Qualidade do sono e fatores associados em universitários do Centro-Oeste do Brasil / Sleep quality and associated factors in university students in the Midwest of Brazil

INTRODUÇÃO: A qualidade do sono é uma das queixas mais frequentes entre estudantes universitários. OBJETIVOS: Identificar a prevalência de má qualidade do sono e os fatores associados em acadêmicos da área da saúde de uma universidade do Centro-Oeste do Brasil. MÉTODOS: Estudo transversal com uma amostra de 2171 universitários com média de idade de 22,7 (±3,9). O desfecho, sono de má qualidade, foi avaliado por meio da versão brasileira do questionário Pittsburgh Sleep Quality Index (PSQI-BR). As variáveis independentes (demográficas, socioeconômicas e comportamentais) foram avaliadas por meio de um questionário padronizado. As análises multivariadas foram realizadas por meio de Regressão de Poisson, estimando-se as Razões de Prevalências (RP) ajustadas e seus respectivos Intervalos de Confiança de 95% (IC95%). RESULTADOS: A média do escore do PSQI-BR foi 7,0. A prevalência de má qualidade do sono foi de 63,5% (IC95% 61,4-65,5), sendo 60,3% nos homens e 64,8% nas mulheres. Após análise ajustada, auto percepção de saúde razoável/ruim esteve associada com má qualidade do sono em ambos os sexos. Além disso, para os homens, a prevalência de má qualidade do sono foi maior para os estudantes que fumavam; e foi menor para aqueles que consumiam adequadamente frutas, legumes e verduras e eram suficientemente ativos. Já para as mulheres, a prevalência de má qualidade do sono foi maior naquelas com 24 ou mais anos de idade, sem companheiro, que consumiam bebidas alcoólicas e que cursavam medicina. CONCLUSÃO: Verificou-se elevada prevalência do desfecho na amostra. Além disso, a má qualidade do sono ocorre de forma diferente entre homens e mulheres. Ressalva-se a importância do monitoramento da má qualidade do sono em estudantes universitários.

INTRODUCTION: Sleep quality is one of the most frequent complaints among college students. OBJETIVE: To identify the prevalence of poor sleep quality and associated factors in health care academics at a university in the Midwest of Brazil. METHODS: Cross-sectional study with a sample of 2171 university students with a mean age of 22.7 (±3.9). The outcome, poor quality sleep, was assessed using the Brazilian version of the Pittsburgh Sleep Quality Index (PSQI-BR) questionnaire. Independent variables (demographic, socioeconomic and behavioral) were assessed using a standardized questionnaire. Multivariate analyzes were performed using Poisson Regression, estimating the adjusted Prevalence Ratios (PR) and their respective 95% Confidence Intervals (95%CI). RESULTS: The mean score of the PSQI-BR was 7.0. The prevalence of poor sleep quality was 63.5% (95%CI 61.4-65.5), being 60.3% in men and 64.8% in women. After adjusted analysis, reasonable/poor self-rated health was associated with poor sleep quality in both sexes. Furthermore, for men, the prevalence of poor sleep quality was higher for students who smoked; and it was lower for those who adequately consumed fruits and vegetables and were sufficiently active. As for women, the prevalence of poor sleep quality was higher in those aged 24 or over, without a partner, who consumed alcoholic beverages and who were studying medicine. CONCLUSION: There was a high prevalence of the outcome in the sample. Furthermore, poor sleep quality occurs differently between men and women. Thus, we emphasize the importance of monitoring poor sleep quality in college students.

Direct and indirect effects of poor sleep quality on BMI and waist circumference in a female population-based study in Southern Brazil.

