Use of medicines by persons with disabilities in São Paulo state areas, Southeastern Brazil

Impairments, health conditions and health risk behaviors: occurrence and associations, in the National Health Survey, Brazil, 2019

OBJECTIVE

To analyze association of visual, hearing, mental/intellectual, physical and multiple impairments with health conditions and health risk behaviors in Brazil.

METHODS

This was a cross-sectional study, using data from the 2019 National Health Survey; associations between impairments and presence of cardiovascular disease (CVD), hypertension, diabetes mellitus (DM), high cholesterol, alcohol abuse and smoking were estimated using logistic regression, thus obtaining the odds ratios (OR).

RESULTS

Impairment was reported by 7.6% of the 90,846 participants. Having a impairment was associated with greater odds of reporting chronic conditions, especially CVD (OR = 2.11; 95%CI 1.76;2.54) and DM (OR = 1.78; 95%CI 1.56;2.02 ); visual impairment was associated with greater odds of smoking (OR = 1.52; 95%CI 1.28;1.81); mental/intellectual impairment was inversely related to smoking (OR = 0.45; 95%CI 0.30;0.67) and alcohol abuse (OR = 0.13; 95%CI 0.06;0.26).

CONCLUSION

Having any of the impairments studied may be associated with greater odds of having chronic health conditions.

MAIN RESULTS

Positive association was identified between having one or more impairments, and health conditions and health risk behaviors. The higher the prevalence of mental/intellectual, physical and multiple impairments, the lower alcohol abuse and smoking.

IMPLICATIONS FOR SERVICES

As this population is vulnerable to chronic health conditions, health services need strategies to reduce barriers to access, as well as health promotion actions, such as health education, adapted for people with impairments.

PERSPECTIVES

Topics for future studies, examining the inverse relationship between impairments and alcohol abuse and smoking, in addition to acting on the causal chain, so as to prevent health conditions and health risk behaviors.

Health Policy on the pages of Revista de Saúde Pública

We carried out a narrative review of the scientific production in the area of Policy, Planning and Management in Revista de Saúde Pública (RSP), between 1967 and 2015. All the fascicles of RSP, in the period, were accessed via SciELO platform, which provides all articles online. We selected and classified the articles according to the main topics of scientific production in the area of Policy, Planning and Management. Revista de Saúde Pública has published 343 articles on this subject, with significant growth in the last two decades. The most discussed topics were Health Economics, Primary Health-care, Access and Use of Health Services, and Evaluation of Services and Programs. In the last decade, the topics of Policy and Access to Medicines and Public-Private Relationship, including judicialization, gained importance. The pages of RSP embraced the vast and diverse production of Policy, Planning and Management in its first 50 years, contributing to the consolidation of the area in Brazil. RESUMO Foi realizada revisão narrativa da produção científica do campo de Política, Planejamento e Gestão veiculada na Revista de Saúde Pública (RSP), entre 1967 e 2015. Todos os fascículos da RSP, no período, foram acessados via plataforma SciELO, que disponibiliza todos os artigos online. Foram selecionados e classificados os artigos segundo os principais temas da produção científica da área de Política, Planejamento e Gestão. Foram publicados 343 artigos, com crescimento expressivo nas últimas duas décadas. Economia da Saúde, Atenção Primária à Saúde, Acesso e Utilização de Serviços de Saúde e Avaliação de Serviços e Programas foram os temas mais abordados. Na última década, os temas Política e Acesso a Medicamentos e Relação Público-Privado, incluindo a judicialização, ganharam importância. As páginas da RSP abrigaram vasta e diversa produção de Política, Planejamento e Gestão nos seus primeiros 50 anos, contribuindo para consolidação da área no Brasil.

