso de Medicamentos/estatística & dados numéricos , Medicamentos sem Prescrição/provisão & distribuição , Autoadministração/estatística & dados numéricos , Antibacterianos/administração & dosagem , Antibacterianos/economia , Uso Indevido de Medicamentos/estatística & dados numéricos , Guatemala , Humanos , Medicamentos sem Prescrição/administração & dosagem , Medicamentos sem Prescrição/economia , Empresa de Pequeno Porte/estatística & dados numéricosRESUMO
La automedicación es una práctica de deno-minación moral subjetiva muy frecuente en los pacientes ambulatorios, en la cual estos optan por adquirir medicamentos sin pres-cripción médica para el alivio de dolencias, frecuentemente consideradas de baja seve-ridad. Objetivo: Determinar el conocimien-to, factores condicionantes y características de automedicación en los estudiantes de las carreras enfermería y medicina de la Escue-la Universitaria de Ciencias de la Salud de la Universidad Nacional Autónoma de Hondu-ras en el Valle de Sula (EUCS/UNAH-VS) en el primer semestre del 2017. Pacientes y Métodos: Estudio cuantitativo, alcance des-criptivo, transversal, prospectivo, realizado en estudiantes de la carrera de enfermería y medicina de la EUCS/UNAH-VS que cursa-ban el 2do y 3er año el primer semestre del 2017. La muestra fue no probabilística por conveniencia de 55 estudiantes pertene-cientes a cada carrera, en total 110. Resul-tados: Se encontró que 50 (90.9%) estu-diantes de enfermería y 49 (89.09%) de medicina admitieron automedicarse. La mayoría no conocen las indicaciones y/o efectos adversos de los fármacos utilizados para automedicarse. El 45.45% (25) de enfermería y 63.63% (35) ignoran la dosificación. Un 67.27% (37) de enfermería y 61.8% (34) de medicina desconocen los efectos adversos de las dosificaciones exce-sivas. La principal causa de automedicación fue la consideración de malestares como no graves, siendo manejados en casa. Conclu-sión: La mayoría de los estudiantes de ambas carreras desconocen sobre indica-ciones, efectos adversos y dosificación de los medicamentos y los toman considerando los malestares no graves y no por los efec-tos que el medicamento pueda causarles. El principal síntoma que presentaron es la cefalea y el medicamento que más consu-mían fué el acetaminofen...(AU)
Assuntos
Humanos , Masculino , Feminino , Automedicação/efeitos adversos , Estudantes de Ciências da Saúde , Autoadministração/estatística & dados numéricos , Estudos Transversais/métodosRESUMO
OBJECTIVE: This study aims to determine the groups of patients who are at risk for noncompliance and misunderstanding of their pain regimen. DESIGN: Survey-based cohort study. SETTING: Suburban Level-I trauma center. PATIENTS/PARTICIPANTS: A total of 171 patients between the ages of 18-89 years who underwent surgical fixation of fractures involving the pelvis, long bones, or periarticular regions of the knee, ankle, elbow, and wrist. MAIN OUTCOME MEASUREMENTS: Patients who cannot accurately reproduce their prescribed pain medication list and patients who modify this pain medication regimen were analyzed by age, employment status, income level, education level, time between surgery and follow-up, and whether pain interfered with activities of daily living. RESULTS: Overall, 147 patients completed the survey. Seventy percent (n = 114) of patients could not accurately reproduce their pain medication regimen, regardless of age, employment status, income level, education level, time between surgery and follow-up, and whether pain interfered with activities of daily living. Patients (61.2%; n = 90), regardless of the 6 aforementioned demographic factors, also admitted to modifying their pain medication regimen with non-prescribed medications, with 55.8% (n = 82) of patients adding over-the-counter medications to surgeon-prescribed narcotic medications. CONCLUSIONS: Misunderstanding and noncompliance of surgeon-prescribed pain regimens are prevalent across all patient demographics. Knowledge of the potential effects these augmentative medications can have on fracture healing and any drug-drug interactions that may arise is an important aspect of patient postoperative care. Surgeons must be wary of these trends and screen for any unintended side effects a patient's pain regimen may have. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Assuntos
