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Freire MDBO, Da Silva BGC, Bertoldi AD, Fontanella AT, Mengue SS, Ramos LR, Tavares NUL, Pizzol TDSD, Arrais PSD, Farias MR, Luiza VL, Oliveira MA, Menezes AMB. Benzodiazepines utilization in Brazilian older adults: a population-based study. Rev Saude Publica 2022; 56:10. [PMID: 35319670 PMCID: PMC8926397 DOI: 10.11606/s1518-8787.2022056003740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/04/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To evaluate the utilization of benzodiazepines (BZD) in Brazilian older adults, based on the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey of Access, Use and Promotion of Rational Use of Medicines). METHODS The PNAUM is a cross-sectional study conducted between 2013 and 2014, representing the Brazilian urban population. In the present study, we included 60 years or older (n = 9,019) individuals. We calculated the prevalence of BZD utilization in the 15 days prior to survey data collection according to independent variables, using a hierarchical Poisson regression model. A semistructured interview performed empirical data collection (household interview). RESULTS The prevalence of BZD utilization in the older adults was 9.3% (95%CI: 8.3–10.4). After adjustments, BZD utilization was associated with female sex (PR = 1.88; 95%CI: 1.52–2.32), depression (PR = 5.31; 95%CI: 4.41–6, 38), multimorbidity (PR = 1.44; 95%CI: 1.20–1.73), emergency room visit or hospitalization in the last 12 months (PR = 1.42; 95%CI: 1.18–1.70 ), polypharmacy (PR = 1.26; 95%CI: 1.01–1.57) and poor or very poor self-rated health (PR = 4.16; 95%CI: 2.10–8.22). Utilization was lower in the North region (PR = 0.18; 95%CI: 0.13–0.27) and in individuals who reported abusive alcohol consumption in the last month (PR = 0.42; 95%CI: 0.19–0.94). CONCLUSION Despite contraindications, results showed a high prevalence of BZD utilization in older adults, particularly in those with depression, and wide regional and sex differences.
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Affiliation(s)
- Marina de Borba Oliveira Freire
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia . Pelotas , RS , Brasil
| | | | - Andréa Dâmaso Bertoldi
- Universidade Federal de Pelotas . Faculdade de Medicina . Departamento de Medicina Social . Pelotas , RS , Brasil
| | - Andréia Turmina Fontanella
- Universidade Federal do Rio Grande do Sul . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia . Porto Alegre , RS , Brasil
| | - Sotero Serrate Mengue
- Universidade Federal do Rio Grande do Sul . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia . Porto Alegre , RS , Brasil
| | - Luiz Roberto Ramos
- Universidade Federal de São Paulo . Escola Paulista de Medicina . Departamento de Medicina Preventiva . São Paulo , SP , Brasil
| | - Noemia Urruth Leão Tavares
- Universidade de Brasília . Faculdade de Ciências da Saúde . Departamento de Farmácia . Brasília , DF , Brasil
| | - Tatiane da Silva Dal Pizzol
- Universidade Federal do Rio Grande do Sul . Faculdade de Farmácia . Departamento de Produção e Controle de Medicamentos . Porto Alegre , RS , Brasil
| | - Paulo Sérgio Dourado Arrais
- Universidade Federal do Ceará . Faculdade de Farmácia, Odontologia e Enfermagem . Departamento de Farmácia . Fortaleza , CE , Brasil
| | - Mareni Rocha Farias
- Universidade Federal de Santa Catarina . Centro de Ciências da Saúde . Departamento de Ciências Farmacêuticas . Florianópolis , SC , Brasil
| | - Vera Lucia Luiza
- Fundação Oswaldo Cruz . Escola Nacional de Saúde Pública Sergio Arouca . Departamento de Política de Medicamentos e Assistência Farmacêutica . Rio de Janeiro , RJ , Brasil
| | - Maria Auxiliadora Oliveira
- Fundação Oswaldo Cruz . Escola Nacional de Saúde Pública Sergio Arouca . Departamento de Política de Medicamentos e Assistência Farmacêutica . Rio de Janeiro , RJ , Brasil
| | - Ana Maria Baptista Menezes
- Universidade Federal de Pelotas . Faculdade de Medicina . Departamento de Medicina Social . Pelotas , RS , Brasil
