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Luz TCB, de Castro AKS, Marques IC, Cota BB, Alves JDC, Law MR. Performance of a pharmaceutical services regionalization strategy policy in Minas Gerais, Brazil: Pre-post analysis from ERAF project. Front Pharmacol 2022; 13:953990. [PMID: 36120343 PMCID: PMC9478725 DOI: 10.3389/fphar.2022.953990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background: In 2016, the Brazilian state of Minas Gerais (∼20 million people), implemented the ERAF policy (“Regionalization Strategy of Pharmaceutical Services”) in an effort to improve medicine procurement and distribution within primary care. We evaluated the impact of the policy on three main goals: price reductions, volume increases, and expansion of therapeutic options. Methods: We analyzed the procurement data from the Integrated System of Management of Pharmaceutical Services database in 2012 and 2018. We estimated the volume, drug mix, and expenditure indicators for all major therapeutic classes, and, in detail, for cardiovascular and nervous system drugs. We evaluated the expenditure drivers using decomposition analyses. Results: Overall, the expenditure increased by 14.5%, drug mix almost doubled, while the volume decreased by a third. Cardiovascular and neurological system drugs followed similar patterns. Decomposition analyses showed that prices and drug mix had positive effects while the volume had negative effects, resulting in an overall increase in expenditure. Conclusion: Our findings suggest that the ERAF policy cannot be considered effective as it has not fulfilled its intended purposes so far. Strategies to address the identified problems and to build a platform for a more sustainable long-lasting policy should be put in place by the government.
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Affiliation(s)
- Tatiana Chama Borges Luz
- GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente), René Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil
- Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), Strathclyde University, Glasgow, United Kingdom
- *Correspondence: Tatiana Chama Borges Luz, ,
| | - Ana Karine Sarvel de Castro
- GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente), René Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil
| | - Isabela Cristina Marques
- GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente), René Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil
| | - Betania Barros Cota
- GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente), René Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil
| | - Jèssica de Castro Alves
- GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente), René Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil
| | - Michael Robert Law
- Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia, Vancouver, CO, Canada
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Hospital pharmacy management in a tertiary care charitable hospital: Compliance study with quality standards. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Ribeiro VRT, Marins LMS, Vieira ACV, Geraldo DS, Costa GG, Araujo RBD, Silva RPND, Guaraldo L, Torres TS. Guidelines for organization, operation and evaluation of clinical trials pharmacies in Brazil: a scope review. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022278.04052022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The development of new drugs depends on several scientific steps, which culminate in clinical trials. The clinical trials pharmacy (CTP) is the place for receiving, preparing, storing and dispensing the investigational product or study drug. Therefore, it must have infrastructure and procedures that guarantee participant safety and quality of research data. This study aimed to systematize guidelines for CTP in Brazil. We conducted a scope review and organized the results using the Ishikawa Method (6Ms). In total, 51 publications were selected for each “M”, 39 laws, regulations or guidelines and 12 scientific articles: 25 publications for pharmaceutical services (pharmacy procedures to ensure participant safety from investigational product ordering to final disposition), 14 for Quality Indicators, 12 for Human Resources, 11 for Infrastructure, 11 for Material Resources and 5 for Investigational Product. Our results synthesize information for the organization, operation and evaluation of CTP in Brazil, emphasizes the inclusion of the pharmacist within the clinical trials context, and contributes to preparation for monitoring, auditing, and inspections conducted by regulatory agencies.
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Ribeiro VRT, Marins LMS, Vieira ACV, Geraldo DS, Costa GG, Araujo RBD, Silva RPND, Guaraldo L, Torres TS. Guidelines for organization, operation and evaluation of clinical trials pharmacies in Brazil: a scope review. CIENCIA & SAUDE COLETIVA 2022; 27:3103-3116. [PMID: 35894322 DOI: 10.1590/1413-81232022278.04052022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 04/25/2022] [Indexed: 11/22/2022] Open
Abstract
The development of new drugs depends on several scientific steps, which culminate in clinical trials. The clinical trials pharmacy (CTP) is the place for receiving, preparing, storing and dispensing the investigational product or study drug. Therefore, it must have infrastructure and procedures that guarantee participant safety and quality of research data. This study aimed to systematize guidelines for CTP in Brazil. We conducted a scope review and organized the results using the Ishikawa Method (6Ms). In total, 51 publications were selected for each "M", 39 laws, regulations or guidelines and 12 scientific articles: 25 publications for pharmaceutical services (pharmacy procedures to ensure participant safety from investigational product ordering to final disposition), 14 for Quality Indicators, 12 for Human Resources, 11 for Infrastructure, 11 for Material Resources and 5 for Investigational Product. Our results synthesize information for the organization, operation and evaluation of CTP in Brazil, emphasizes the inclusion of the pharmacist within the clinical trials context, and contributes to preparation for monitoring, auditing, and inspections conducted by regulatory agencies.