Atividades Cotidianas/psicologia , Analgésicos/administração & dosagem , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Procedimentos Ortopédicos/psicologia , Dor Pós-Operatória/psicologia , Dor Pós-Operatória/terapia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Compreensão , Escolaridade , Emprego/psicologia , Emprego/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/estatística & dados numéricos , Dor Pós-Operatória/epidemiologia , Pennsylvania/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Autoadministração/psicologia , Autoadministração/estatística & dados numéricos , Adulto JovemRESUMO
OBJETIVO: Analizar la frecuencia de errores de medicación que son cometidos e informados por los pacientes. MÉTODOS: Estudio descriptivo basado en encuestas telefónicas a una muestra aleatoria de pacientes adultos del nivel primario de salud del sistema público español. Respondieron un total de 1 247 pacientes (tasa de respuesta, 75 por ciento). El 63 por ciento eran mujeres y 29 por ciento eran mayores de 70 años. RESULTADOS: Mientras 37 pacientes (3 por ciento, IC 95 por ciento: 2-4) sufrieron complicaciones asociadas a la medicación en el curso del tratamiento, 241 (19,4 por ciento, IC 95 por ciento: 17-21) informaron haber cometido algún error con la medicación. Un menor tiempo de consulta (P < 0,01) y una peor valoración de la información proporcionada por el médico (P < 0,01) se asociaron al hecho de que en la dispensación en la farmacia le indicaran al paciente que el tratamiento prescrito no era apropiado. CONCLUSIONES: A los riesgos conocidos de sufrir un evento adverso, fruto de la intervención sanitaria por error del sistema o del profesional, hay que sumar los asociados a los errores de los pacientes en la autoadministración de la medicación. Los pacientes insatisfechos con la información proporcionada por el médico informaron un mayor número de errores.
OBJECTIVE: Analyze the frequency of medication errors committed and reported by patients. METHODS: Descriptive study based on a telephone survey of a random sample of adult patients from the primary care level of the Spanish public health care system. A total of 1 247 patients responded (75 percent response rate); 63 percent were women and 29 percent were older than 70 years. RESULTS: While 37 patients (3 percent, 95 percent CI: 2-4) experienced complications associated with medication in the course of treatment, 241 (19.4 percent, 95 percent CI: 17-21) reported having made some mistake with their medication. A shorter consultation time (P < 0.01) and a worse assessment of the information provided by the physician (P < 0.01) were associated with the fact that during pharmacy dispensing the patient was told that the prescribed treatment was not appropriate. CONCLUSIONS: In addition to the known risks of an adverse event due to a health intervention resulting from a system or practitioner error, there are risks associated with patient errors in the self-administration of medication. Patients who were unsatisfied with the information provided by the physician reported a greater number of errors.
Assuntos
Humanos , Masculino , Feminino , Idoso , Erros de Medicação/estatística & dados numéricos , Autoadministração/estatística & dados numéricos , Inquéritos e Questionários , AutomedicaçãoRESUMO
OBJECTIVE: To determine the compliance with tuberculosis treatment among patients enrolled the tuberculosis control program in the city of Carapicuíba, Brazil, before and after the implementation of the directly observed treatment, short-course (DOTS) strategy. METHODS: A retrospective historical cohort study of operational aspects based on records of attendance and treatment evolution of patients in self-administered treatment (SAT) and of those submitted to DOTS. Monthly treatment outcome tables were created, and the probability of compliance with the treatment was calculated for both groups of patients. RESULTS: A total of 360 patients with tuberculosis met the inclusion criteria: 173 (48.1%) in the SAT group; and 187 (51.9%) in the DOTS group. Treatment compliance was 6.1% higher in the DOTS group than in the SAT group. The proportion of patients completing the six months of treatment was 91.6% and 85.5% in the DOTS group and in the SAT group, respectively. CONCLUSIONS: The results of this study show that DOTS can be successfully implemented at primary health care clinics. In this population of patients, residents of a city with low incomes and a high burden of tuberculosis infection, DOTS was more effective than was SAT.
