[Medicine consumption in the adult population: Influence of self-medication]

Pharmaceutical intervention in the pharmacological therapy of elderly patients in San Luis-ECUADOR

Population's aging leads to a frequent usage of pharmaceutical medications to treat or control various ailments because of aging, increasing the probability of occurrence of problems related to its usage. The primary objective of this study was to conduct pharmaceutical interventions in elderly patients from San Luis - Riobamba, using surveys to identify the sociodemographic characteristics, diseases, and medicines usage. Once the problems related to pharmacological therapy were identified, pharmaceutical interventions were carried our prior the acceptance of each patient. The study had the participation of 422 elderly patients, with the prevalence of females (59.7%), aged between 60 and 70 years (45.5%); we identified that 82.5% of the elderly patients have diseases, finding that joint pain such as Arthritis/Osteoarthritis has the higher incidence (38.8%), and 50% of the surveyed people consume medication to treat the disease. 40.28% (n=170) of the participants conciliate the treatment review to identify any medication-related problem (MRP), finding interactions (21.2%) and adverse effects probability (21.2%), starting from the PRM identified, 170 pharmaceutical interventions were conducted, considering as priority (67.6%) the education on non-pharmacological measures. The pharmaceutical interventions done through the study benefited the elderly patients and will contribute to reduce the appearance of PRM.

Self-medication practices in riverside communities in the Brazilian Amazon Rainforest

OBJECTIVES

to analyze the practice of self-medication and the associated factors in the riverside population of the Middle Solimões river region - Amazon rainforest.

METHODS

a cross-sectional population-based study conducted between April and July 2015, through interviews at home.

RESULTS

the prevalence of self-medication among the riverside population was 76.3%. Analgesics and antibacterials were the main therapeutic classes used in self-medication. Self-medication proved to be associated with the male gender, young people, not having sought the health service in the last month, longer commuting from the community to the urban area and the habit of consuming allopathic medicines on their own.

CONCLUSIONS

self-medication among the riverside population of Coari - Amazon may reflect the need to seek self-care by people, with the use of allopathic medicines without prescription, mainly due to the restricted access to health services.

Use of medicines by adults in primary care: Survey on health services in Minas Gerais, Brazil

INTRODUCTION

Inappropriate use and increase of health care spending reinforce the need to extend our knowledge about the quality of medication use.

OBJECTIVES

To describe and evaluate the profile of medication use in a representative sample of adult users of primary care services in the Unified Health System (SUS) of Minas Gerais.

METHOD

Cross-sectional study, with 1,159 interviewees in 104 municipalities and 253 health care services. Data on sociodemographic characteristics, health conditions and use of medicines were collected, and these variables were stratified by age group. Univariate and multivariate analyses, using logistic regression, were conducted to identify predictors of self-medication. We set a significance level of 5% for all tests.

RESULTS

The prevalence of medication use was 81.8%, with an average of 2.67 medicines per user, which increased with age. The most used drugs were losartan, hydrochlorothiazide and simvastatin, which differed between age groups. Significant self-medication was observed not only in young adults but also in the elderly. The predictors of self-medication were: being a young adult, having a higher level of education, not having chronic diseases, having worse self-perception of health and not adhering to prescription drugs. Young and elderly adults showed characteristics that made them more vulnerable in relation to the rational use of medicines.

CONCLUSION

This study can contribute to improving primary care, where it identified problems related to the extent of medication use, especially among young adults and the elderly in Minas Gerais.