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Mengue SS, Tierling VL, Tavares NUL, Fontanella AT. Sources of medicines for hypertension and diabetes in Brazil: results from the National Health Survey. CAD SAUDE PUBLICA 2022; 38Suppl 1:e00152721. [DOI: 10.1590/0102-311x00152721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/23/2022] [Indexed: 11/21/2022] Open
Abstract
This study aims to analyze the sources people over 18 years of age use to obtain medication for the treatment of hypertension and diabetes, according to sociodemographic characteristics from 2013 to 2019. Data from the Brazilian National Health Survey were analyzed. Most individuals with diagnosis and prescription to pharmacological treatment reported obtaining medicines exclusively from one type of source. The percentage of people who acquired hypertension medicine exclusively from public pharmacies decreased, from 24.5% in 2013 to 16.2% in 2019; while there was an increase in those obtaining from the Popular Pharmacy program, from 23.5% to 31.4%; as well as for out-of-pocket payment, which rose from 30.9% to 35.5% The percentage of people who acquired diabetes medication exclusively from public pharmacies increased from 7.4% to 18.6% and with out-of-pocket payment increased from 21.6% to 26.8%, while the percentage of those who acquired from the Popular Pharmacy program decreased from 47.2% to 36.4%. The percentage of those who acquired medication from various sources decreased for both hypertension and diabetes. For men, white, and those with higher education, the source of medication acquisition, for both conditions, was mostly by out-of-pocket payment. The high number of medicine acquisition from public sources represents an advance in Brazil’s response to the treatment of these conditions, but reducing regional differences still represents a challenge to be overcome by the healthcare system.
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Rodrigues PS, Francisco PMSB, Fontanella AT, Costa KS. Free acquisition of psychotropic drugs by the Brazilian adult population and presence on the National List of Essential Medicines. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Costa ÂK, Bertoldi AD, Fontanella AT, Ramos LR, Arrais PSD, Luiza VL, Mengue SS, Nunes BP. Does socioeconomic inequality occur in the multimorbidity among Brazilian adults? Rev Saude Publica 2021; 54:138. [PMID: 33331530 PMCID: PMC7703529 DOI: 10.11606/s1518-8787.2020054002569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/19/2020] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To assess the prevalence of multimorbidity among Brazilian adults and its association with socioeconomic indicators. METHODS Cross-sectional study that used data from the Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM - Brazilian National Survey on Access, Use and Promotion of Rational Use of Medicines), carried out between 2013 and 2014. The definition of multimorbidity was the coexistence, in a single individual, of two or more chronic diseases, measured through a list of 14 morbidities (self-reported medical diagnosis throughout life). Economic status and educational level were the socioeconomic indicators used, being the inequalities assessed through the Slope Index of Inequality (SII) and the Concentration Index, stratified by gender. RESULTS The study comprehended 23,329 adults (52.8% of which were women), with an average age of 37.9 years. Hypertension and high cholesterol levels were the most prevalent conditions. The prevalence of multimorbidity was of 10.9% (95%CI 10.1-11.7) representing nearly 11 million individuals in Brazil, of which 14.5% (95%CI 13.5-15.4) were women and 6.8% (95%CI 5.9-7.8) were men. The occurrence of multimorbidity was similar according to the socioeconomic indicators. In the inequality analysis, we observed absolute and relative differences in men with a higher purchasing power (SII = 3.7; 95%CI 0.3-7.0) and higher educational level (CIX = 7.1; 95%CI 0.9-14.7), respectively. CONCLUSIONS The frequency of comorbidities in Brazilian adults is high, especially in absolute terms. We only observed socioeconomic inequalities in multimorbidities among men.