OBJECTIVE: This study aimed to investigate the direct and indirect effects of poor sleep quality on BMI and waist circumference (WC), considering behavioural factors as intermediate variables. DESIGN: A population-based cross-sectional study design was adopted. Data were collected between February and October 2015. Poor sleep quality was assessed using the Brazilian version of the Pittsburgh Sleep Quality Index (PSQI-BR). Weight, height (used to calculate BMI) and WC were measured using standard protocols. Physical activity, sedentary behaviour and fast food consumption were considered intermediate variables. Non-standardised effects were estimated by path analysis with bootstrapped CI. SETTING: Urban region of the city of São Leopoldo, southern Brazil. PARTICIPANTS: Representative sample of 1117 women aged between 20 and 69 years. RESULTS: Poor sleep quality (higher PSQI-BR scores) was significantly associated with low physical activity levels (ß = -0·05; 95 % CI -0·09, -0·01). High physical activity levels were associated with lower BMI (ß = -0·21; 95 % CI -0·37, -0·07) and WC (ß = -0·64; 95 % CI -1·00, -0·30). There was a non-significant direct effect of poor sleep quality on BMI and WC. However, low physical activity showed a significant indirect effect on the association between poor sleep quality and increased WC (ß = 0·03; 95 % CI 0·01, 0·07). CONCLUSIONS: The results indicate that the association between sleep quality and WC is mediated by physical activity. This finding can assist in the development of strategies to prevent and reduce abdominal obesity in adult women.

[Combined HIV prevention? Systematic review of interventions with women from low- and middle-income countries]. / Prevenção combinada do HIV? Revisão sistemática de intervenções com mulheres de países de média e baixa renda.

The scope of this systematic review was to characterize interventions for HIV prevention that included adult women and was conducted in low- and middle-income countries after 1996, identifying how they covered individual, social and programmatic vulnerabilities. Databases were accessed from 1997 to July 2016 and the studies selected included adult women, with combined strategies or otherwise, only excluding biomedical or mass media interventions. Thus, 72 interventions developed in 32 countries were selected, most of them in African countries and/or in the upper-middle income bracket, with 26 focusing solely on women. Among the 64 interventions that evaluated results in behavioral, psychosocial and biomedical knowledge on HIV/STI and use of health services, 62 reported positive results, but also of no-effect (n = 52). Few of them reported a reduction in HIV/STI incidence (n = 9), in partner numbers (n = 12) and in stigma and violence reports (n = 7). The content analysis of the interventions revealed that the majority (n = 51) considered only individual vulnerabilities. The need to strengthen preventive approaches targeting structural determinants of the epidemic, encompassing the social contexts of women in a relational and intersectional perspective of vulnerabilities was discussed.

Prevenção combinada do HIV? Revisão sistemática de intervenções com mulheres de países de média e baixa renda / Combined HIV prevention? Systematic review of interventions with women from low- and middle-income countries

Resumo A revisão sistemática objetivou caracterizar as intervenções para prevenção do HIV que incluíam mulheres adultas e desenvolvidas em países de baixa e média renda após 1996, identificando como abarcavam as vulnerabilidades individuais, sociais e programáticas. Foram acessadas bases de dados de 1997 a julho de 2016 e selecionados estudos que incluíam mulheres adultas, com estratégias combinadas ou não, excluindo-se intervenções apenas biomédicas ou de mídia em massa. Foram selecionadas 72 intervenções desenvolvidas em 32 países, sendo a maioria africanos e/ou de renda média-alta e 26 só com mulheres. Entre 64 intervenções que avaliaram aspectos comportamentais, psicossociais, biomédicos, de conhecimentos sobre HIV/IST e uso de serviços de saúde, 62 tiveram resultados positivos, mas também de não efeito (n = 52). Poucas relataram diminuição na incidência de HIV/IST (n = 9), no número de parceiros (n = 12), dos relatos de estigma e de violências (n = 7). A análise de conteúdo das intervenções mostrou que a maioria (n = 51) contemplava apenas vulnerabilidades individuais. Discute-se a necessidade de fortalecer abordagens preventivas que atuem nos determinantes estruturais da epidemia, abarcando os contextos sociais das mulheres numa perspectiva relacional e interseccional das vulnerabilidades.

Abstract The scope of this systematic review was to characterize interventions for HIV prevention that included adult women and was conducted in low- and middle-income countries after 1996, identifying how they covered individual, social and programmatic vulnerabilities. Databases were accessed from 1997 to July 2016 and the studies selected included adult women, with combined strategies or otherwise, only excluding biomedical or mass media interventions. Thus, 72 interventions developed in 32 countries were selected, most of them in African countries and/or in the upper-middle income bracket, with 26 focusing solely on women. Among the 64 interventions that evaluated results in behavioral, psychosocial and biomedical knowledge on HIV/STI and use of health services, 62 reported positive results, but also of no-effect (n = 52). Few of them reported a reduction in HIV/STI incidence (n = 9), in partner numbers (n = 12) and in stigma and violence reports (n = 7). The content analysis of the interventions revealed that the majority (n = 51) considered only individual vulnerabilities. The need to strengthen preventive approaches targeting structural determinants of the epidemic, encompassing the social contexts of women in a relational and intersectional perspective of vulnerabilities was discussed.