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Affiliation(s)
- Valeria Rita Teixeira Ribeiro
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | - Luana Monteiro Spindola Marins
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | - Ana Carolina Vitorino Vieira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | - Debora Santana Geraldo
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | - Giovanna Giannini Costa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | - Renata Bastos de Araujo
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | - Robson Pierre Nascimento da Silva
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | - Lusiele Guaraldo
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | - Thiago Silva Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
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Luz TCB, Tavares NUL, de Castro AKS, Marques IC, Dos Santos EM, Cota BB. MedMinas project: design and use of mixed methods in the evaluation of pharmaceutical services in primary health care in Minas Gerais, Brazil. BMC Med Res Methodol 2022; 22:80. [PMID: 35346045 PMCID: PMC8962222 DOI: 10.1186/s12874-022-01568-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 02/25/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The main purposes of primary care-based pharmaceutical services (PHCPS) in Brazil are to provide free access to medicines and pharmaceutical care to patients. Several obstacles hinder achieving their goals; thus, MedMinas Project aimed to evaluate the PHCPS, the supply system, and the use of medicines. This paper reflects on our experience designing, planning, and conducting the project, describing the issues yielded in the field and lessons learned. METHODS This work consists of a mixed-methods study conducted in Minas Gerais, Southeastern Brazil. We adopted the principles of Rapid Evaluation Methods, employing a multistage stratified sampling for the quantitative and a purposeful sampling for the qualitative components, respectively, and a documentary research. Data sources included individuals (patients and professionals), prescriptions, dispensed medicines, and policy documents collected between April and October 2019. The quantitative data described in this paper were analysed by descriptive statistics and the qualitative by Thematic Content Analysis. RESULTS A total of 26 municipalities varying from 37,784 to 409,341 inhabitants were included. The field team spent, on average, 16 days in each location. We interviewed 1019 respondents, of which 127 were professionals and 892 patients. The participation rate varied from 92 to 100%, depending on the respondent subgroup. Most interviews lasted between 45 min and one hour. Fieldwork challenges included participants' enrolment, field team, interview processes, and project budget. The participants provided positive feedback and five main themes emerged from the interview experience (self-awareness, sense of gratitude, research value, access to findings, and benefits of the research). Additionally, we collected copies of 1072 documents and 2070 pieces of data from prescriptions filled and medicines dispensed at the PCP. CONCLUSION We demonstrated the viability of conducting the MedMinas Project in an extensive geographic area within effective time frames that provided meaningful, high-quality data from multiple actors. The methods and lessons learned are valuable for researchers across various disciplines in similar urban settings in Brazil and other countries of low- and middle-income (LMIC).
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Affiliation(s)
- Tatiana Chama Borges Luz
- GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente), Rene Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Ave, Barro Preto, Belo Horizonte, Minas Gerais, 30190-009, Brazil.
- Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), University of Strathclyde, Glasgow, G4 0RE, UK.