Assuntos
Terapia Diretamente Observada/normas , Adesão à Medicação/estatística & dados numéricos , Tuberculose/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Pré-Escolar , Estudos de Coortes , Terapia Diretamente Observada/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Autoadministração/estatística & dados numéricos , Fatores Socioeconômicos , Adulto JovemRESUMO
OBJETIVO: Verificar a adesão ao tratamento dos casos atendidos no programa de controle da tuberculose do município de Carapicuíba (SP), antes e após a implantação da estratégia directly observed treatment, short-course (DOTS, tratamento supervisionado). MÉTODOS: Estudo operacional do tipo coorte histórica a partir dos registros de comparecimento e evolução do tratamento dos pacientes submetidos ao tratamento autoadministrado (TAA) e daqueles submetidos a DOTS. Tábuas de desfecho de tratamento mês a mês foram elaboradas, e a probabilidade de adesão foi calculada para cada grupo de pacientes. RESULTADOS: Um total de 360 pacientes com tuberculose preencheu os critérios de elegibilidade: 173 (48,1 por cento) no grupo TAA e 187 (51,9 por cento) no grupo TS. A adesão ao tratamento foi 6,1 por cento maior no grupo DOTS do que no grupo TAA. Ao final de seis meses, 91,6 por cento dos pacientes sob TS completaram o tratamento padrão, enquanto 85,5 por cento dos pacientes do grupo TAA completaram o tratamento. CONCLUSÕES: Este estudo mostrou que a estratégia DOTS pode ser realizada com sucesso em unidades básicas de saúde e que essa estratégia foi mais efetiva que o TAA nesta população de pacientes de uma cidade com população de baixa renda e alta carga de tuberculose.
OBJECTIVE: To determine the compliance with tuberculosis treatment among patients enrolled the tuberculosis control program in the city of Carapicuíba, Brazil, before and after the implementation of the directly observed treatment, short-course (DOTS) strategy. METHODS: A retrospective historical cohort study of operational aspects based on records of attendance and treatment evolution of patients in self-administered treatment (SAT) and of those submitted to DOTS. Monthly treatment outcome tables were created, and the probability of compliance with the treatment was calculated for both groups of patients. RESULTS: A total of 360 patients with tuberculosis met the inclusion criteria: 173 (48.1 percent) in the SAT group; and 187 (51.9 percent) in the DOTS group. Treatment compliance was 6.1 percent higher in the DOTS group than in the SAT group. The proportion of patients completing the six months of treatment was 91.6 percent and 85.5 percent in the DOTS group and in the SAT group, respectively. CONCLUSIONS: The results of this study show that DOTS can be successfully implemented at primary health care clinics. In this population of patients, residents of a city with low incomes and a high burden of tuberculosis infection, DOTS was more effective than was SAT.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Terapia Diretamente Observada/normas , Adesão à Medicação/estatística & dados numéricos , Tuberculose/tratamento farmacológico , Brasil , Estudos de Coortes , Terapia Diretamente Observada/métodos , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Fatores Socioeconômicos , Autoadministração/estatística & dados numéricosRESUMO
OBJECTIVE: To describe the implantation and the effects of directly-observed treatment short course (DOTS) in primary health care units. METHODS: Interviews were held with the staff of nine municipal health care units (MHU) that provided DOTS in Rio de Janeiro City, Southeastern Brazil, in 2004-2005. A dataset with records of all tuberculosis treatments beginning in 2004 in all municipal health care units was collected. Bivariate analyses and a multinomial model were applied to identify associations between treatment outcomes and demographic and treatment process variables, including being in DOTS or self-administered therapy (SAT). RESULTS: From 4,598 tuberculosis cases treated in public health units administrated by the municipality, 1,118 (24.3 percent) were with DOTS and 3,480 (75.7 percent) with SAT. The odds of DOTS were higher among patients with age under 50 years, tuberculosis relapse and prior history of default or treatment failure. The odds of death were 52.0 percent higher among patients on DOTS as compared to SAT. DOTS modality including community health workers (CHWs) showed the highest treatment success rate. A reduction of 21.0 percent was observed in the odds of default (vs. cure) among patients on DOTS as compared to patients on SAT, and a reduction of 64.0 percent among patients on DOTS with CHWs as compared to those without CHWs. CONCLUSIONS: Patients with a "low compliance profile" were more likely to be included in DOTS. This strategy improves the quality of care provided to tuberculosis patients, although the proposed goals were not achieved.