Identification of effective parameters for anti-inflammatory concentration in València City's wastewater using fuzzy-set qualitative comparative analysis

The current literature about pharmaceutical and personal care compounds (PPCPs) focuses on identifying their concentration and toxicological risk both in surface water and in wastewater. However, the influence of urban areas (population ageing, income level, hospitals and others) has not yet been analysed. Knowing how a population (and its facilities) affects PPCPs' presence in wastewater is important to identify the conditions that are responsible for their presence. In this work, the influence of water consumption, population ageing, income level, hospitals and nursing homes on the anti-inflammatory concentration have been analysed. To fill the gap between the quantitative data on PPCPs' concentration and the qualitative reasoning of the influence of urban areas on the anti-inflammatory concentration, the use of fuzzy-set qualitative comparative analysis (fsQCA) is proposed. The fsQCA results are presented as recipes that show the different causal combinations of conditions that explain the presence of anti-inflammatories in wastewater. Using fsQCA for urban wastewater management with the aim of explaining the presence of anti-inflammatories in wastewater treatment plants (WWTPs) is a novelty in the literature. The results obtained here show the influence of water consumption (WATCON), hospitals (HOSP) and population ageing (POPAG) as the main conditions for the anti-inflammatory concentration in Valèncian wastewater. Specifically, these conditions are present in all the recipes obtained with consistency of 99%. Through the results obtained, it would be possible to identify that HOSP are the main facilities that discharge anti-inflammatories into urban wastewater. Hence, the necessity of preventive measures to avoid the anti-inflammatory discharge into water bodies has been showed. Furthermore, under a methodological point of view, this work highlights the eligibility of fsQCA as a wastewater cycle management tool.

Workers' medication as occupational risk at construction site with formworks

BACKGROUND

Accidents in the construction sector are a cause for concern. The influence of many different factors in construction accidents have been studied (age, company size, length of service, deviation, drugs or alcohol consumption, etc.) but the influence of medicinal substances in specific construction activities has not been evaluated until now.

OBJECTIVE

The aim of the research presented here is to identify the effect of different medicinal substances on the occupational risk levels of construction activities with formworks.

METHODS

An expert panel was selected in order to quantify the individual risk of each medication for each individual construction activity.

RESULTS

Results showed that narcotics, antipsychotics, and hypnotics had the highest risk values, and the use of cranes and cutting materials were considered the most dangerous activities for a medicated worker.

CONCLUSIONS

Data obtained in this research can help reduce the negative effects of the substances studied on the occupational safety of construction workers. A better knowledge of the risk levels according to the current capabilities of workers under the effects of medication is a powerful tool in planning safer construction activities.

Factors associated with self-medication in Spain: a cross-sectional study in different age groups

Objective

The identification of factors which may influence a patient’s decision to self-medicate.

Methods

Descriptive, cross-sectional study of the adult population (at least 16 years old), using data from the 2009 European Health Interview Survey in Spain, which included 22 188 subjects. Logistic regression models enabled us to estimate the effect of each analysed variable on self-medication.

Key findings

In total, 14 863 (67%) individuals reported using medication (prescribed and non-prescribed) and 3274 (22.0%) of them self-medicated. Using logistic regression and stratifying by age, four different models have been constructed. Our results include different variables in each of the models to explain self-medication, but the one that appears on all four models is education level. Age is the other important factor which influences self-medication. Self-medication is strongly associated with factors related to socio-demographic, such as sex, educational level or age, as well as several health factors such as long-standing illness or physical activity.

Conclusions

When our data are compared to those from previous Spanish surveys carried out in 2003 and 2006, we can conclude that self-medication is increasing in Spain.

Factors Associated to Medication Consumption Among the Immigrant Population Residing in Spain

We aimed to determine the prevalence of medication use by the immigrant population residing in Spain, and to identify the factors associated with this consumption. Descriptive cross-sectional study was performed using secondary data retrieved from the 2012 Spanish National Health Survey (SNHS). Using logistic multivariate regression analysis, three models were generated: one for immigrants from high income countries (HIC), another for immigrants from low income countries (LIC), and a third one for the native population. The prevalence of total consumption of medicinal products is greater in the native population (61.75%) than in the immigrant population (HIC: 56.22%; LIC: 48.55%). Analgesics are the most consumed drugs in all the groups. Greater medication consumption is associated with being female, being of an advanced age (immigrants from HIC: AOR 9.75, for older than 75 years), the presence of chronic disease, a perception of bad health (HIC: AOR 3.48) and the use of emergency services (LIC immigrants: AOR 1.68). Medicine consumption in the immigrant population living in Spain is lower than in the native population. The factors associated with this consumption are similar; however, LIC immigrants who needed healthcare services and did not receive them presented a greater probability of consuming medicinal products.