Prevalência de sobrepeso e obesidade e fatores associados em mulheres de São Leopoldo, Rio Grande do Sul: um estudo de base populacional / Prevalence of overweight and obesity and associated factors in women of São Leopoldo/RS - Population-based study

Resumo Introdução O sobrepeso e a obesidade são multicausais, porém seus determinantes ainda não foram completamente estudados. Objetivo Estimar a prevalência de sobrepeso e de obesidade e os fatores associados. Método Estudo transversal de base populacional com 981 mulheres (20 a 60 anos) de São Leopoldo/RS. O peso e a altura foram aferidos para o cálculo do Índice de Massa Corporal (IMC). Mulheres com IMC entre 25,0 e 29,9 kg/m2 e IMC ≥ 30,0 kg/m2 foram classificadas com sobrepeso e obesidade, respectivamente. As razões de prevalência e os intervalos de confiança de 95% foram estimados por meio de regressão de Poisson. Resultados A prevalência de sobrepeso foi de 33% (IC95%: 30,1-36,0) e de obesidade foi de 31,2% (IC95%: 28,3-34,1). Após ajuste, maiores probabilidades de sobrepeso ocorreram em mulheres mais velhas, pertencentes às classes econômicas mais baixas, casadas ou em união, com histórico de obesidade materna e com uma ou mais gestações. As maiores probabilidades de obesidade ocorreram em mulheres mais velhas, de baixa renda, com histórico de obesidade materna e paterna e com três ou quatro gestações. Menarca acima de 12 anos e prática de atividade física de lazer foram fatores de proteção para a obesidade. Conclusão Esses resultados evidenciam a necessidade de ações de prevenção de longo prazo, algumas delas envolvendo ações transgeracionais.

Abstract Background Overweight and obesity are multicausal; however, their determinants have not been fully studied. Objective To estimate the prevalence of overweight and obesity and associated factors. Method A population-based cross-sectional study with 981 women (20-60 years) from São Leopoldo/RS was carried out. Weight and height were measured by the calculation of Body Mass Index (BMI). Women with a BMI between 25.0-29.9kg/m2 and a BMI ≥30.0kg/m2 were classified as overweight and obese, respectively. Prevalence ratios and 95% confidence intervals were estimated using Poisson regression. Results The prevalence of overweight was 33.0% (95%CI: 30.1-36.0) and obesity was 31.2% (95%CI: 28.3-34.1). After adjustment, higher probabilities of overweight occurred in older women, from lower economic classes, married or in union, with a history of maternal obesity and with one or more pregnancies. The highest probabilities of obesity occurred in older women, from low-income, with a history of maternal and paternal obesity and with three or four pregnancies. Menarche over 12 years old and leisure-time physical activity were protective factors for obesity. Conclusion These results highlighted the need for long-term prevention actions, some involving transgenerational actions.

Social inequalities in the use of contraceptives in adult women from Southern Brazil.

OBJECTIVE: To describe the contraceptive methods used by adult women and the associated socioeconomic and demographic factors. METHODS: Population-based cross-sectional study with 20 to 49-year-old women from São Leopoldo, state of Rio Grande do Sul, in 2015. Three outcomes were considered to analyze the association with demographic and socioeconomic characteristics: use of oral contraceptive pills, tubal ligation and male condom. The crude prevalence ratios, stratified by age, and 95% confidence intervals (95%CI) were obtained using Poisson regression, taking the experimental error into account. RESULTS: A total of 736 women, aged from 20 to 49 years old, were evaluated. The prevalence of the use of oral contraceptive pills, tubal ligation and male condom were respectively 31.8% (95%CI 28.4-35.3), 11.1% (95%CI 9.0-13.6) and 10.9% (95%CI 8.7-13.3). In addition, 10.5% (n = 77) of the women reported making combined use of oral contraceptive pills and condom. In the stratified analysis, younger women with lower education level and from lower social classes reported less use of oral contraceptive pills. Tubal ligation was more prevalent among the lower social classes, but only in the age group from 30 to 39 years old. No differences were found in relation to male condom. CONCLUSIONS: The results indicated that differences persist in relation to contraception, which can be associated with both the difficulties of access to these inputs and the frailty of actions in reproductive health to achieve the needs and preferences of women who are more socially vulnerable.