OBJETIVO: Descrever a implantação e os efeitos do directly-observed treatment short course (DOTS) em centros municipais de saúde. MÉTODOS: Foram realizadas entrevistas com profissionais dos nove centros municipais de saúde que ofereciam DOTS no Rio de Janeiro, RJ, em 2004-2005. Foram coletados os dados de todos os centros municipais de saúde da cidade sobre os tratamentos de tuberculose iniciados em 2004. Análises bivariadas e modelo multinomial foram aplicados para identificar associações entre resultados do tratamento e variáveis demográficas e relativas ao processo de tratamento, incluindo estar em DOTS ou terapia auto-administrada (SAT). RESULTADOS: Dos 4.598 casos de tuberculose tratados, 1.118 (24,3 por cento) utilizaram DOTS e 3.480 (75,7 por cento), SAT. As chances de uso de DOTS foram maiores entre pacientes com menos de 50 anos, recidiva de tuberculose, história prévia de abandono ou falência de tratamento. As chances de morte foram 52,0 por cento maiores entre pacientes em DOTS comparados àqueles em SAT. A modalidade de tratamento com maior sucesso foi DOTS com agentes comunitários de saúde. Foi observada redução de 21,0 por cento na razão de chances de abandono (vs. cura) entre pacientes em DOTS, comparados a pacientes em SAT, e redução de 64,0 por cento entre pacientes em DOTS com ACS, comparados àqueles sem. CONCLUSÕES: Pacientes com perfil de menor adesão ao tratamento tenderam a ser incluídos em DOTS. Essa estratégia melhora a qualidade da atenção provida a pacientes com tuberculose, ainda que metas propostas não tenham sido atingidas.
OBJETIVO: Describir la implantación y los efectos del directly-observed treatment short course (DOTS) en centros municipales de salud. MÉTODOS: Se realizaron entrevistas con profesionales de los nueve centros municipales de salud que ofrecían DOTS en Rio de Janeiro, Sureste de Brasil, en 2004-2005. Los datos de todos los centros municipales de salud de la ciudad sobre los tratamientos de tuberculosis iniciados en 2004 fueron colectados. Análisis bivariados y modelo multinomial fueron aplicados para identificar asociaciones entre resultados del tratamiento y variables demográficas y relativas al proceso de tratamiento, incluyendo estar en DOTS o terapia auto administrativa (SAT). RESULTADOS: De los 4.598 casos de tuberculosis tratados, 1.118 (24,3 por ciento) utilizaron DOTS y 3.480 (75,7 por ciento), SAT. Las oportunidades de uso de DOTS fueron mayores entre pacientes con menos de 50 años, recidiva de tuberculosis, historia previa de abandono u omisión del tratamiento. Las oportunidades de muerte fueron 52,0 por ciento mayores entre pacientes en DOTS comparados con aquellos en SAT. La modalidad de tratamiento con mayor éxito fue DOTS con agentes comunitarios de salud. Se observó reducción de 21,0 por ciento en la relación de oportunidades de abandono (vs. cura) entre pacientes en DOTS, comparados con pacientes en SAT, y reducción de 64,0 por ciento entre pacientes en DOTS con ACS, comparados con aquellos sin el. CONCLUSIONES: Pacientes con perfil de menor adhesión al tratamiento tendieron a ser incluidos en DOTS. Esta estrategia mejora la calidad de atención provista a pacientes con tuberculosis, aunque las metas propuestas no hayan sido alcanzadas.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Diretamente Observada , Tuberculose , Brasil , Terapia Diretamente Observada/estatística & dados numéricos , Métodos Epidemiológicos , Adesão à Medicação/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Atenção Primária à Saúde , Autoadministração/estatística & dados numéricos , Resultado do Tratamento , Tuberculose/mortalidade , TuberculoseRESUMO
OBJECTIVE: To describe the implantation and the effects of directly-observed treatment short course (DOTS) in primary health care units. METHODS: Interviews were held with the staff of nine municipal health care units (MHU) that provided DOTS in Rio de Janeiro City, Southeastern Brazil, in 2004-2005. A dataset with records of all tuberculosis treatments beginning in 2004 in all municipal health care units was collected. Bivariate analyses and a multinomial model were applied to identify associations between treatment outcomes and demographic and treatment process variables, including being in DOTS or self-administered therapy (SAT). RESULTS: From 4,598 tuberculosis cases treated in public health units administrated by the municipality, 1,118 (24.3%) were with