Predisposing factors to the practice of self-medication in Brazil: Results from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM)

OBJECTIVE

To understand the predisposing factors that lead to the practice of self-medication and the factors associated with the use of medicines via self-medication in the adult population of Brazil.

METHODS

The analyzed data are part of the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), a survey whose population consisted of individual residents permanently domiciled in urban areas in Brazil. In this work, the data references the 31 573 respondents aged 20 or higher (76.2% of the final PNAUM sample). Poisson regression models with robust variance were used for estimating the independent effect of each variable with medicine use via self-medication.

RESULTS

Of the interviewees, 73.6% stated they had used some medication without medical recommendation if they had previously used the same product; 73.8% stated they had used non-prescribed medicine when the medicine was already present at home; and 35.5% stated they had used some non-prescribed medication when they knew someone who had already taken the same medication. The prevalence of self-medication was 18.3%. The variables associated with the highest probability of using medicine via self-medication were: geographic region within Brazil, gender, age group, per capita income, self-assessment of health, self-reported use of previously used non-prescribed medication, and self-reported use of non-prescribed medication when that medication was already present at home.

CONCLUSIONS

The use of medicines via self-medication in Brazil is relatively frequent and influenced by previous experience and familiarity with the medications, and is more common among women and individuals with low self-assessment of health.

Sociodemographic profile of medicines users in Brazil: results from the 2014 PNAUM survey

OBJECTIVE

To analyze the prevalence of medicine use by the Brazilian population and its distribution according to sociodemographic factors.

METHODS

Study using data from the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), a nationwide household survey of a representative sample of the Brazilian urban population. The data were collected between September 2013 and February 2014. The overall use of medicines, defined as the use of any medicine, use of medicines for treating chronic medical conditions and for acute health conditions, was evaluated. The independent variables included gender, age group, socioeconomic position, and region of Brazil. Analyzes included prevalence calculations, 95% confidence intervals (95%CI) and Pearson Chi-square tests to evaluate the differences between groups, considering a 5% level of significance.

RESULTS

The prevalence of medicines use was 50.7% (95%CI 49.3-52.2), with 39.3% (95%CI 37.5-41.1) accounting for men and 61.0% (95%CI 59.3-62.6) for women. Medicines use was observed to increase with increasing age, except among children within the zero to four years age group. The lowest prevalence for medicines use was found among those with a low socioeconomic position and those who reside in the North region of Brazil. The prevalence of medicine use to treat chronic diseases was 24.3% (95%CI 23.3-25.4), whereas it was 33.7% (95%CI 32.1-35.4) for treating acute diseases.

CONCLUSIONS

We found extensive variability in the prevalence of medicines use across regions of Brazil. The poorest regions (North, Northeast, and Midwest) have a lower prevalence of medicines use to treat chronic diseases, indicating the need to minimize inequalities in access to medicines within the country.

OBJETIVO

Analisar a prevalência do uso de medicamentos pela população brasileira e sua distribuição segundo aspectos sociodemográficos.

MÉTODOS

Estudo com dados da Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM), pesquisa nacional de base populacional, realizada entre setembro de 2013 e fevereiro de 2014 em residências de municípios urbanos. Avaliou-se o uso de todos os medicamentos (global), uso de medicamentos para doenças crônicas e uso de medicamentos para doenças agudas. As variáveis independentes utilizadas foram sexo, idade, classificação econômica e região do País. Foram calculados prevalências e intervalos de confiança de 95% (IC95%) e aplicado teste Qui-quadrado de Pearson para avaliação das diferenças entre os grupos, considerando o nível de significância de 5%.

