Medicine use among adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study

Healthcare utilisation in overweight and obese children: a systematic review and meta-analysis

OBJECTIVE

This systematic review and meta-analysis aims to systematically analyse the association of overweight and obesity with health service utilisation during childhood.

DATA SOURCES

PubMed, MEDLINE, CINAHL, EMBASE and Web of Science.

METHODS

Observational studies published up to May 2020 that assessed the impact of overweight and obesity on healthcare utilisation in children and adolescents were included. Studies were eligible for inclusion if the included participants were ≤19 years of age. Findings from all included studies were summarised narratively. In addition, rate ratios (RRs) and 95% CIs were calculated in a meta-analysis on a subgroup of eligible studies.

OUTCOME MEASURES

Included studies reported association of weight status with healthcare utilisation measures of outpatient visits, emergency department (ED) visits, general practitioner visits, hospital admissions and hospital length of stay.

RESULTS

Thirty-three studies were included in the review. When synthesising the findings from all studies narratively, obesity and overweight were found to be positively associated with increased healthcare utilisation in children for all the outcome measures. Six studies reported sufficient data to meta-analyse association of weight with outpatient visits. Five studies were included in a separate meta-analysis for the outcome measure of ED visits. In comparison with normal-weight children, rates of ED (RR 1.34, 95% CI 1.07 to 1.68) and outpatient visits (RR 1.11, 95% CI 1.02 to 1.20) were significantly higher in obese children. The rates of ED and outpatient visits by overweight children were only slightly higher and non-significant compared with normal-weight children.

CONCLUSIONS

Obesity in children is associated with increased healthcare utilisation. Future research should assess the impact of ethnicity and obesity-associated health conditions on increased healthcare utilisation in children with overweight and obesity.

PROSPERO REGISTRATION NUMBER

CRD42018091752.

[Physical activity, screen time, and use of medicines among adolescents: the 1993 Pelotas (Brazil) birth cohort study]

This study aimed to evaluate cross-sectional and longitudinal associations between physical activity, screen time, and use of medicines among adolescents from the 1993 Pelotas (Brazil) birth cohort study, followed at 11 (N = 4,452), 15 (N = 4,325), and 18 years of age (N = 4,106). The study recorded the use of medicines in the previous 15 days, continuous use of some medication, level of physical activity (by questionnaire and accelerometry), and screen time (TV, computer, and videogame). One-third of adolescents had used at least one medicine in the previous 15 days and approximately 10% were on some continuous medication. In the adjusted analysis, the results showed that higher levels of physical activity at 18 years and less screen time at 15 years in boys were associated with lower overall use of medicines (p < 0.05). For boys, physical activity at 11 and 18 years were inversely related to continuous medication (p < 0.05). More physically active boys and those with less screen time in adolescence showed lower use of medicines at 18 years of age.

Self-medication practices and risk factors for self-medication among medical students in Belgrade, Serbia

Introduction

Self-medication among future health care professionals can represent a serious threat to professionalism in medicine and it has potential to put at risk public trust into this profession. The aim of this research was to investigate prevalence and risk factors for self-medication among population of medical students, because it was previously shown that their attitudes towards pharmacotherapy could affect the way they could prescribe medication in the future.

Material and Methods

Research was performed as a cross-sectional study and it included 1296 (84.1%) 1st, 3rd and 6th year students of School of Medicine, University of Belgrade. Students filled out a demographic and self-medication questionnaire created for the purpose of this research and the Physical Health Questionnaire – 9 (PHQ-9). Questions about self-medication were related to the period of the previous year.

Results

Self-medication was reported by 79.9% students. The most frequently self-prescribed medications were analgesics (55.4%). Independent risk factors for self-medication were possession of home-pharmacies (OR = 5.3, CI 95% 3.89–7.23), lower level of father's education (OR = 1.6, CI 95% 1.18–2.25), consumption of alcoholic beverages (OR = 1.5, CI 95% 1.13–2.08), less than 1 hour spent in physical activity per week (OR = 1.4, CI 95% 1.00–2.02), female gender (OR = 1.4, CI 95% 1.02–1.89), older age (OR = 1.1, CI 95% 1.07–1.21) and higher PHQ-9 score (OR = 1.09, CI 95% 1.05–1.12).

Conclusions

Self-medication is an important issue among population of medical students. Prevalence of self-medication could be controlled through regulatory authorities and further education.