| | - Noemia Urruth Leão Tavares
- Department of Pharmacy, Faculty of Health Sciences, University of Brasília, Darcy Ribeiro University Campus, Asa Norte, Brasília, Distrito Federal, 70910-90, Brazil
| | - Ana Karine Sarvel de Castro
- GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente), Rene Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Ave, Barro Preto, Belo Horizonte, Minas Gerais, 30190-009, Brazil
| | - Isabela Cristina Marques
- GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente), Rene Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Ave, Barro Preto, Belo Horizonte, Minas Gerais, 30190-009, Brazil
| | - Elizabeth Moreira Dos Santos
- LASER (Laboratório de Avaliação de Situações Endêmicas Regionais), National School of Public Health Sérgio Arouca (ENSP), Oswaldo Cruz Foundation (FIOCRUZ), 1480 Leopoldo Bulhões St, Manguinhos, Rio de Janeiro, 21041-210, Brazil
| | - Betania Barros Cota
- GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente), Rene Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Ave, Barro Preto, Belo Horizonte, Minas Gerais, 30190-009, Brazil
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Chaves ZJL, Silva LS, Nascimento RCRMD. Public Programs for Essential Medicine Access in a Small Municipality: A Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.36660/ijcs.20200287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Barbosa MM, Moreira TA, Nascimento RC, Nascimento MM, Acurcio FA, Godman B, Guerra AA, Alvares-Teodoro J. Access to medicines in the Brazilian Unified Health System's primary health care: assessment of a public policy. J Comp Eff Res 2021; 10:869-879. [PMID: 34032143 DOI: 10.2217/cer-2021-0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In 2008, the Programa Rede Farmácia de Minas (RFM, literally translated: 'Minas Gerais Pharmacy Network' program) was created as a strategy to expand access to medicines. Aim: Measure access to medicines in public pharmacies through comparison between municipalities that joined or not the RFM. Materials & methods: Cross-sectional, evaluative study, gathering information from a representative sample of the municipalities in Minas Gerais between July 2014 and May 2015. The Poisson regression results were obtained by calculating the prevalence ratios. Results: Adequate access to medicines in Minas Gerais was 69.9%, being 75.8% in municipalities with and 69.2% without the RFM. The municipalities with the RFM showed statistically higher percentages in the Availability, Adequacy/Accommodation, and Acceptability dimensions. Conclusion: RFM appears an efficient strategy for promoting access to medicines.
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Affiliation(s)
- Mariana M Barbosa
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Thais A Moreira
- School of Medicine, Postgraduate Program in Public Health Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Renata Crm Nascimento
- School of Pharmacy, Department of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Mariana Mg Nascimento
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Francisco A Acurcio
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Brian Godman
- Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK.,Health Economics Centre, University of Liverpool Management School, Liverpool, UK.,Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden.,School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, Pretoria, South Africa
| | - Augusto A Guerra
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Juliana Alvares-Teodoro
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Barbosa MM, Nascimento RC, Garcia MM, Acurcio FA, Godman B, Guerra AA, Alvares-Teodoro J. Strategies to improve the availability of medicines in primary health care in Brazil: findings and implications. J Comp Eff Res 2021; 10:243-253. [PMID: 33541125 DOI: 10.2217/cer-2020-0125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Aim: Access to essential medicines is a key component of managing patients in ambulatory care. In 2008, the State of Minas Gerais, Brazil, created the Pharmacy Network of Minas (Rede Farmácia de Minas [RFM]) program to improve access to medicines, increasing availability and restructuring the infrastructures. The aim was to assess the current situation, comparing municipalities with and without RFM. Materials & methods: Descriptive survey study, data collected from 2014 July to May 2015. Availability was verified by stock levels. Results: The drug availability index was 61.0%, higher in municipalities with RFM. Most physicians considered the pharmaceutical services as good/very good. The main reasons for medicines shortage were 'financial transference problems', 'insufficient financial resources' and 'budget'. Conclusion: Strategies, such as the RFM can promote improvements in medicine availability.
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Affiliation(s)
- Mariana M Barbosa
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Renata Crm Nascimento
- School of Pharmacy, Department of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Marina M Garcia
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Francisco A Acurcio
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Brian Godman
- Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK.,Health Economics Centre, University of Liverpool Management School, Liverpool, UK.,Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, SE 141 86, Sweden.,School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, Pretoria, South Africa
| | - Augusto A Guerra
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Juliana Alvares-Teodoro
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Moreira T, Alvares-Teodoro J, Barbosa MM, Do Nascimento RCRM, Guerra Júnior AA, Acurcio FA. Polypharmacy among adult and older adult users of primary care services delivered through the Unified Health System in Minas Gerais, Brazil. Expert Rev Clin Pharmacol 2020; 13:1401-1409. [PMID: 33054470 DOI: 10.1080/17512433.2020.1836958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To estimate the prevalence of polypharmacy (≥5 drugs) among adults and to analyze related factors. METHODS Cross-sectional study with 1,159 interviewees distributed across 104 cities and 253 primary healthcare services delivered through the Brazilian Unified Health System. Polypharmacy-related factors were identified using logistic regression model. RESULTS 949 (81.8%) interviewees were using at least one medication and were included in this analysis. The prevalence of polypharmacy among them was 13.7% (95%CI:11.7-16.0%) in the general population and 33.3%(95%CI:26.1-41.4%) in older adults(≥65 years). Polypharmacy was positively associated with age (45 to 64 years, OR=2.02; 95%CI:1.03-3.94; ≥65 years, OR=4.17; 95%CI:1.92-9.17) and the following chronic diseases: stroke (OR=4.20; 95%CI:1.53-11.55); diabetes mellitus (OR=4.03; 95%CI:2.43-6.68); heart disease (OR=3.18; 95%CI:1.92-5.29); depression (OR=2.85; 95%CI:1.80-4.53); hypertension (OR=2.13; 95%CI:1.17-3.86); and dyslipidemia (OR=1.73; 95%CI:1.07-2.80). CONCLUSION This study revealed that polypharmacy is a real concern in primary health care and affects older and middle-aged adults alike. Groups of patients that are more likely to experience polypharmacy were identified. Our findings emphasize the relevance of an appropriate approach to polypharmacy driven by aging and multimorbidity.