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Affiliation(s)
- Ândria Krolow Costa
- Universidade Federal de Pelotas. Faculdade de Enfermagem. Programa de Pós-Graduação em Enfermagem. Pelotas, RS, Brasil
| | - Andréa Dâmaso Bertoldi
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Andréia Turmina Fontanella
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Luiz Roberto Ramos
- Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil
| | | | - Vera Lucia Luiza
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro, RJ, Brasil
| | - Sotero Serrate Mengue
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Bruno Pereira Nunes
- Universidade Federal de Pelotas. Faculdade de Enfermagem. Departamento de Enfermagem em Saúde Coletiva. Pelotas, RS, Brasil
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Rodrigues PS, Francisco PMSB, Fontanella AT, Borges RB, Costa KS. Use and sources of psychotropic drugs by Brazilian adults and seniors. Cien Saude Colet 2020; 25:4601-4614. [PMID: 33175066 DOI: 10.1590/1413-812320202511.35962018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 02/22/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to estimate the prevalence of psychotropic drug utilization among adults and seniors and determine associated factors, therapeutic classes and sources of acquisition. Data from the Brazilian National Survey on Access, Use and Promotion of the Rational Use of Medicines (2013-2014) were analyzed. The prevalence of use of at least one psychotropic drug in the overall sample (adults and seniors) was 8.7%. In the adjusted analyses, positive associations were found between the use of psychotropic drugs and the female sex, poorer self-rated health and chronic diseases (p < 0.05). The most frequently used therapeutic classes were antidepressants (55.3%) by the adults and anxiolytics (59.3%) by the seniors. Approximately 23.0% of psychotropic drugs were obtained exclusively from pharmacies of the public healthcare system and 77.0% were acquired from other sources. The findings reveal a low proportion of attaining psychotropic drugs through the Brazilian public healthcare system as well as the need for public policies that encourage the rational use of prescriptions and treatments to promote a better quality of life and ensure the population's right to health.
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Affiliation(s)
- Patrícia Silveira Rodrigues
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Campinas (UNICAMP). R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
| | - Priscila Maria Stolses Bergamo Francisco
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Campinas (UNICAMP). R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil. .,Faculdade de Ciências Médicas, UNICAMP. Campinas SP Brasil
| | - Andréia Turmina Fontanella
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre RS Brasil
| | - Rogério Boff Borges
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre RS Brasil
| | - Karen Sarmento Costa
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Campinas (UNICAMP). R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil. .,Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre RS Brasil
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Pereira LB, Gonçalves AMRF, Fernandes CSE, Fontanella AT, Francisco PMSB, Mengue SS, Borges RB, Pizzol TDSD, Costa KS. Use of drugs for gastrointestinal disorders: evidence from National Survey on Access, Use and Promotion of Rational Use of Medicines. Einstein (Sao Paulo) 2020; 18:eAO5314. [PMID: 32785451 PMCID: PMC7416649 DOI: 10.31744/einstein_journal/2020ao5314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/12/2019] [Indexed: 11/10/2022] Open
Abstract
Objective To estimate the prevalence of use of drugs to treat gastrointestinal disorders, according to demographic, socioeconomic, and health characteristics of the Brazilian population. Methods This is a population-based survey that interviewed individuals residing in cities of the five regions in Brazil. The study sample was composed of 32,348 individuals aged 20 or more years. The profile of use of drugs for gastrointestinal disorders was evaluated considering the variables sex, age, healthcare plan, region, and number of chronic diseases. We also analyzed the frequency of individuals who declared using other drugs, besides those already employed for treatment of gastrointestinal disorders. Additionally, the estimated frequencies of the drug classes used were determined. Results The prevalence of use of drugs for gastrointestinal disorders in Brazil was 6.9% (95% confidence interval − 6.4-7.6), higher in females, among persons aged over 60 years, in those who had a private healthcare insurance, and presented with two or more chronic diseases. It was noted that 42.9% of the aged who used drugs for gastrointestinal disorders were also on polypharmacy. As to the classes of drugs, 82% corresponded to drugs for the food tract and metabolism, particularly proton pumps inhibitors. Conclusion The use of drugs for treatment of gastrointestinal disorders was significant among women and elderly. In this age group, consumption may be linked to gastric protection due to polypharmacy. This study is an unprecedented opportunity to observe the self-reported consumption profile of these drugs in Brazil and, therefore, could subsidize strategies to promote their rational use.