DOTS and 3,480 (75.7%) with SAT. The odds of DOTS were higher among patients with age under 50 years, tuberculosis relapse and prior history of default or treatment failure. The odds of death were 52.0% higher among patients on DOTS as compared to SAT. DOTS modality including community health workers (CHWs) showed the highest treatment success rate. A reduction of 21.0% was observed in the odds of default (vs. cure) among patients on DOTS as compared to patients on SAT, and a reduction of 64.0% among patients on DOTS with CHWs as compared to those without CHWs. CONCLUSIONS: Patients with a "low compliance profile" were more likely to be included in DOTS. This strategy improves the quality of care provided to tuberculosis patients, although the proposed goals were not achieved.
Assuntos
Terapia Diretamente Observada/normas , Tuberculose/tratamento farmacológico , Adulto , Brasil/epidemiologia , Terapia Diretamente Observada/estatística & dados numéricos , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Cooperação do Paciente/estatística & dados numéricos , Atenção Primária à Saúde , Autoadministração/estatística & dados numéricos , Resultado do Tratamento , Tuberculose/mortalidade , Tuberculose/prevenção & controleRESUMO
OBJECTIVE: To determine treatment noncompliance rates among patients participating in a municipal tuberculosis control program and to identify the variables related to noncompliance depending on the type of treatment strategy used. METHODS: A longitudinal non-concurrent cohort study was carried out involving two cohorts of patients participating in the Tuberculosis Control Program of the city of Carapicuíba, Brazil. The first cohort comprised 173 patients with tuberculosis treated from January 1, 2003 to December 31, 2003 using self administration of treatment, and the second comprised 187 patients with tuberculosis treated from July 1, 2004 to June 30, 2005 using the directly observed therapy, short-course strategy. RESULTS: Noncompliance rates decreased from 13.3% (self administration of treatment) to 5.9% (directly observed therapy, short-course), a significant difference (p < 0.05). For the self administration of treatment strategy, the variables significantly associated with treatment noncompliance were as follows: being an unregistered worker (relative risk [RR] = 3.06); retreatment (RR = 2.73); alcoholism (RR = 3.10); and no investigation of contacts (RR = 8.94). For the directly observed therapy, short-course strategy, no variables were significantly associated with noncompliance. CONCLUSION: The directly observed therapy, short-course strategy decreased noncompliance rates and produced better treatment outcomes, even when the risk factors for noncompliance were the same.
Assuntos
Terapia Diretamente Observada , Autoadministração/estatística & dados numéricos , Recusa do Paciente ao Tratamento/estatística & dados numéricos , Tuberculose Pulmonar/terapia , Adulto , Alcoolismo/epidemiologia , Brasil/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/prevenção & controle , População UrbanaRESUMO
OBJETIVO: Verificar as taxas de abandono e identificar as variáveis relacionadas ao abandono do tratamento, segundo o tipo de estratégia utilizada em pacientes matriculados no Programa de Controle da Tuberculose do município de Carapicuíba (SP) Brasil. MÉTODO: Estudo longitudinal não concorrente de duas coortes de tratamento de tuberculose, a primeira de 1 de janeiro a 31 de dezembro de 2003 com a estratégia tratamento auto-administrado (173 casos) e a segunda de 1 de julho de 2004 a 30 de junho de 2005 com a estratégia tratamento supervisionado (187 casos). RESULTADOS: A taxa de abandono diminuiu significativamente (p < 0,05), de 13,3 por cento (tratamento auto-administrado) para 5,9 por cento (tratamento supervisionado). Na estratégia tratamento auto-administrado, as variáveis associadas significativamente ao abandono foram: estar trabalhando na informalidade (risco relativo [RR] = 3,06); ser caso de retratamento (RR = 2,73); ser alcoolista (RR = 3,10); e não ter os contatos examinados (RR = 8,94). Não houve variável associada ao abandono para os casos sob a estratégia tratamento supervisionado. CONCLUSÃO: A estratégia tratamento supervisionado reduziu a taxa de abandono e produziu bons resultados quanto ao desfecho do tratamento, mesmo nos pacientes com fatores de risco para abandono como na coorte tratamento auto-administrado.