Self-medication among adolescents aged 18 years: the 1993 Pelotas (Brazil) birth cohort study

PURPOSE

To estimate the point prevalence of self-medication among adolescents aged 18 years and to evaluate the type of drugs used (either over-the-counter or prescription drugs) and socioeconomic, health-related, and behavioral correlates of self-medication.

METHODS

This cross-sectional study used data from the 1993 Pelotas (Brazil) Birth Cohort Study. Data were obtained through the administration of a questionnaire to adolescents aged 18 years. The outcome variables were point prevalence of medicine use and self-medication collected by self-report. The independent variables studied were gender, continuous medicine use, socioeconomic status, schooling, self-rated health, body mass index, and physical activity levels. Medicines were classified into therapeutic groups according to the Anatomical Therapeutic Chemical classification system.

RESULTS

A total of 4,106 adolescents were interviewed. The point prevalence of medicine use was 41.1% (95% confidence interval [CI] 39.6-42.6), and the proportion of self-medication among medicine users was 65.1% (95% CI 62.8-67.4). The point prevalence of self-medication was 26.7% (95% CI 25.4-28.1), and it was higher among female adolescents, those more educated, and those who rated their health as poor. Out of the drugs used for self-medication (58% of all drugs used), 1,003 (78.7%) were nonprescription drugs and 271 (21.3%) were prescription drugs. The most frequently used drugs for self-medication were analgesics (56.1%), systemic antihistamines (7.4%), and anti-inflammatory and antirheumatic products (7.1%).

CONCLUSIONS

A high point prevalence of self-medication was found among adolescents, which is particularly concerning due to high use of prescription drugs for self-medication. Interventions are needed to promote rational use of medicines in this population.

Consumo de medicamentos, álcool e fumo na gestação e avaliação dos riscos teratogênicos

Medicações, álcool e fumo podem gerar danos fetais. Este estudo transversal foi realizado entre 2006 e 2007, com 326 puérperas do Hospital Geral de Fortaleza, para avaliar o uso de medicamentos, álcool e fumo na gestação e potencial teratogênico relacionado a diferentes características populacionais. Incluíram-se as puérperas com partos no local da pesquisa e excluíram-se as que não tinham seus filhos internados. Na análise, utilizaram-se os testes Qui-quadrado e t de Student, adotando p < 0,05. O consumo de medicamentos ocorreu em 96,6% (2,8 medicamentos/gestante), e 11,3% automedicaram-se. Solteiras utilizaram mais medicações com alto risco teratogênico (p = 0,037). Foram observados 11 casos de malformação fetal, sendo cinco expostos a elevado risco teratogênico, na gestação. O tabagismo ocorreu em 11,3%, e o etilismo em 16%. Observou-se como fator de risco para exposição a maior risco teratogênico o estado civil solteira. Outras variáveis sociodemográficas e a qualidade do pré-natal não se mostraram relacionadas ao risco teratogênico das exposições.

Tracking of medicine use and self-medication from infancy to adolescence: 1993 Pelotas (Brazil) birth cohort study

PURPOSE

To track the use of medicine and self-medication from infancy to adolescence.

METHODS

All newborns in the city of Pelotas, Brazil, were monitored and enrolled in the 1993 Pelotas (Brazil) Birth Cohort Study. Subsamples of the cohort were visited at 1, 3, and 6 months and at 1 and 4 years of age. At 11 and 15 years of age, all cohort members were sought. In each of these visits, information on medicine use in the 15 days before the interview was collected. Two outcomes were analyzed: prevalence of medicine use and prevalence of self-medication.

RESULTS

Prevalence of medicine use in the first year of life ranged from 52.0% to 68.6%. From 4 to 15 years of age, the prevalence decreased, ranging from 30.9% to 37.2%. At age 15, girls presented a 33% higher prevalence of medicine use than boys. The proportion of self-medication ranged from 12.4% to 29.0% and was higher in girls aged 11 and 15 years than boys of the same age. In all follow-up periods, use of medicines was significantly higher among children who used medicines in the earlier period. Prevalence of self-medication was higher among those who were self-medicated in the previous periods.

CONCLUSIONS

Tracking studies are important to public health because they can predict future behavior by analyzing past behavior, thus helping in designing preventive actions. In this study, previous use of medicines predicts future use, thus creating an opportunity to plan actions that promote the rational use of medicines.