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Affiliation(s)
- Thais Moreira
- Postgraduate Program in Public Health, Federal University of Minas Gerais , Belo Horizonte, Brazil
| | - J Alvares-Teodoro
- Department of Social Pharmacy, Federal University of Minas Gerais , Belo Horizonte, Brazil
| | - M M Barbosa
- Department of Social Pharmacy, Federal University of Minas Gerais , Belo Horizonte, Brazil
| | | | - A A Guerra Júnior
- Department of Social Pharmacy, Federal University of Minas Gerais , Belo Horizonte, Brazil
| | - F A Acurcio
- Postgraduate Program in Public Health, Federal University of Minas Gerais , Belo Horizonte, Brazil.,Department of Social Pharmacy, Federal University of Minas Gerais , Belo Horizonte, Brazil
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Moreira TDA, Alvares-Teodoro J, Barbosa MM, Guerra Júnior AA, Acurcio FDA. Use of medicines by adults in primary care: Survey on health services in Minas Gerais, Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200025. [PMID: 32401914 DOI: 10.1590/1980-549720200025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/09/2020] [Indexed: 12/18/2022] Open
Abstract
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.
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Affiliation(s)
- Thais de Abreu Moreira
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Juliana Alvares-Teodoro
- Departamento de Farmácia Social, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Mariana Michel Barbosa
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Augusto Afonso Guerra Júnior
- Departamento de Farmácia Social, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Francisco de Assis Acurcio
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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11
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Garcia MM, Barbosa MM, Silva RM, Reis EA, Alvares J, Assis Acurcio FD, Godman B, Guerra Junior AA. Indicator of access to medicines in relation to the multiple dimensions of access. J Comp Eff Res 2019; 8:1027-1041. [DOI: 10.2217/cer-2019-0031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Aim: Creation of a single indicator of access to medicines. Methods: Data collection was performed with individuals who obtained their medication from either public and/or private pharmacies. A Likert scale was used to measure the importance and satisfaction in relation to various access dimensions. Results: A total of 580 individuals were interviewed. Overall, participants attributed very similar importance scores to the dimensions of access to medicines. The results of the mean score of each dimension showed a statistically significant difference according to the type of pharmacy that the participant visited. Conclusion: This developed indicator will enable a review of access to medicines, making comparisons possible as well as improving decision making about public policies in the field of Pharmaceutical Services.
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Affiliation(s)
- Marina M Garcia
- Federal University of Minas Gerais, Department of Social Pharmacy, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Mariana M Barbosa
- Federal University of Minas Gerais, Department of Social Pharmacy, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Rondineli M Silva
- Sérgio Arouca National School of Public Health of the Oswaldo Cruz Foundation, Department of Drug Policy and Pharmaceutical Assistance, St Leopoldo Bulhões, Room 622–632, Rio de Janeiro, 21041-210, Brazil
| | - Edna A Reis
- Federal University of Minas Gerais, Department Institute of Exact Sciences, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Juliana Alvares
- Federal University of Minas Gerais, Department of Social Pharmacy, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Francisco de Assis Acurcio
- Federal University of Minas Gerais, Department of Social Pharmacy, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK
- Health Economics Centre, University of Liverpool Management School, Liverpool, UK
- Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Gauteng, South Africa
| | - Augusto A Guerra Junior
- Federal University of Minas Gerais, Department of Social Pharmacy, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
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