OBJECTIVE: To determine treatment noncompliance rates among patients participating in a municipal tuberculosis control program and to identify the variables related to noncompliance depending on the type of treatment strategy used. METHODS: A longitudinal non-concurrent cohort study was carried out involving two cohorts of patients participating in the Tuberculosis Control Program of the city of Carapicuíba, Brazil. The first cohort comprised 173 patients with tuberculosis treated from January 1, 2003 to December 31, 2003 using self administration of treatment, and the second comprised 187 patients with tuberculosis treated from July 1, 2004 to June 30, 2005 using the directly observed therapy, short-course strategy. RESULTS: Noncompliance rates decreased from 13.3 percent (self administration of treatment) to 5.9 percent (directly observed therapy, short-course), a significant difference (p < 0.05). For the self administration of treatment strategy, the variables significantly associated with treatment noncompliance were as follows: being an unregistered worker (relative risk [RR] = 3.06); retreatment (RR = 2.73); alcoholism (RR = 3.10); and no investigation of contacts (RR = 8.94). For the directly observed therapy, short-course strategy, no variables were significantly associated with noncompliance. CONCLUSION: The directly observed therapy, short-course strategy decreased noncompliance rates and produced better treatment outcomes, even when the risk factors for noncompliance were the same.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Diretamente Observada , Autoadministração/estatística & dados numéricos , Recusa do Paciente ao Tratamento/estatística & dados numéricos , Tuberculose Pulmonar/terapia , Alcoolismo/epidemiologia , Brasil/epidemiologia , Estudos Longitudinais , Avaliação de Programas e Projetos de Saúde , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/prevenção & controle , População UrbanaRESUMO
The Floripa H and L rat lines were selectively bred, respectively, for high and low scores of locomotion in the central aversive area of an open field (OF), which is a putative index of experimental anxiety. In the present study, we used these lines to examine the relationship between anxiety-related behaviors and ethanol intake through the use of three animal tests used to investigate anxiety (OF, elevated plus maze, and black/white box) and one oral ethanol consumption procedure. Males and females of the Floripa L line were more anxious-like than their counterparts in the three behavioral tests. No line differences in the tests of taste control solutions (saccharin and quinine) and forced ethanol (10%) were found. However, Floripa L female rats consumed more ethanol than their Floripa H counterparts at concentrations of 6 and 10% in a two-bottle choice protocol. Moreover, Floripa L females showed a higher ratio of ethanol to total fluids consumed, regardless of the concentration offered, than all other subgroups (males of both lines and Floripa H females). Males showed no line differences for ethanol consumption. Taken together, the results of this study confirm that there are important sex differences in both anxiety-related behaviors and ethanol consumption. Accordingly, these data suggest a positive genetic relationship between anxiety-related behaviors and ethanol intake, at concentrations of 6 and 10%, in females but not in males. This supports the use of both sexes in animal experiments involving anxiety- and ethanol-related behaviors. Finally, the results and the existing literature indicate that selectively bred laboratory animals constitute a useful tool in the search for genes influencing both anxiety and ethanol consummatory behavior.
