A comparative analysis of the pharmacovigilance systems of Brazil, Spain, the European Union and the United States based on the information provided by their regulatory agency websites.

BACKGROUND: Pharmacovigilance (PV) plays an essential role in monitoring and raising awareness of adverse drug reactions (ADRs). Increasingly, ADRs are reported and PV information and activities are circulated via the Internet. PV actions are carried out by the Regulatory Agencies (RAs) responsible for medicinal products in each country. OBJECTIVE: The objective of this study is to ascertain and assess the operation and areas of competence of the PV system in Brazil and to compare them with those of Spain, the European Union (EU) and the United States (USA), through the information available on the websites of the RAs in each country. METHODS: A search of the information provided on the websites of these countries' RAs, establishing indicators to assess how far the information is available and accessible. RESULTS: The RAs we studied are similarly organised and they complied with most of the 38 indicators we defined to obtain and assess the information they provide on PV procedures and their systems for electronic reporting of ADRs. Brazil's RA, ANVISA, complied with 100% of the areas of competence analysed and with 92.11% of the indicators established for the study. CONCLUSIONS: Brazil's PV system, through ANVISA, achieves a good level of performance, both in itself and compared to the other RAs. There is room for improvement in three of the indicators analysed.

Consumption of medicines in high-risk pregnancy: evaluation of determinants related to the use of prescription drugs and self-medication

The use of drugs during pregnancy still represents a challenge for medicine, since the majority of drugs cross the placental barrier with a potential to cause several congenital problems to the fetus, and most of them have not been clinically tested in pregnant patients. At the same time, the medicalization phenomenon, self-medication, and lack of patient information about the misuse of medicines are additional problems. Thus, the aim of this study was to evaluate the pattern of medicine consumption in high-risk pregnancies and the determinants related to this consumption pattern. In order to do so, a cross-sectional descriptive study was performed with puerperal women who had a history of high-risk pregnancy. Statistically significant associations were found between self-medication and fewer prenatal visits, and cigarette use during pregnancy and a higher number of children. According to these data, the vulnerability of this population to the risks of drug use is evident, demonstrating a gap that requires urgent interventions in health-care education.

O uso de medicamentos na gestação representa, ainda hoje, um desafio para a medicina, visto que grande parte dos fármacos atravessa a barreira placentária e, na maioria, não foi testada clinicamente em gestantes, podendo vir a ocasionar diversos problemas congênitos ao feto. Ao mesmo tempo, a automedicação, o fenômeno da medicalização e a falta de informação sobre os riscos do mau uso de medicamentos são problemas adicionais. Diante disto, o objetivo deste estudo consistiu em avaliar o padrão de consumo de medicamentos na gestação de alto risco e os determinantes relacionados ao seu padrão de consumo. Para tanto, realizou-se um estudo descritivo de corte transversal com puérperas, que apresentaram gestação de alto risco. Verificaram-se associações estatisticamente significativas entre automedicação e mulheres com menor número de consultas de pré-natal, uso de cigarro na gestação e maior número de filhos. De posse destes dados, fica evidente a vulnerabilidade dessa população aos riscos decorrentes do uso de medicamentos, sendo esta lacuna um campo de prática com necessidade de intervenções urgentes no âmbito da educação em saúde.