[Self-medication, the new silence epidemic. Studies in patients of clinical practice and mental health]. / La automedicación, una nueva epidemia silenciosa. Estudio en población de Salud Mental y Clínica Médica.

OBJECTIVE: The goal of this study is to describe magnitude and characteristics of self- medication in a psychiatric and clinical out-patients unit. METHOD: consecutive sample of 898 subjects (Mental Health 358 and Clinical Practice 540) at University Hospital, Buenos Aires, Argentina (2002). A questionnaire was administered by interviewers and was completed with information about social and demographics characteristics, physical and psychological health problems, and perception about doctors and patient relationships were collected. RESULTS: use of medication under prescription, 27.5%; without prescription, 60% (27.5% OTC and 31.9% automedication). The drugs more used in automedications were the psychotropics 59.8% (ansiolitics 88.8%) y antibiotics 9.4%. The 50% of the sample didn't consider automedication a risky behavior. Main reasons for beginning: 38.9% had had same problem previously treated by a doctor with that medication; and to alleviate symptomatic distress. No statistical significance was found related to age, sex, educational status. There was statistically significance associated with: less medical visits during last 12 months (p<0.01). Use of complementary therapies (p<0.0001), pain for more than 6 months (p<0.001), dissatisfaction with the manner in which the cause of the illness was investigated and how the diagnosis and treatment were informed to the patient (p<0.02). CONCLUSION: The automedication is dangerously installed and it's control is shared responsibility of doctors, patients, pharmaceutics and Public Health. The doctor must include the detection of abuse or misuse of psychotropics and assume the pedagogical task discussing the risk of autoprescription.

[Physician-patient relationship, scientific medicine and alternative therapies]. / La relación médico-paciente, la medicina científica y las terapias alternativas.

The objective of this paper is to describe the magnitude and characteristics of the use of complementary therapies in clinical practice. A consecutive sample of 540 outpatients who had sought medical care for the first time at the General Internal Medicine Program of a University Hospital were interviewed. A questionnaire was completed, collecting socio-demographic informations, data on physical and psychological health, perception of physician-patient relationship, self-medication, and beliefs associated with the disease and its treatment. Lifetime prevalence use of alternative therapies was near 55%. The most used were homeopathy and herbal medicines (40.8% and 37.6%, respectively). The evaluation of these practices was considered "excellent/very good/and good" 84.5% of the time. Significant associations were: females (p < 0.00001), high level of education (p < 0.001), dissatisfaction with the way in which the cause of the disease had been investigated and how the diagnosis and treatment had been communicated (p < 0.03), psychological and psychiatric treatment (p < 0.00001), self-medication (p < 0.0002), pain and concern during over 6 months due to disease or disability (p < 0.00001), lack of confidence in scientific medicine (p < 0.00001), the belief that "spiritual problems" (p < 0.00001), "mental conditions" (p < 0.003), and "emotional conditions" (p < 0.00001), popular beliefs, particularly daño & envidia (p < 0.00001), and mal de ojo (p < 0.001) have triggered the disease. One third of the patients attended the hospital while undergoing an alternative therapy that may pose an interference or interaction hazard. Emphasis is placed on the importance of medical education to assess physician-patient relationship and the ability to convey trust in medical procedures and treatments, and scientific consulting for other practices.

La relacion medico-paciente, la medicina cientifica y las terapias alternativas / Physician-patient relationship, scientific medicine and alternative therapies

The objective of this paper is to describe the magnitude and characteristics of the use of complementary therapies in clinical practice. A consecutive sample of 540 outpatients who had sought medical care for the first time at the General Internal Medicine Program of a University Hospital were interviewed. A questionnaire was completed, collecting socio-demographic informations, data on physical and psychological health, perception of physician-patient relationship, self-medication, and beliefs associated with the disease and its treatment. Lifetime prevalence use of alternative therapies was near 55%. The most used were homeopathy and herbal medicines (40.8% and 37.6%, respectively). The evaluation of these practices was considered "excellent/very good/and good" 84.5% of the time. Significant associations were: females (p < 0.00001), high level of education (p < 0.001), dissatisfaction with the way in which the cause of the disease had been investigated and how the diagnosis and treatment had been communicated (p < 0.03), psychological and psychiatric treatment (p < 0.00001), self-medication (p < 0.0002), pain and concern during over 6 months due to disease or disability (p < 0.00001), lack of confidence in scientific medicine (p < 0.00001), the belief that "spiritual problems" (p < 0.00001), "mental conditions" (p < 0.003), and "emotional conditions" (p < 0.00001), popular beliefs, particularly dano & envidia (p < 0.00001), and mal de ojo (p < 0.001) have triggered the disease. One third of the patients attended the hospital while undergoing an alternative therapy that may pose an interference or interaction hazard. Emphasis is placed on the importance of medical education to assess physician-patient relationship and the ability to convey trust in medical procedures and treatments, and scientific consulting for other practices