Assuntos
Consumo de Bebidas Alcoólicas/genética , Ansiedade/induzido quimicamente , Comportamento Animal/fisiologia , Modelos Animais de Doenças , Comportamento de Ingestão de Líquido/fisiologia , Etanol/efeitos adversos , Consumo de Bebidas Alcoólicas/psicologia , Animais , Ansiedade/psicologia , Comportamento Animal/efeitos dos fármacos , Cruzamentos Genéticos , Comportamento de Ingestão de Líquido/efeitos dos fármacos , Etanol/administração & dosagem , Etanol/farmacologia , Comportamento Exploratório/efeitos dos fármacos , Comportamento Exploratório/fisiologia , Feminino , Humanos , Locomoção/efeitos dos fármacos , Locomoção/fisiologia , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Aprendizagem em Labirinto/fisiologia , Modelos Genéticos , Ratos , Seleção Genética , Autoadministração/psicologia , Autoadministração/estatística & dados numéricos , Fatores Sexuais , Especificidade da EspécieRESUMO
The aim is to investigate patient's behaviour after the myocardium revascularization surgery. This is an exploratory-descriptive study, carried out at a cardiology clinic of a government hospital, in Fortaleza, Ceará, Brazil, with 52 patients. The following self-care practices were identified: 98.07% patients regularly attended the doctor's appointment and took their medicines; more than 50% presented BMI > 25 Kg/m2, practiced physical exercises, did not smoke or drink, ate healthy foods, said they were usually calm. The conclusion was that patients that participated in this study maintained a satisfactory self-care level, supporting the importance of guidance process developed in group.
Assuntos
Revascularização Miocárdica/reabilitação , Pacientes Ambulatoriais/estatística & dados numéricos , Autocuidado , Atividades Cotidianas , Afeto , Índice de Massa Corporal , Comorbidade , Feminino , Hábitos , Hospitais Públicos , Humanos , Masculino , Ambulatório Hospitalar , Cooperação do Paciente , Autoadministração/estatística & dados numéricosRESUMO
BACKGROUND: Ethnic differences in health care utilisation are frequently reported in research. Little is known about the concordance between different methods of data collection among ethnic minorities. The aim of this study was to examine to which extent ethnic differences between self-reported data and data based on electronic medical records (EMR) from general practitioners (GPs) might be a validity issue or reflect a lower compliance among minority groups. METHODS: A cross-sectional, national representative general practice study, using EMR data from 195 GPs. The study population consisted of Dutch, Turks, Surinamese, Antilleans and Morrocans. Self-reported data were collected through face-to-face interviews and could be linked to the EMR of GPs. The main outcome measures were the level of agreement between annual prescribing rate based on the EMRs of GPs and the self-reported receipt and use of prescriptions during the preceding 14 days. RESULTS: The pattern of ethnic differences in receipt and use of prescription medication depended on whether self-reported data or EMR data were used. Ethnic differences based on self-reports were not consistently reflected in EMR data. The percentage of agreement above chance between EMR data and self-reported receipt was in general relative low. CONCLUSION: Ethnic differences between self-reported data and EMR data might not be fully perceived as a cross-cultural validity issue. At least for Moroccans and Turks, compliance with the prescribed medication by the GP is suggested not to be optimal.
Assuntos
Uso de Medicamentos/estatística & dados numéricos , Medicina de Família e Comunidade/estatística & dados numéricos , Grupos Minoritários/psicologia , Cooperação do Paciente/etnologia , Autoadministração/estatística & dados numéricos , Comparação Transcultural , Coleta de Dados/métodos , Humanos , Registro Médico Coordenado , Sistemas Computadorizados de Registros Médicos , Grupos Minoritários/estatística & dados numéricos , Marrocos/etnologia , Países Baixos , Autorrevelação , Suriname/etnologia , Turquia/etnologiaRESUMO
Women are the fastest growing segment of the adult population acquiring HIV, and most women infected with HIV are in their reproductive years. The success of HAART is highly dependent upon the ability and willingness of the individual to adhere to complex antiretroviral regimens. Improved adherence among HIV-infected pregnant women will delay disease progression in the mother and should also reduce HIV transmission to the baby. Modified directly observed therapy (MDOT), may benefit this population. MDOT has been shown to be an acceptable and feasible intervention among HIV substance users; however, no-one has yet evaluated the use of MDOT in pregnant and postpartum women. Based on semi-structured interviews with 17 Latina women with HIV infection, we explored women's adherence patterns and barriers to adherence and their perceptions of a hypothetical MDOT program. The vast majority of women positively appraised the MDOT program as an effective means to increase and reinforce adherence to demanding drug regimens. Respondents cited the face-to-face contact, the supportive nature of the relationship, and the practical approach of the program as the primary reasons for the effectiveness of MDOT. Results indicate that MDOT could be an acceptable intervention for pregnant and postpartum Latina women to improve adherence to HAART.