Medication Use in Adults with and without Hearing Impairment

The objective of this study was to determine whether hearing ability in adults is associated with medication use in general, the use of specific types of medication, or polypharmacy. In this exploratory study, data of the National Longitudinal Study on Hearing (NL-SH; n = 2,160) were used. In total, 62% of the participants reported using any medication in the past 28 days. Hearing ability in noise, as determined with an online digit-triplet speech-in-noise test, was significantly associated with (1) medication acting on the alimentary tract and metabolism (including diabetes and acid-related disorders), (2) use of calcium blockers, and (3) medication used for sensory organs.

Exploring medication use by blind patients in Saudi Arabia

OBJECTIVE

To explore the characteristics of medication use and challenges experienced by the blind patients.

METHODS

This cross-sectional descriptive study included blind persons living in Saudi Arabia who were at least 18 years of age. Participants were recruited through a number of nongovernmental blind associations (in the central, western, eastern regions), universities, social networks, and specialized websites for the blind. A questionnaire was designed and administered via face-to-face meetings with participants and made available online through Google Docs.

RESULTS

There were a total of 121 respondents of which 26 were excluded based on their ability to visually identify their medications or being <18 years old. The majority of the respondents were 18-29 years old (68%), 49% were male and 51% were female. Around 57% had a college degree while 27% had a high school degree. Diagnosis with a chronic disease was reported by 71 participants (79%, 5 missing). The most common diseases were diabetes and asthma (22%) followed by hypertension (17%). Most blind patients (75%) believed that physicians were the most reliable source of medication information. The medication information and services provided by pharmacists were viewed as inadequate by 46%. The most common challenges encountered by blind patients were linked to drug identification (75%), dose recognition (82%), and identification of expiration date (92%). A large number of patients had to rely on persons with normal vision for dispensing and administering the medications.

CONCLUSIONS

Pharmacists can no longer ignore the medication use problems encountered by the blind people. This study may serve as an initial step for planning improvements in pharmaceutical services provided to blind patients. The government, pharmaceutical companies and pharmacists must work in collaboration to address the special needs of the blind.

Associação entre deficiências físicas e hospitalizações na população da cidade de São Paulo, Brasil

O objetivo foi verificar a associação entre presença de deficiências físicas e hospitalizações na cidade de São Paulo, Brasil. Foi realizado inquérito de saúde na cidade de São Paulo em 2008. Utilizou-se processo de amostragem probabilística, estratificada (sexo/idade) e por conglomerados em dois estágios (setores censitários e domicílios). Os dados foram coletados por entrevistas por meio de um questionário estruturado, com 21 blocos, com a maioria das questões fechadas. A análise inferencial foi realizada com o uso de razões de prevalência (RP) bruta e ajustada e intervalo de 95% de confiança (IC95%) pelo método de regressão de Poisson. O módulo survey do programa Stata 9.2 foi usado para as análises, com significância de 5%. Foram entrevistadas 2.690 pessoas, com idade média de 38,75 anos (IC95%: 37,54-39,96). A hospitalização foi associada à deficiência (auditiva, RP = 1,59; física, RP = 3,77; múltipla, RP = 3,26). As pessoas com deficiência (auditiva, física - paralisia/amputação e múltipla) relataram internações com mais frequência que aquelas sem deficiência.

[Use of medication and associated factors: a population-based study in Campinas, São Paulo State, Brazil]

This article analyzes prevalence rates in the use of medication according to demographic, socioeconomic, and health-related behavioral variables through a population-based cross-sectional study of individuals 18 years and older (n=941) in Campinas, São Paulo State, Brazil. The study used multistage sampling, both stratified and cluster. Chi-square test was performed, and adjusted prevalence ratios were estimated by gender and age, both with 95% confidence intervals. A Poisson multiple regression model was developed, and the following factors were associated with use of medication: female gender, age 40 and over, reported illness in the previous two weeks, and number of chronic diseases. The most widely consumed drugs were for the cardiovascular and nervous systems, besides herbal remedies. Prevalence of medication in Campinas was lower than in most studies. Local health surveys could help identify drug use patterns and guarantee more appropriate interventions for pharmaceutical care policy.