Factors associated with not having Pap Smears in São Leopoldo, Rio Grande do Sul, Brazil, 2015: a cross-sectional population-based study. / Fatores associados a não realização de exame citopatológico em São Leopoldo, Rio Grande do Sul, 2015: estudo transversal de base populacional.

OBJECTIVE: to estimate the prevalence of Pap tests not performed in the last three years and never performed in women and to analyze factors. METHODS: this was a cross-sectional study with women aged 20 to 69 years living in São Leopoldo, RS, Brazil, in 2015; prevalence ratios (PR) were calculated using Poisson regression. RESULTS: among 919 women, prevalence of delayed testing was 17.8% (95% confidence interval [95%CI]15.4;20.3) and never tested prevalence was 8.1% (95%CI6.3%;9.8%); in the adjusted analysis, the increase in the prevalence of delayed testing was associated with economic class D/E (PR=2.1 - 95%CI1.3;3.5), being aged 20-29 years (PR=3.2 - 95%CI2.1;4.9) and not having had a medical appointment (PR=3.0 - 95%CI2.1;4.1); never having tested was associated with economic class D/E (PR=2.6 - 95%CI1.4;5.0), being aged 20-29 years (PR=24.1 - 95%CI6.4;90.9), and not having had a medical appointment (PR=2.9 - 95%CI1.7;4.8). CONCLUSION: coverage of the test was high but characterized by social inequality.

Social inequalities in the use of contraceptives in adult women from Southern Brazil / Desigualdades sociais no uso de contraceptivos em mulheres adultas no Sul do Brasil

ABSTRACT OBJECTIVE: To describe the contraceptive methods used by adult women and the associated socioeconomic and demographic factors. METHODS: Population-based cross-sectional study with 20 to 49-year-old women from São Leopoldo, state of Rio Grande do Sul, in 2015. Three outcomes were considered to analyze the association with demographic and socioeconomic characteristics: use of oral contraceptive pills, tubal ligation and male condom. The crude prevalence ratios, stratified by age, and 95% confidence intervals (95%CI) were obtained using Poisson regression, taking the experimental error into account. RESULTS: A total of 736 women, aged from 20 to 49 years old, were evaluated. The prevalence of the use of oral contraceptive pills, tubal ligation and male condom were respectively 31.8% (95%CI 28.4-35.3), 11.1% (95%CI 9.0-13.6) and 10.9% (95%CI 8.7-13.3). In addition, 10.5% (n = 77) of the women reported making combined use of oral contraceptive pills and condom. In the stratified analysis, younger women with lower education level and from lower social classes reported less use of oral contraceptive pills. Tubal ligation was more prevalent among the lower social classes, but only in the age group from 30 to 39 years old. No differences were found in relation to male condom. CONCLUSIONS: The results indicated that differences persist in relation to contraception, which can be associated with both the difficulties of access to these inputs and the frailty of actions in reproductive health to achieve the needs and preferences of women who are more socially vulnerable.

RESUMO OBJETIVO: Descrever os métodos contraceptivos utilizados e fatores demográficos e socioeconômicos associados em mulheres adultas. MÉTODOS: Estudo transversal de base populacional com mulheres de 20 a 49 anos de São Leopoldo, RS, em 2015. Foram considerados três desfechos para analisar a associação com características demográficas e socioeconômicas: uso de anticoncepcional oral, ligadura tubária e uso de preservativo masculino. Foram obtidas razões de prevalências, brutas e estratificadas por idade, e intervalos de confiança de 95% (IC95%) por meio de regressão de Poisson, levando em conta o erro de delineamento. RESULTADOS: Foram avaliadas 736 mulheres com idades entre 20 e 49 anos. A prevalência de uso de anticoncepcional oral, de ligadura tubária e de uso de preservativo masculino foram, respectivamente, 31,8% (IC95% 28,4-35,3), 11,1% (IC95% 9,0-13,6) e 10,9% (IC95% 8,7-13,3). Além disso, 10,5% (n = 77) das mulheres relataram fazer uso combinado de anticoncepcional oral e preservativo masculino. Na análise estratificada, as mulheres mais jovens, de menor escolaridade e classe econômica mais baixa relataram menor uso de anticoncepcional oral. Já a ligadura tubária foi mais prevalente entre as de classe econômica mais baixa, mas apenas na faixa etária de 30 a 39 anos. Não foram encontradas diferenças quanto ao preservativo masculino. CONCLUSÕES: Os resultados indicaram que ainda persistem diferenças quanto à contracepção, o que pode se relacionar tanto a dificuldades no acesso a esses insumos como a fragilidades das ações em saúde reprodutiva para atingir as necessidades e preferências das mulheres em maior vulnerabilidade social.