Assuntos
Fármacos Anti-HIV/uso terapêutico , Terapia Diretamente Observada/métodos , Infecções por HIV/tratamento farmacológico , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto , Terapia Antirretroviral de Alta Atividade , Esquema de Medicação , Feminino , Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino/psicologia , Humanos , Período Pós-Parto , Gravidez , Complicações Infecciosas na Gravidez/psicologia , Porto Rico , Autoadministração/estatística & dados numéricos , Inquéritos e Questionários , Saúde da MulherRESUMO
OBJECTIVE: This comparative study in four countries was designed to explore differences in women's and men's patterns of medication use. METHODS: A total of 539 individuals, 303 women and 236 men, aged 15 years and older, were interviewed in Mexico, the Philippines, Uganda, and the US. Country-specific variables and codes adapted questions and answers to local contexts, and the instrument alternated between closed- and open-ended questions. RESULTS: In all sites, women reported using medications more frequently than men. Differences in reported use between women and men over the month preceding the survey were significant in Mexico and Uganda, but not in the two countries with the highest medication use, the Philippines and the USA. Gender differences are explained in part by differences in the frequencies with which major symptoms/conditions are reported, as women were generally more likely to report these conditions then men, but not more likely to treat symptoms or conditions with medications. This analysis also found gendered patterns of communication and information about health: women are central to the process of communication about health and therapies and they appear to draw on a richer repertoire of knowledge, perceptions and attitudes regarding medications. CONCLUSIONS: This study documents differences in patterns of medication use, with women reporting higher use than men overall. It also finds gendered patterns of use, manifested in information and perceptions surrounding medications.
Assuntos
Atitude Frente a Saúde , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Nível de Saúde , Autocuidado/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Filipinas/epidemiologia , Autoadministração/estatística & dados numéricos , Automedicação/estatística & dados numéricos , Distribuição por Sexo , Fatores Sexuais , Inquéritos e Questionários , Uganda/epidemiologia , Estados Unidos/epidemiologiaRESUMO
The aim of this study was to evaluate scientific articles published between 1991-1995, in order to identify the compliance in antihypertensive therapy, One hundred seven scientific articles were evaluated. The results showed that 68% were related to patient, 63% to pharmacological treatment, 62% general, 39% non pharmacological treatment, 34% organizational factors, and 8% related to disease. Compliance with antihypertensive therapy was the major challenge of hypertension management and to know how this aspect was focalized in scientific articles possible reduce non compliance in hypertension.
Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Hipertensão/psicologia , Cooperação do Paciente/psicologia , Autoadministração/psicologia , Humanos , Cooperação do Paciente/estatística & dados numéricos , Projetos de Pesquisa , Fatores de Risco , Autoadministração/estatística & dados numéricosRESUMO
In the present study, which was carried out in peri-urban areas of Lima and Chimbote, Peru, and La Paz, Bolivia, the household survey method was used to investigate the manner in which drugs are used in treating the most common diseases in each locality. The objectives were to detect inappropriate practices, correct them through educational interventions, and determine the interventions' effectiveness. Simple random sampling was used to select the residences surveyed, which were then divided into study groups and control groups. A preliminary survey determined that the most frequent illnesses were the common cold, diarrhea, and dietary deficiency diseases and that their treatment often involved the inappropriate use of drugs. Educational interventions of varying duration were carried out, and subsequently a second survey was performed using the same instrument in order to determine the effectiveness of the interventions. Although there was an increased tendency not to treat the aforementioned diseases, the responses directly related to the use of drugs did not reveal any significant changes in behavior. Various factors were identified that influence the consumption of drugs.