Indicadores de prescrição e de cuidado ao paciente na atenção básica do município de Esperança, Paraíba, 2007 / Prescription indicators and patient-care in public primary care in the municipality of Esperança, Paraíba, 2007

Objetivo: descrever aspectos da prescrição e cuidado a pacientes em Unidades Básicas de Saúde da Família (UBSF) do município de Esperança, estado da Paraíba, Brasil. Métodos: estudo descritivo, sobre indicadores de prescrição e cuidado ao paciente propostos pela Organização Mundial da Saúde; amostra de conveniência, composta por pacientes maiores de 18 anos atendidos em janeiro-agosto de 2007. Resultados: foram considerados 600 pacientes, com média de medicamentos/receita de 2,4, 74,6 por cento dos medicamentos prescritos pelo nome genérico e 85,3 por cento constantes da Relação Municipal de Medicamentos Essenciais (REMUME); 9,3 por cento das receitas continham ao menos algum antibiótico, 10,1 por cento algum psicofármaco e 2,97 por cento alguma medicação injetável; foram dispensados 48,0 por cento dos medicamentos prescritos; o tempo médio de dispensação foi de 49 segundos e o tempo médio de consulta, 7 minutos e 8 segundos. Conclusão: os prescritores seguem a relação de medicamentos padronizados embora a REMUNE necessite atualizá-la periodicamente para atender o perfil epidemiológico populacional.

Objective: to discribe aspects of prescription and patient-care at Healthcare Units of Family Health (HUFH) in the municipality of Esperança, state of Bahia, Brazil. Methods: a descriptive cross-sectional study on prescription and patient-care indicators proposed by the World Health Organization. Results: average for prescribed drugs were 2.4; 74.6 percent of the medicaments were prescribed by generic name; 85.3 percent were listed by the Municipal List of Essential Drugs (REMUME); 9.3 percent had at least one antibiotic; 10.1 percent had at least one psychotropic; and 2.97 percent, at least an injectable medication; 48.0 percent of the prescribed drugs were effectively dispensed; the average time of dispensation was 49 seconds, and the medical consultation time, 7 minutes and 8 seconds. Conclusion: prescription follows standard list recommended, but REMUME needs actualization to attend the epidemiologic profile of the population.

The correlation between anthropometric measurements and biochemical cardiovascular risk markers in the hypertensive elderly.

OBJECTIVES: This study was aimed at correlating anthropometric markers indicating additional cardiovascular risk in a hypertensive elderly population enrolled in the HIPERDIA programme in Campina Grande, Paraíba, Brazil, South America. METHODS: The sample consisted of 131 hypertensive elderly people aged60 to 92 (25.9 % males and 74.1 % females). A socioeconomic, demographic, life-style questionnaire was used in the assessment. Information about anthropometry measurements and pathology frequency were also recorded via this questionnaire. Pearson's correlation, descriptive statistics, comparison between anthropometric variables by gender using Student's t-test and one-way ANOVA were used in the analysis for comparing groups by age(60 to 69, 70 to 79 and > 80 years). RESULTS: 14.7 % of men and 24.7 % of women were overweight and 11.8 % of men and 21.6 % of women were obese. 57.0 % of women and 26.5 % of men had inadequate values in waist-to-hip ratio analysis. 95.9 % of women and 52.9 % of men had high risk and 95.9 % of women and 38.2 % of men had high abdominal circumference values regarding waistline measurement. After selection (n=40) for correcting potential confounders, it was found that 27 subjects had high C-reactive protein values, an additional cardiovascular risk factor. CONCLUSIONS: The results suggested that additional cardiovascular risk could be demonstrated by the high prevalence of being overweight and central obesity presented by the population and the presence of subclinical inflammation amongst hypertensive ones.