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Affiliation(s)
- Lucas Borges Pereira
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | | | - Andréia Turmina Fontanella
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Sotero Serrate Mengue
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rogério Boff Borges
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Tatiane da Silva Dal Pizzol
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Karen Sarmento Costa
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Ramos LR, Mari JDJ, Fontanella AT, Pizzol TDSD, Bertoldi AD, Mengue SS. Nationwide use of psychotropic drugs for treatment of self-reported depression in the Brazilian urban adult population. Rev Bras Epidemiol 2020; 23:e200059. [PMID: 32578675 DOI: 10.1590/1980-549720200059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 01/07/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Antidepressant use is increasing worldwide, but national data on psychotropic drug use by depressed patients in Brazil is lacking. METHODOLOGY Between 2013 and 2014, a representative sample of urban adult individuals were asked if they had a diagnosis of chronic disease, had a medical indication for drug treatment, and were taking chronic medications at the time for each reported diagnosis. We analyzed the frequencies of reported depression and the medications related to this disease. RESULTS Overall, 6.1% of respondents reported depression. The prevalence increased with age - 9.5% among the elders - was higher among women (8.9%) and in the south of the country (8.9%). As a single disease, the prevalence of depression was higher among young people (17.6%). Among those with multimorbidity, the prevalence of depression rose to 25.7%. Of those who reported depression, 81.3% had medical indication for treatment and 90.3% were under treatment - this proportion was lower among young people (84.5%) and those living in the poorest region (78.6%). Antidepressants accounted for 47.2% of psychotropic drugs taken by respondents with depression, with regional differences - only 30% used antidepressants in the North. Polypharmacy was reported by 22% of those with depression and other chronic diseases. CONCLUSION Depression in Brazil, is common among young adults as a single chronic disease and highly prevalent among people with chronic multimorbidity, especially the young. The treatment gap was larger among young people and in the less developed regions of the country.
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Affiliation(s)
- Luiz Roberto Ramos
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo (SP), Brazil
| | - Jair de Jesus Mari
- Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo (SP), Brazil
| | - Andréia Turmina Fontanella
- Graduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil
| | - Tatiane da Silva Dal Pizzol
- Department of Drug Manufacturing and Control, School of Pharmacy, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil
| | - Andréa Dâmaso Bertoldi
- Department of Social Medicine, School of Medicine, Universidade Federal de Pelotas - Pelotas (RS), Brazil
| | - Sotero Serrate Mengue
- Graduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil
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Luiza VL, Mendes LVP, Tavares NUL, Bertoldi AD, Fontanella AT, Oliveira MA, Campos MR. Inappropriate use of medicines and associated factors in Brazil: an approach from a national household survey. Health Policy Plan 2020; 34:iii27-iii35. [PMID: 31816070 PMCID: PMC6901078 DOI: 10.1093/heapol/czz038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2019] [Indexed: 11/20/2022] Open
Abstract
This article aims to describe the inappropriate use of medicines in the Brazilian urban population and to identify associated factors. We conducted a data analysis of a household survey carried out in Brazil in 2013–14. The sampling plan was done by clusters with representativeness of the urban population and large regions of the country, according to gender and age domains. For this analysis, we considered a sample of adults (≥20 years) who reported having chronic non-communicable diseases, medical indication for drug treatment and medicine use (n = 12 283). We evaluated the prevalence of inappropriate use in the domains: non-adherence, inappropriate use behaviour and inadequate care with medicines, all verified in the following groups of independent variables: demographic and socio-economic characteristics, health and pharmaceutical care, health status and use of medicines. Crude and adjusted prevalence ratios were obtained using robust Poisson regression. It was found 46.1% of people having at least one behaviour of inappropriate use of medicines. The worst results were found for the domain of inappropriate use behaviour, a situation of 36.6% of the users, which included unauthorized prescriber, inadequate source of information and indication of the medicines by non-authorized prescribers. The best result was found for the lack of medicines care, informed by only 4.6% of users who kept expired drugs at home. The inappropriate use of medicines was associated with gender (female), region of residence (Northeast), not visiting the doctor regularly or visiting more than one doctor, not having free access to medicines and using of five or more medicines. There was a high prevalence of inappropriate use, which was associated with both individual and health system characteristics pointing out the need to set priorities as for health education and public interventions.