Shift work, sleep duration, and body image dissatisfaction among female workers in southern Brazil.

We examined the association between shift work and sleep duration with body image dissatisfaction (BID) among shift-working women in southern Brazil. In this cross-sectional study, data of 505 women shift workers, between 18 and 60 years old, were collected between January and April 2011. BID was assessed using the Stunkard Figure Rating Scale. Information on shift work, sleep duration, and other explanatory variables was collected through a questionnaire. An aggregated exposure variable was created and termed "sleep deprivation," with the exposure category being night-shift workers who slept < 7 h/day. The respective prevalence ratio values were estimated using a Poisson regression. The prevalence of BID among shift-working women was 42.4 (95% CIs = 38.0 to 46.7%), and 199 (93.0%) of these women wished they had a smaller body size. Shift work (PR = 1.40; p = 0.006) and sleep duration (PR = 1.32; p = 0.010) were independently associated with BID. Additionally, workers with sleep deprivation exhibited a higher probability of BID than those without sleep deprivation (PR = 1.31; p = 0.012). These results reveal a situation of vulnerability and the need for strategies and actions directed at shift-working women with the aim of reducing the effects of sleep deprivation on mental health, particularly with regard to body image disorders.

Fatores associados a não realização de exame citopatológico em São Leopoldo, Rio Grande do Sul, 2015: estudo transversal de base populacional / Factores asociados a la no realización de examen citopatológico en São Leopoldo, Rio Grande do Sul, Brasil, 2015: estudio transversal de base poblacional / Factors associated with not having Pap Smears in São Leopoldo, Rio Grande do Sul, Brazil, 2015: a cross-sectional population-based study

Objetivo: estimar a prevalência de exame citopatológico não realizado nos últimos três anos e de nunca realizado em mulheres, e analisar fatores associados. Métodos: estudo transversal, com mulheres de 20 a 69 anos de idade, em São Leopoldo, RS, Brasil, em 2015; calcularam-se as razões de prevalência (RP) por regressão de Poisson. Resultados: entre 919 mulheres, a prevalência de exame atrasado foi 17,8% (intervalo de confiança de 95% [IC95%15,4;20,3), e de nunca realizado, 8,1% (IC95%6,3;9,8); na análise ajustada, o aumento na prevalência de exame atrasado mostrou-se associado à classe econômica D/E (RP=2,1 - IC95%1,3;3,5), idade de 20-29 anos (RP=3,2 - IC95%2,1;4,9) e nenhuma consulta realizada (RP=3,0 - IC95%2,1;4,1); nunca ter realizado exame associou-se com classe econômica D/E (RP=2,6 - IC95%1,4;5,0), idade de 20-29 anos (RP=24,1 - IC95%6,4;90,9) e nenhuma consulta (RP=2,9 - IC95%1,7;4,8). Conclusão: a cobertura de exame foi alta e com iniquidade.

Objetivo: estimar la prevalencia de examen en mujeres, no realizado en los últimos tres años y de nunca realizado, y analizar factores asociados. Métodos: estudio transversal con mujeres de 20 a 69 años de edad de São Leopoldo, RS, Brasil, en 2015; se calcularon las razones de prevalencia (RP) por la regresión de Poisson. Resultados: entre 919 mujeres, la prevalencia de examen retrasado fue 17,8% (intervalo de confianza del 95% [IC95%]15,4;20,3) y de nunca realizado fue del 8,1% (IC95%6,3;9,8); en el análisis ajustado, el aumento en la prevalencia de examen retrasado se asoció con clase económica D/E (RP=2,1 - IC95%1,3;3,5), a edad entre 20-29 años (RP=3,2 - IC95%2,1;4,9) y ninguna consulta (RP=3,0 - IC95%2,1;4,1); nunca haber realizado examen se asoció con clase D/E (RP=2,6 - IC95%1,4;5,0), a 20-29 años de edad (RP=24,1 - IC95%6,4;90,9) y ninguna consulta (RP=2,9 - IC95%1,7;4,8). Conclusión: la cobertura de examen fue alta y con inequidad.

