RESUMEN
Abstract The World Health Organization recognized the use of herbal medicines as a therapeutic resource and its application in the primary attention to heath. The begin of this expansion was in 2006, with the National Policy on Integrative and Complementary practices of the Unified Health System (SUS). This research aimed to evaluate the questionnaires applied to doctors, who may have prescribed industrialized herbal medicines and to identify the difficulties involved with the implementation of this therapy as an integrative and complementary practice. It is a quantitative, observational and transversal study conducted in the municipality of Pinhais/Brazil. The questionnaire applied had as themes the experience of personal use of industrialized herbal medicines, improvement after their use. Forty-four individuals from four different nationalities: Brazilian (88.64%), Cuban (6.82%), Mexican (2.27%) and Argentinian (2.27%), ages between 25 and 69 years, mainly male sex (54.55%) answered the questionnaire. According to the study, the doctors consider herbal medicines an alternative to the conventional treatment and these medical professionals have already prescribed some industrialized herbal medications. Despite the difficulties faced by medical doctors with the prescription of herbs, it is possible to define strategies to assist these professionals, such as the incentive the actions by the governments.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Médicos/clasificación , Sistema Único de Salud , Medicamento Fitoterápico , Encuestas y Cuestionarios/estadística & datos numéricos , Estrategias de Salud , Prescripciones/clasificaciónRESUMEN
OBJECTIVE: To analyze the legal demands of tiotropium bromide to treat chronic obstructive pulmonary disease. METHODS: We included secondary data from the pharmaceutical care management systems made available by the Paraná State Drug Center. RESULTS: Public interest civil action and ordinary procedures, among others, were the most common used by the patients to obtain the medicine. Two Health Centers in Paraná (Londrina and Umuarama) concentrated more than 50% of the actions. The most common specialty of physicians who prescribed (33.8%) was pulmonology. There is a small financial impact of tiotropium bromide on general costs with medicines of the Paraná State Drug Center. However, a significant individual financial impact was observed because one unit of the medicine represents 38% of the Brazilian minimum wage. CONCLUSION: Our study highlights the need of incorporating this medicine in the class of long-acting anticholinergic bronchodilator in the Brazilian public health system.
Asunto(s)
Broncodilatadores/economía , Medicamentos Esenciales/provisión & distribución , Necesidades y Demandas de Servicios de Salud/legislación & jurisprudencia , Rol Judicial , Enfermedad Pulmonar Obstructiva Crónica/economía , Bromuro de Tiotropio/economía , Brasil , Medicamentos Esenciales/economía , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Accesibilidad a los Servicios de Salud/tendencias , Necesidades y Demandas de Servicios de Salud/economía , Necesidades y Demandas de Servicios de Salud/tendencias , Humanos , Programas Nacionales de Salud , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Estudios Retrospectivos , Estadísticas no Paramétricas , Factores de TiempoRESUMEN
ABSTRACT Objective To analyze the legal demands of tiotropium bromide to treat chronic obstructive pulmonary disease. Methods We included secondary data from the pharmaceutical care management systems made available by the Paraná State Drug Center. Results Public interest civil action and ordinary procedures, among others, were the most common used by the patients to obtain the medicine. Two Health Centers in Paraná (Londrina and Umuarama) concentrated more than 50% of the actions. The most common specialty of physicians who prescribed (33.8%) was pulmonology. There is a small financial impact of tiotropium bromide on general costs with medicines of the Paraná State Drug Center. However, a significant individual financial impact was observed because one unit of the medicine represents 38% of the Brazilian minimum wage. Conclusion Our study highlights the need of incorporating this medicine in the class of long-acting anticholinergic bronchodilator in the Brazilian public health system.
RESUMO Objetivo Analisar as demandas judiciais do brometo de tiotrópio para tratar a doença pulmonar obstrutiva crônica. Métodos Foram considerados dados secundários dos sistemas gerenciais de assistência farmacêutica, disponibilizados pelo Centro de Medicamentos do Paraná. Resultados Ações civis públicas e ações ordinárias, de procedimento comum, entre outras, foram as mais praticadas pelos pacientes para obter o medicamento. Duas Regionais de Saúde do Paraná (Londrina e Umuarama) concentraram mais de 50% das ações. Quanto à especialidade dos médicos prescritores, 33,8% eram pneumologistas. Verificou-se discreto impacto financeiro do brometo de tiotrópio nos gastos gerais com medicamentos pelo Centro de Medicamentos do Paraná. Entretanto, também houve relevante impacto financeiro individual, pois uma unidade do medicamento consome 38% do salário mínimo. Conclusão O estudo aponta para a necessidade de incorporação deste medicamento da classe broncodilatadores anticolinérgicos de longa duração, no Sistema Único de Saúde.