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Affiliation(s)
- Vera Lucia Luiza
- Department of Medicines and Pharmaceutical Policies, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, 1480 Rua Leopoldo Bulhões # 624 or 632, Manguinhos, ZC 21041-210, Rio de Janeiro, RJ, Brazil
| | - Luiz Villarinho Pereira Mendes
- Department of Medicines and Pharmaceutical Policies, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, 1480 Rua Leopoldo Bulhões # 624 or 632, Manguinhos, ZC 21041-210, Rio de Janeiro, RJ, Brazil
| | - Noemia Urruth Leão Tavares
- Pharmacy Department, Health Science School, University of Brasília (UnB), Campus Darcy Ribeiro, Asa Norte, Brasilia, DF, 70910-900, Brazil
| | - Andrea Damaso Bertoldi
- Department of Social Medicine, School of Medicine, Postgraduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro Street, Pelotas, RS, 96020-220, Brazil
| | - Andréia Turmina Fontanella
- Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos Street, Porto Alegre, RS, 90.035-003, Brazil
| | - Maria Auxiliadora Oliveira
- Department of Medicines and Pharmaceutical Policies, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, 1480 Rua Leopoldo Bulhões # 624 or 632, Manguinhos, ZC 21041-210, Rio de Janeiro, RJ, Brazil
| | - Mônica Rodrigues Campos
- Department of Social Sciences, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, 1480 Rua Leopoldo Bulhões # 624 or 632, Manguinhos, ZC 21041-210, Rio de Janeiro, RJ, Brazil
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da Silva Dal Pizzol T, Turmina Fontanella A, Cardoso Ferreira MB, Dâmaso Bertoldi A, Boff Borges R, Serrate Mengue S. Correction: Analgesic use among the Brazilian population: Results from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM). PLoS One 2020; 15:e0229039. [PMID: 32023316 PMCID: PMC7001930 DOI: 10.1371/journal.pone.0229039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Arrais PSD, Vianna MPDN, Zaccolo AV, Moreira LIM, Thé PMP, Quidute ARP, Fontanella AT, Pizzol TDSD, Tavares NUL, Oliveira MA, Luiza VL, Ramos LR, Farias MR, Bertoldi AD, Mengue SS. [Use of artificial sweeteners in Brazil: a household survey approach]. CAD SAUDE PUBLICA 2019; 35:e00010719. [PMID: 31691774 DOI: 10.1590/0102-311x00010719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 09/03/2019] [Indexed: 11/22/2022] Open
Abstract
The objective was to estimate the prevalence of artificial sweetener use by the adult Brazilian population and users' characteristics. Analysis of data from the Brazilian National Survey on Access, Utilization, and Promotion of Rational Use of Medicines (PNAUM, 2014), a nationwide population-based survey. The target outcome was self-reported use of sweeteners by Brazilians 20 years and older. The independent variables were sex, age, major geographic region of Brazil, schooling in complete years, and economic status according to the Brazilian Economic Classification Criterion of the Brazilian Association of Research Companies (ABEP). The health condition indicators were: self-reported noncommunicable diseases (NCDs), number of NCDs, and body mass index (BMI). Prevalence of sweetener use in the Brazilian adult population was 13.4% (95%CI: 12.5-14.3), and it was higher in females and in persons 60 years or older, in the Northeast and Southeast, among individuals from economic classes A and B, and among obese individuals. Persons with chronic diseases (especially diabetes) showed the highest prevalence of use of sweeteners, and their use increased with the number of reported comorbidities. Prevalence of use of artificial sweeteners was 13.4% and was associated with sociodemographic and health characteristics.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Vera Lucia Luiza
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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da Silva Dal Pizzol T, Turmina Fontanella A, Cardoso Ferreira MB, Dâmaso Bertoldi A, Boff Borges R, Serrate Mengue S. Correction: Analgesic use among the Brazilian population: Results from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM). PLoS One 2019; 14:e0216005. [PMID: 30998779 PMCID: PMC6472808 DOI: 10.1371/journal.pone.0216005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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da Silva Dal Pizzol T, Turmina Fontanella A, Cardoso Ferreira MB, Dâmaso Bertoldi A, Boff Borges R, Serrate Mengue S. Analgesic use among the Brazilian population: Results from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM). PLoS One 2019; 14:e0214329. [PMID: 30897156 PMCID: PMC6428399 DOI: 10.1371/journal.pone.0214329] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/11/2019] [Indexed: 11/28/2022] Open
Abstract
Purpose To estimate the prevalence of use of analgesics in Brazil; and to characterize this use, according to sociodemographic and health-related characteristics. Methods A cross-sectional population-based study (National Survey on Access, Use and Promotion of Rational Use of Medicines, PNAUM) was conducted between September 2013 and February 2014. A total of 41,433 people of all ages in Brazilian urban households were interviewed. Occasional use (within the last 15 days) and continuous use of non-opioid analgesics, opioid analgesics and non-steroidal anti-inflammatory drugs were investigated, regardless of whether this use occurred through prescription or self-medication. The main outcome was the use of at least one analgesic. Results The majority of the individuals were female (52.8%), aged between 20 and 59 years (57.2%), with 1 to 8 years of schooling (45.6%). The overall prevalence of analgesic use was 22.8% [95% CI: 21.4–24.2]. The use of analgesics was significantly higher among women, adults and elderly (20 years or more), highly educated individuals and respondents who referred: diagnosis of one or more chronic diseases, using three or more medications, possession of health insurance and with one or more emergency care admittances or hospitalizations within the last year. Non-opioid analgesics were the agents most used (18.5% of the sample), followed by non-steroidal anti-inflammatory drugs (6.9%) and opioid analgesics (0.5%). The most commonly used drugs were metamizole (37.8% of all analgesics), paracetamol (25.3%) and diclofenac (10.7%). These drugs were used mainly to manage occasional health conditions, particularly pain. Conclusion One in five Brazilians used some analgesic, especially non-opioid analgesics, to manage acute health problems such as painful conditions.