Objective: to estimate the prevalence of Pap tests not performed in the last three years and never performed in women and to analyze factors. Methods: this was a cross-sectional study with women aged 20 to 69 years living in São Leopoldo, RS, Brazil, in 2015; prevalence ratios (PR) were calculated using Poisson regression. Results: among 919 women, prevalence of delayed testing was 17.8% (95% confidence interval [95%CI]15.4;20.3) and never tested prevalence was 8.1% (95%CI6.3%;9.8%); in the adjusted analysis, the increase in the prevalence of delayed testing was associated with economic class D/E (PR=2.1 - 95%CI1.3;3.5), being aged 20-29 years (PR=3.2 - 95%CI2.1;4.9) and not having had a medical appointment (PR=3.0 - 95%CI2.1;4.1); never having tested was associated with economic class D/E (PR=2.6 - 95%CI1.4;5.0), being aged 20-29 years (PR=24.1 - 95%CI6.4;90.9), and not having had a medical appointment (PR=2.9 - 95%CI1.7;4.8). Conclusion: coverage of the test was high but characterized by social inequality.

Basal cortisol levels and metabolic syndrome: A systematic review and meta-analysis of observational studies.

OBJECTIVE: To perform a qualitative synthesis (systematic review) and quantitative analysis (meta-analysis) to summarize the evidence regarding the relationship between basal cortisol levels and metabolic syndrome (MetS) in adults. METHODS: A systematic search was performed in the PubMed, Embase, and PsycINFO databases for observational studies on the association between basal cortisol levels and MetS. The quality of individual studies was assessed by the Newcastle-Ottawa score. A random effects model was used to report pooled quantitative results and the I2 statistic was used to assess heterogeneity. Egger's and Begg's tests were used to evaluate publication bias. RESULTS: Twenty-six studies (19 cross-sectional and seven case-control) met the inclusion criteria for the systematic review. The majority was classified as having a low risk of bias and used established criteria for the diagnosis of MetS. Twenty-one studies provided data on basal cortisol levels as continuous values and were included in the meta-analysis; they comprised 35 analyses and 11,808 subjects. Pooled results showed no significant difference in basal cortisol levels between subjects with and without MetS (standardized mean difference [SMD] = 0.02, 95% confidence interval [CI]=-0.11 to 0.14). There was high heterogeneity between the studies when all comparisons were considered (I2 = 83.1%;p < 0.001). Paradoxically, meta-analysis of studies evaluating saliva samples showed no significantly lower basal cortisol levels among subjects with MetS (SMD=-0.18, 95% CI=-0.37 to 0.01), whereas those studies that evaluated serum samples (SMD = 0.11, 95% CI=-0.02 to 0.24) and urine samples (SMD = 0.73, 95% CI=-0.40 to 1.86) showed no significantly higher basal cortisol levels among subjects with MetS. In the subgroup and meta-regression analyses, a significant difference in basal cortisol levels was observed according to study design, population base, age, gender, cortisol level assessment method, and study quality. CONCLUSION: This systematic review and meta-analysis does not reveal any association between basal cortisol levels and MetS based on results of observational studies. The results of a random-effect meta-analysis showed no significant difference in basal cortisol levels between subjects with and without MetS. The present findings should be considered in order to help future studies.

Pharmacotherapeutic profile of users and expenditure on high-cost drugs in São Leopoldo, Rio Grande do Sul State, Brazil, 2014. / Perfil farmacoterapêutico dos usuários e gasto com medicamentos de alto custo em São Leopoldo, Rio Grande do Sul, Brasil, 2014.