The correlation between anthropometric measurements and biochemical cardiovascular risk markers in the hypertensive elderly / Correlación entre parámetros antropométricos y marcadores bioquímicos de riesgo cardiovascular en ancianos hipertensos

Objectives This study was aimed at correlating anthropometric markers indicating additional cardiovascular risk in a hypertensive elderly population enrolled in the HIPERDIA programme in Campina Grande, Paraíba, Brazil, South America. Methods The sample consisted of 131 hypertensive elderly people aged60 to 92 (25.9 percent males and 74.1 percent females). A socioeconomic, demographic, life-style questionnaire was used in the assessment. Information about anthropometry measurements and pathology frequency were also recorded via this questionnaire. Pearson's correlation, descriptive statistics, comparison between anthropometric variables by gender using Student's t-test and one-way ANOVA were used in the analysis for comparing groups by age(60 to 69, 70 to 79 and > 80 years). Results 14.7 percent of men and 24.7 percent of women were overweight and 11.8 percent of men and 21.6 percent of women were obese. 57.0 percent of women and 26.5 percent of men had inadequate values in waist-to-hip ratio analysis. 95.9 percent of women and 52.9 percent of men had high risk and 95.9 percent of women and 38.2 percent of men had high abdominal circumference values regarding waistline measurement. After selection (n=40) for correcting potential confounders, it was found that 27 subjects had high C-reactive protein values, an additional cardiovascular risk factor. Conclusions The results suggested that additional cardiovascular risk could be demonstrated by the high prevalence of being overweight and central obesity presented by the population and the presence of subclinical inflammation amongst hypertensive ones.

Objetivos El objetivo de este estudio fue correlacionar indicadores antropométricos de riesgo cardiovascular adicionales en una población de ancianos hipertensos registrados en el programa HIPERDIA, en Campiña Grande, Paraíba, Brasil, América del Sur. Métodos La muestra contó con 131 ancianos hipertensos, de 60 a 92 años (25,9 por ciento masculino y 74,1 por ciento femenino). Se utilizaron antropometría y encuesta por medio de un cuestionario con informaciones socioeconómicas, demográficas, hábitos de vida, y frecuencia de las enfermedades. En el análisis fue utilizada la correlación de Pearson, estadística descriptiva y para la comparación de las variables antropométricas por sexo Test t de Student y ANOVA One-Way para comparación por edad: 60 a 69, 70 a 79 y > 80. Resultados Los hombres presentaron frecuencias de 14,7 por ciento de sobrepeso y 11,8 por ciento de obesidad, y mujeres 24,7 por ciento y 21,6 por ciento, respectivamente. En el análisis de índice cintura-cadera, 57,0 por ciento de las mujeres y 26,5 por ciento de los hombres presentaron valores de riesgo. Analizando el perímetro de la cintura, 95,9 por ciento de las mujeres y 52,9 por ciento de los hombres presentaron riesgo, y 95,9 por ciento de las mujeres y 38,2 por ciento de los hombres presentaron elevados valores del perímetro abdominal. Despúes de una selección (n=40) para la corrección de posibles factores de confusión, 27 personas presentaron Proteína C Reactiva elevada. Conclusiones Los resultados muestran riesgo cardiovascular adicional, que se demuestra por la alta frecuencia del sobrepeso y obesidad central que se presentan en la población, asociados a inflamación subclínica en hipertensos.

[Medical prescriptions: adequate orientation to medicine use?]. / Prescrição médica: orientações adequadas para o uso de medicamentos?

During physician's consultation, the lack of adequate information on medication to the patient is a major problem to reach the correct pharmacotherapy. This study aims at assessing the patient knowledge about prescribed drugs. In order to proceed the investigation, interviews were performed about type of medication, dosage, administration schedule, purpose, duration of treatment and side effects. From 199 patients interviewed after they had received a prescription, 53.8% didn't have any information about the medicine, 20.3% didn't know the dosage and 25.4% didn't know the medication schedule. The purpose of the medication was the information with the highest percentage of correct answers, with 75.1% of the patients showing good level of knowledge. Regarding to the duration of the treatment and side effects, 57.4% and 94.4% of the patients, respectively, didn't present any correct information. Results suggest that the majority of the patients didn't have sufficient and safe knowledge to the use of prescribed medication.