Asunto(s)
Humanos , Broncodilatadores/economía , Medicamentos Esenciales/provisión & distribución , Enfermedad Pulmonar Obstructiva Crónica/economía , Rol Judicial , Bromuro de Tiotropio/economía , Necesidades y Demandas de Servicios de Salud/legislación & jurisprudencia , Factores de Tiempo , Brasil , Estudios Retrospectivos , Estadísticas no Paramétricas , Medicamentos Esenciales/economía , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Accesibilidad a los Servicios de Salud/tendencias , Necesidades y Demandas de Servicios de Salud/economía , Necesidades y Demandas de Servicios de Salud/tendencias , Programas Nacionales de SaludRESUMEN
The present article studied the use of industrialized phytotherapies by patients attended at the basic health units in Pinhais county, located in the metropolitan region of Curitiba, ParanaÌ, Brazil. This is a quantitative, observational and cross-sectional study that was conducted by semi-structured questionnaire interviews that were used as a data collection instrument. The population sample consisted of 267 patients from basic health care organizations. Regardless of gender or age, 56.2% of the interviewed participants reported using industrialized herbal medicines, of which 21.3% acquired their drugs from drugstores from around the county. Patients reported positive results using industrialized herbal medicines (89.33%), of whom women were predominant, making up (80%) (p<0.05). Among the drugs used by all the patients, "guaco" syrup was the most frequent (34%). The present study demonstrates the good acceptance by patients of treatments that involve integrative practices, such as herbal medicine, but when a drug has a vegetal origin, the idea that these products do not cause adverse effects persists.
El presente articulo se estudio el uso de hierbas medicinales procesadas por pacientes tratados en unidades baÌsicas de salud del municiÌpio de Pinhais, en la regioÌn metropolitana de Curitiba, ParanaÌ, Brasil. Se trata de un estudio cuantitativo, observacional y transversal, realizado por medio de entrevistas que utilizan como instrumento de recoleccioÌn de datos un cuestionario semi-estructurado. La poblacioÌn de la muestra consistioÌ en 267 pacientes de atencioÌn baÌsica a la salud. Independiente del sexo o de la edad, 56.2% de los entrevistados relatoÌ hacer uso de fitoteraÌpicos industrializados, siendo que de los 21.3% hizo la adquisicioÌn en las farmacias de las unidades de salud del municipio. Los pacientes reportaron resultados positivos con el tratamiento realizado con fitoteraÌpicos industrializados (89.33%). Entre ellos predominan las mujeres (80%) (p<0.05). Entre los medicamentos citados por los pacientes, el jarabe de guaco se mostroÌ el maÌs frecuente (34%). El presente estudio demuestra la buena aceptacioÌn por parte de los pacientes en realizar tratamientos que implican praÌcticas integrativas como la fitoterapia, pero, por poseer origen vegetal, todaviÌa existe la idea de que estos productos no tienen la capacidad de causar efectos adversos.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Plantas Medicinales , Atención Primaria de Salud , Terapias Complementarias , Industria Farmacéutica , Fitoterapia , Brasil , Estudios Transversales , Encuestas y Cuestionarios , Estudios Observacionales como AsuntoRESUMEN
Em função do grande volume de produção e comercialização do capim-limão, estima-se que uma contaminação microbiológica deste produto possa representar importante risco para a saúde pública. Esta pesquisa visou avaliar marcas de chá de capim-limão, em relação às qualidades microbiológica e físico-química, tendo como base a legislação brasileira do Ministério da Saúde. Nenhuma das amostras apresentou Salmonella sp, porém em 50% delas, houve presença de coliformes a 35ºC. Em três amostras, evidenciaram-se coliformes a 45ºC, com presença de Escherichia coli em uma destas. 81,25% das amostras apresentaram bolores e leveduras, porém sem relação direta com os teores de umidade observados. Dentre os fungos presentes, identificou-se Aspergillus niger, no entanto sem produção de aflatoxinas. Todos infusos analisados negativaram a contaminação evidenciada nos testes com o produto seco. Os resultados indicaram possíveis falhas nos procedimentos pós-colheita e de comercialização. A implementação do Sistema APPCC (HACCP) poderia substancialmente minimizar esta contaminação.
Considering the great volume of lemongrass production and commercialization, it is estimated that a potential microbiological contamination of this product could represent an important hazard to public health. This study was performed to evaluate different brands of lemongrass tea, regarding their microbiological and physical-chemical quality, based on the legislation of the Brazilian Health Ministry. No traces of Salmonella sp were found, but in 50% of samples, the presence of coliforms was detected at 35ºC. Three samples presented coliforms at 45ºC, with Escherichia coli found in one of them. 81.25% of samples presented molds and yeasts. Among the fungi present, Aspergillus niger was identified, but aflatoxins were absent. None of the infusions analyzed presented the contamination evidenced in the dry product. The results obtained may be indicative of failure in procedures of postharvest and commercialization. The implementation of a hazard analysis and critical control point system (HACCP) could reduce this contamination substantially.