OBJECTIVE: to describe the pharmacotherapeutic profile of users of the Specialized Program for Pharmaceutical Assistance, and to measure the expenditure on the most prevalent and the most expensive medications. METHODS: descriptive study conducted in São Leopoldo-RS, Brazil, with secondary data regarding information about requests accepted in 2014, through administrative proceedings; delivery notes of the State Health Department/RS were used to assess the costs. RESULTS: 1,528 users were included in the study, mostly women (56.7%), and the average age was 52 years (standard deviation=17.9); the most frequent diagnoses were allergic asthma (17.1%), chronic kidney disease (11.5%) and rheumatoid arthritis (8.4%); the most prevalent drug was budesonide+formoterol fumarate (18.3%); among the most prevalent drugs, the highest total monthly expense was with epoetin alfa (BRL37,922.34) and among the most expensive drugs, infliximab (BRL72,503.28). CONCLUSION: the data show the importance of the Specialized Program for Pharmaceutical Assistance in the high-cost treatment of highly prevalent.

Perfil farmacoterapêutico dos usuários e gasto com medicamentos de alto custo em São Leopoldo, Rio Grande do Sul, Brasil, 2014 / Perfil farmacoterapéutico de los usuarios y gasto en medicamentos de alto costo en São Leopoldo, Rio Grande do Sul, Brasil, 2014 / Pharmacotherapeutic profile of users and expenditure on high-cost drugs in São Leopoldo, Rio Grande do Sul State, Brazil, 2014

OBJETIVO: descrever o perfil farmacoterapêutico dos usuários do Componente Especializado da Assistência Farmacêutica (CEAF) e mensurar os gastos com os medicamentos mais prevalentes e os mais onerosos. MÉTODOS: estudo descritivo, realizado no município de São Leopoldo-RS, Brasil; utilizaram-se dados secundários sobre solicitações de medicamentos deferidas em 2014 via processo administrativo; para avaliar os custos, foram consultadas as guias de remessa da Secretaria de Estado da Saúde/RS. RESULTADOS: foram incluídos 1.528 usuários, sobretudo mulheres (56,7%), e idade média de 52 anos (desvio-padrão=17,9); os diagnósticos mais frequentes foram asma alérgica (17,1%), doença renal crônica (11,5%) e artrite reumatoide (8,4%); o medicamento mais prevalente foi o fumarato de formoterol+budesonida (18,3%); o maior gasto total mensal entre os medicamentos mais prevalentes foi com alfaepoetina (R$37.922,34), e entre os mais onerosos, com infliximab (R$72.503,28). CONCLUSÃO: os dados apontam para a importância do CEAF no tratamento de alto custo de morbidades com elevada prevalência.

OBJETIVO: describir el perfil farmacoterapéutico de usuarios del Programa de Asistencia Farmacéutica Especializada (CEAF), y medir los costos de los medicamentos más comunes y más costosos. MÉTODOS: estudio descriptivo realizado en São Leopoldo/RS, con datos secundarios sobre solicitudes de drogas diferidas en 2014 a través de procesos administrativos; para evaluar el costo, utilizamos las entregas de Secretaría Estatal de Salud/RS. RESULTADOS: se incluyeron 1.528 usuarios, la mayoría mujeres (56,7%), edad media 52 años (desviación estándar=17,9); los diagnósticos más frecuentes fueron asma alérgica (17,1%), enfermedad renal crónica (11,5%) y artritis reumatoide (8,4%); la droga más frecuente fue budesónida+formoterol fumarato (18,3%); el mayor gasto total mensual de los fármacos más prevalentes fue con alfaepoetina (R$37.922,34) y entre los más caros, con infliximab (R$72.503,28). CONCLUSIÓN: los datos señalan la importancia de este componente en el tratamiento de alto costo de morbilidad con altas prevalencias.

OBJECTIVE: to describe the pharmacotherapeutic profile of users of the Specialized Program for Pharmaceutical Assistance, and to measure the expenditure on the most prevalent and the most expensive medications. METHODS: descriptive study conducted in São Leopoldo-RS, Brazil, with secondary data regarding information about requests accepted in 2014, through administrative proceedings; delivery notes of the State Health Department/RS were used to assess the costs. RESULTS: 1,528 users were included in the study, mostly women (56.7%), and the average age was 52 years (standard deviation=17.9); the most frequent diagnoses were allergic asthma (17.1%), chronic kidney disease (11.5%) and rheumatoid arthritis (8.4%); the most prevalent drug was budesonide+formoterol fumarate (18.3%); among the most prevalent drugs, the highest total monthly expense was with epoetin alfa (BRL37,922.34) and among the most expensive drugs, infliximab (BRL72,503.28). CONCLUSION: the data show the importance of the Specialized Program for Pharmaceutical Assistance in the high-cost treatment of highly prevalent.