Prescrição médica: orientações adequadas para o uso de medicamentos? / Medical prescriptions: adequate orientation to medicine use?

O conhecimento insuficiente de informação dada ao paciente durante a consulta médica resulta em grandes dificuldades para a condução correta da terapêutica medicamentosa. Baseados nesse contexto, o estudo teve como objetivo avaliar o grau de conhecimento dos pacientes sobre os medicamentos prescritos na Atenção Básica no município de Esperança (PB). Para tal, foram entrevistadas 199 pessoas que, após consulta médica, receberam prescrição, tendo sido avaliado o nível de conhecimento desses pacientes em relação ao nome do medicamento, a dose, o horário, a finalidade, o tempo de uso e reações desagradáveis. Entre os entrevistados, 53,8 por cento evidenciaram desconhecer o nome do medicamento, 20,3 por cento a dosagem e 25,4 por cento o horário de utilização. O item em que se observou maior frequência de acerto foi finalidade do medicamento, tendo 75,1 por cento dos pacientes apresentado bom conhecimento. No que se refere ao tempo de uso e às reações desagradáveis, 57,4 por cento e 94,4 por cento dos pacientes, respectivamente, não possuíam nenhuma informação correta. Os resultados sugerem que a maioria dos pacientes não apresenta o conhecimento adequado e seguro para a utilização dos medicamentos prescritos.

During physician's consultation, the lack of adequate information on medication to the patient is a major problem to reach the correct pharmacotherapy. This study aims at assessing the patient knowledge about prescribed drugs. In order to proceed the investigation, interviews were performed about type of medication, dosage, administration schedule, purpose, duration of treatment and side effects. From 199 patients interviewed after they had received a prescription, 53.8 percent didn't have any information about the medicine, 20.3 percent didn't know the dosage and 25.4 percent didn't know the medication schedule. The purpose of the medication was the information with the highest percentage of correct answers, with 75.1 percent of the patients showing good level of knowledge. Regarding to the duration of the treatment and side effects, 57.4 percent and 94.4 percent of the patients, respectively, didn't present any correct information. Results suggest that the majority of the patients didn't have sufficient and safe knowledge to the use of prescribed medication.

[Effects of differerent types of training and life styles on anthropometric and cardiocirculatory markers in aging]. / Efeitos de Diferentes Treinamentos e Estilos de Vida nos Indicadores Antropométricos e Cardiocirculatórios no Envelhecimento.

OBJECTIVE: The aim of this experimental study was to compare the effects of different forms of training and life styles on hemodynamic markers, cardiac capacity, Waist-to-Hip Ratio-WHR and Body Mass Index-BMI in elders, between 60-69 years, of both sexes. MATERIALS AND METHODS: The sample was composed of elders, between 60-69 years, of both sexes: masculine N=159 and feminine N=157. They were divided into three groups: experimental 1: n=53 (masculine) and n=51 (feminine) activity: cardio respiratory endurance; experimental 2: n=53 (masculine) and n=53 (feminine) activity: resistance training with Local Muscle Resistance-RML; control group: n=53 (masculine) and n=53 (feminine) who didn t practice any regular physical activity, considered sedentary. The variables investigated were BMI, WHR, Cardiac Frequency at rest, Systolic Blood Pressure, Diastolic Blood Pressure, Mean Blood Pressure and Double Product. The data analysis was descriptive and inferential and comparisons were performed between groups and inter groups. The data collected in this study and the hypothesis test showed the benefits of physical activity on the selected parameters for observation. RESULTS: It was demonstrated the existence of significative difference (p<0.05) in the studied variables. CONCLUSIONS: There is a need for adherence in broad-spectrum physical activity in elders.