RESULTADOS

A prevalência global de uso de medicamentos foi de 50,7% (IC95% 49,3-52,2), sendo 39,3% (IC95% 37,5-41,1) no sexo masculino e 61,0% (IC95% 59,3-62,6) no sexo feminino. Observou-se aumento nas prevalências de uso com a idade (exceto de zero a quatro anos). As menores prevalências de uso ocorreram no grupo mais pobre e na região Norte do País. A prevalência de uso de medicamentos para doenças crônicas foi de 24,3% (IC95% 23,3-25,4) e para doenças agudas foi de 33,7% (IC95% 32,1-35,4).

CONCLUSÕES

Existe grande variabilidade nas prevalências globais de uso de medicamentos por regiões brasileiras. As regiões consideradas mais pobres (Norte, Nordeste e Centro-Oeste) apresentam menores prevalências de uso de medicamentos para doenças crônicas, o que indica a necessidade de minimizar as desigualdades no acesso aos medicamentos dentro do País.

Prevalence of self-medication in Brazil and associated factors

OBJECTIVE

To analyze the prevalence and associated factors regarding the use of medicines by self-medication in Brazil.

METHODS

This cross-sectional population-based study was conducted using data from the PNAUM (National Survey on Access, Use and Promotion of Rational Use of Medicines), collected between September 2013 and February 2014 by interviews at the homes of the respondents. All people who reported using any medicines not prescribed by a doctor or dentist were classified as self-medication practitioners. Crude and adjusted prevalence ratios (Poisson regression) and their respective 95% confidence intervals were calculated in order to investigate the factors associated with the use of self-medication by medicines. The independent variables were: sociodemographic characteristics, health conditions and access to and use of health services. In addition, the most commonly consumed medicines by self-medication were individually identified.

RESULTS

The self-medication prevalence in Brazil was 16.1% (95%CI 15.0-17.5), with it being highest in the Northeast region (23.8%; 95%CI 21.6-26.2). Following the adjusted analysis, self-medication was observed to be associated with females, inhabitants from the North, Northeast and Midwest regions and individuals that have had one, or two or more chronic diseases. Analgesics and muscle relaxants were the therapeutic groups most used for self-medication, with dipyrone being the most consumed medicines. In general, most of the medicines used for self-medication were classified as non-prescriptive (65.5%).

CONCLUSIONS

Self-medication is common practice in Brazil and mainly involves the use of non-prescription medicines; therefore, the users of such should be made aware of the possible risks.

OBJETIVO

Analisar a prevalência e os fatores associados à utilização de medicamentos por automedicação no Brasil.

MÉTODOS

Este estudo transversal de base populacional foi realizado com dados da Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de medicamentos (PNAUM), coletados de setembro de 2013 a fevereiro de 2014, por meio de entrevistas em domicílio. Todas as pessoas que referiram usar qualquer medicamento sem prescrição por médico ou dentista foram classificadas como praticantes de automedicação. Foram calculadas razões de prevalência bruta e ajustada (regressão de Poisson) e seus respectivos intervalos de confiança de 95% na investigação dos fatores associados ao consumo de medicamentos por automedicação. As variáveis independentes foram: aspectos sociodemográficos, de condições de saúde e de acesso e utilização de serviços de saúde. Adicionalmente, foram identificados os medicamentos mais consumidos por automedicação.

RESULTADOS

A prevalência da automedicação no Brasil foi de 16,1% (IC95% 15,0-17,5), sendo maior na região Nordeste (23,8%; IC95% 21,6-26,2). Após análise ajustada, automedicação mostrou-se associada a ser do sexo feminino, pertencer às faixas etárias 10-19 anos, 20-29 anos, 40-59 anos e 60 anos ou mais, residir na região Norte, Nordeste ou Centro-Oeste, e ter uma ou duas ou mais doenças crônicas. Os analgésicos e os relaxantes musculares foram os grupos terapêuticos mais utilizados por automedicação, sendo a dipirona o fármaco mais consumido. No geral, a maioria dos medicamentos usados por automedicação foram classificados como isentos de prescrição (65,5%).

CONCLUSÕES

A automedicação é prática corrente no Brasil e envolve, principalmente, o uso de medicamentos isentos de prescrição, devendo os usuários ficarem atentos aos seus possíveis riscos.