Prescription, dispensation and marketing patterns of methylphenidate / Padrões de prescrição, dispensação e comercialização de metilfenidato

OBJECTIVE To analyze the patterns and legal requirements of methylphenidate consumption. METHODS We conducted a cross-sectional study of the data from prescription notification forms and balance lists of drugs sales – psychoactive and others – subject to special control in the fifth largest city of Brazil, in 2006. We determined the defined and prescribed daily doses, the average prescription and dispensation periods, and the regional sales distribution in the municipality. In addition, we estimated the costs of drug acquisition and analyzed the individual drug consumption profile using the Lorenz curve. RESULTS The balance lists data covered all notified sales of the drug while data from prescription notification forms covered 50.6% of the pharmacies that sold it, including those with the highest sales volumes. Total methylphenidate consumption was 0.37 DDD/1,000 inhabitants/day. Sales were concentrated in more developed areas, and regular-release tablets were the most commonly prescribed pharmaceutical formulation. In some regions of the city, approximately 20.0% of the prescriptions and dispensation exceeded 30 mg/day and 30 days of treatment. CONCLUSIONS Methylphenidate was widely consumed in the municipality and mainly in the most developed areas. Of note, the consumption of formulations with the higher abuse risk was the most predominant. Both its prescription and dispensation contrasted with current pharmacotherapeutic recommendations and legal requirements. Therefore, the commercialization of methylphenidate should be monitored more closely, and its use in the treatment of behavioral changes of psychological disorders needs to be discussed in detail, in line with the concepts of the quality use of medicines. .

OBJETIVO Analisar padrões e requisitos legais do consumo de metilfenidato. MÉTODOS Estudo transversal realizado em Belo Horizonte, MG, em 2006. Foram analisados dados de notificações de receitas de metilfenidato e de balanços de vendas de medicamentos – psicoativos e outros – sujeitos a controle especial. Determinou-se a dose diária definida, a dose diária prescrita, o período médio de prescrição e de dispensação, bem como a distribuição regional das vendas desse medicamento no município. Foram estimados, ainda, os gastos com a aquisição do medicamento e analisado o perfil de consumo individual do fármaco por meio da Curva de Lorenz. RESULTADOS Os dados dos balanços mensais de comercialização de psicotrópicos cobriram toda a comercialização notificada do fármaco, enquanto aqueles coletados nas notificações de receita cobriram 50,6% das farmácias que o comercializaram, incluindo aquelas de maior volume de venda. O consumo de metilfenidato foi 0,37 DDD/1.000 habitantes/dia. As vendas concentraram-se em áreas mais desenvolvidas e as formulações farmacêuticas de liberação não controlada foram as mais prescritas. A prescrição e a dispensação com dosagens > 30 mg/dia e período de tratamento > 30 dias apresentaram valores em torno de 20,0% em algumas regiões da cidade. CONCLUSÕES O consumo de metilfenidato apresentou-se elevado no município, maior em áreas mais favorecidas economicamente e predominando o consumo de formulações com maior risco de abuso. Tanto a prescrição quanto a dispensação apresentaram características não compatíveis com as recomendações farmacoterapêuticas e determinações legais. O controle de venda do fármaco ...

Lipodystrophy among patients with HIV infection on antiretroviral therapy: a systematic review protocol.

INTRODUCTION: Lipodystrophy is a frequent and disfiguring adverse effect of antiretroviral therapy (ART) in patients with HIV. It affects the quality of life of the patient and adherence to treatment, and generates new needs for comprehensive healthcare services. The aim of this study will be to conduct a systematic review of the literature from observational studies and describe lipodystrophy among patients with HIV infection during current or previous use of ART. METHODS AND ANALYSIS: A systematic review of observational studies published in MEDLINE, CINAHL, LILACS, EMBASE and International Pharmaceutical Abstracts will be carried out. Citations of included studies will be checked to identify additional studies not identified in the electronic searches. It will include any observational study that considered lipodystrophy as the primary or secondary outcome and that had enrolled adolescent and adult patients with HIV infection who were on current or previous ART for at least 6 months. Data extraction and analysis will be performed independently by two reviewers. The extracted data will be discussed, decisions documented and, where necessary, the authors of the studies will be contacted for clarification. Measures of frequency, prevalence and incidence of lipodystrophy will be stratified according to definition, method of diagnosis and risk factors of the outcome. ETHICS AND DISSEMINATION: Ethics is not required given this is a protocol for a systematic review. The findings of this study will be widely disseminated through peer-reviewed publications and conference presentations. Updates of the review will be conducted to inform and guide healthcare practice. PROTOCOL REGISTRATION: PROSPERO-42013005450.

Prescription, dispensation and marketing patterns of methylphenidate.

OBJECTIVE To analyze the patterns and legal requirements of methylphenidate consumption. METHODS We conducted a cross-sectional study of the data from prescription notification forms and balance lists of drugs sales - psychoactive and others - subject to special control in the fifth largest city of Brazil, in 2006. We determined the defined and prescribed daily doses, the average prescription and dispensation periods, and the regional sales distribution in the municipality. In addition, we estimated the costs of drug acquisition and analyzed the individual drug consumption profile using the Lorenz curve. RESULTS The balance lists data covered all notified sales of the drug while data from prescription notification forms covered 50.6% of the pharmacies that sold it, including those with the highest sales volumes. Total methylphenidate consumption was 0.37 DDD/1,000 inhabitants/day. Sales were concentrated in more developed areas, and regular-release tablets were the most commonly prescribed pharmaceutical formulation. In some regions of the city, approximately 20.0% of the prescriptions and dispensation exceeded 30 mg/day and 30 days of treatment. CONCLUSIONS Methylphenidate was widely consumed in the municipality and mainly in the most developed areas. Of note, the consumption of formulations with the higher abuse risk was the most predominant. Both its prescription and dispensation contrasted with current pharmacotherapeutic recommendations and legal requirements. Therefore, the commercialization of methylphenidate should be monitored more closely, and its use in the treatment of behavioral changes of psychological disorders needs to be discussed in detail, in line with the concepts of the quality use of medicines.