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Affiliation(s)
- Tatiane da Silva Dal Pizzol
- Department of Production and Control of Medicines, School of Pharmacy, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
| | - Andréia Turmina Fontanella
- Graduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Beatriz Cardoso Ferreira
- Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Andréa Dâmaso Bertoldi
- Graduate Program in Epidemiology, Federal University of Pelotas (UFPEL), Pelotas, Rio Grande do Sul, Brazil
| | - Rogerio Boff Borges
- Graduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Sotero Serrate Mengue
- Graduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
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Turmina Fontanella A, Molina‐Bastos CG, da Silva Dal Pizzol T, Mengue SS. Too much or too little opioid use? A comment on Bosetti et al. Eur J Pain 2019; 23:639-640. [DOI: 10.1002/ejp.1359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/28/2018] [Accepted: 12/29/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Andréia Turmina Fontanella
- Graduate Studies Program in Epidemiology, School of Medicine Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Cynthia Goulart Molina‐Bastos
- Graduate Studies Program in Epidemiology, School of Medicine Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Tatiane da Silva Dal Pizzol
- Graduate Studies Program in Epidemiology, School of Medicine Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Sotero Serrate Mengue
- Graduate Studies Program in Epidemiology, School of Medicine Federal University of Rio Grande do Sul Porto Alegre Brazil
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Matta SR, Bertoldi AD, Emmerick ICM, Fontanella AT, Costa KS, Luiza VL. [Sources of medicines for chronic patients using the Brazilian Unified National Health System]. CAD SAUDE PUBLICA 2018; 34:e00073817. [PMID: 29590242 DOI: 10.1590/0102-311x00073817] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 09/15/2017] [Indexed: 11/21/2022] Open
Abstract
The article aimed to identify the sources of medicines for users of the Brazilian Unified National Health System (SUS) that reported chronic non-communicable diseases, characterizing the group according to demographic, socioeconomic, and health variables in the different regions of Brazil. Data were analyzed from the National Survey on Access, Use, and Promotion of Rational Use of Medicines in Brazil (PNAUM), a cross-sectional population-based study. The dependent variable was "source of medicines", and the associations were analyzed with demographic, socioeconomic, and health status variables. Users that obtained care and medicines solely in the SUS were designated here as SUS-exclusive. Some 39% of persons obtained their medicines from SUS pharmacies and 28.5% from other sources. The study found 42.9%, 41.8%, 40.2%, and 31% of exclusive SUS users in the Southeast, South, North, and Northeast regions of Brazil, respectively. SUS users have the SUS as their primary source of medicines, but there is also a relevant share from other sources, suggesting problems with access in the SUS. In the South and Southeast regions, the population relies less on private pharmacies than in the Northeast and North.
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Affiliation(s)
- Samara Ramalho Matta
- Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro, Rio de Janeiro, Brasil.,Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Andréa Dâmaso Bertoldi
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | | | - Andréia Turmina Fontanella
- Programa de Pós-graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Karen Sarmento Costa
- Núcleo de Estudos de Políticas Públicas, Universidade Estadual de Campinas, Campinas, Brasil
| | - Vera Lucia Luiza
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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