Efeitos de Diferentes Treinamentos e Estilos de Vida nos Indicadores Antropométricos e Cardiocirculatórios no Envelhecimento / Effects of differerent types of training and life styles on anthropometric and cardiocirculatory markers in aging / Efectos de diferentes tipos de entrenamiento y estilos de vida sobre indicadores antropométricos y cardiocirculatorios en el envejecimiento

Objetivo O presente estudo, de caráter experimental, pretende comparar os efeitos de diferentes formas de treinamento e estilo de vida sobre os indicadores hemodinâmicos, capacidade cardíaca, relação cintura quadril e índice de massa corporal, em adultos velhos de ambos os sexos entre 60 e 69 anos de idade. Materiais e Métodos As amostras utilizaram adultos velhos de 60 a 69 anos de ambos os sexos: masculino N=159 e feminino N=157, divididos em três grupos: experimental 1, n=53 (masculino) e n=51 (feminino) atividade endurance cardio-respitatório; experimental 2, n=53 (masculino) e n=53 (feminino) atividade musculação com séries de Resistência Muscular Localizada (RML); controle n=53 (masculino) e n=53 (feminino) não praticantes de atividade física considerados sedentários. As variáveis investigadas foram Índice de Massa Corporal (IMC) e Relação Cintura Quadril (RCQ), Freqüência Cardíaca de Repouso (FCrep), Pressão Arterial Sistólica (PAS), Pressão Arterial Diastólica (PAD), Pressão Arterial Média (PAM) e Duplo Produto (DP). As estatísticas utilizadas foram a descritiva e a inferencial a comparação intra e entre grupos. Os dados coletados neste estudo e o teste de hipótese demonstram os benefícios da atividade física, nos parâmetros escolhidos para observação. Resultados Foi demonstrada a existência de uma diferença significativa (p<0.05) nas variáveis estudadas. Conclusões Há necessidade da aderência à atividade física de amplo espectro nas idades mais avançadas.

Objective The aim of this experimental study was to compare the effects of different forms of training and life styles on hemodynamic markers, cardiac capacity, Waist-to-Hip Ratio-WHR and Body Mass Index-BMI in elders, between 60-69 years, of both sexes. Materials and Methods The sample was composed of elders, between 60-69 years, of both sexes: masculine N=159 and feminine N=157. They were divided into three groups: experimental 1: n=53 (masculine) and n=51 (feminine) activity: cardio respiratory endurance; experimental 2: n=53 (masculine) and n=53 (feminine) activity: resistance training with Local Muscle ResistanceRML; control group: n=53 (masculine) and n=53 (feminine) who didn´t practice any regular physical activity, considered sedentary. The variables investigated were BMI, WHR, Cardiac Frequency at rest, Systolic Blood Pressure, Diastolic Blood Pressure, Mean Blood Pressure and Double Product. The data analysis was descriptive and inferential and comparisons were performed between groups and inter groups. The data collected in this study and the hypothesis test showed the benefits of physical activity on the selected parameters for observation. Results It was demonstrated the existence of significative difference (p<0.05) in the studied variables. Conclusions There is a need for adherence in broad-spectrum physical activity in elders.

Objetivo El presente estudio, de carácter exploratorio, se propuso comparar los efectos de diferentes tipos de entrenamiento y estilos de vida sobre indicadores hemodinámicos, capacidad cardíaca, relación cintura/caderaRCC e Índice de Masa CorporalIMC, en personas de 60 a 69 años de edad, de los dos sexos. Materiales y Métodos La muestra se conformó con personas de 60 a 69 años de edad, de los dos sexos: masculino N=159 y feminino N=157, divididos en tres grupos: experimental 1 n=53 (masculino) y n=51 (feminino). Actividad: terapia cardiorrespiratoria; experimental 2 n=53 (masculino) y n=53 (feminino). Actividad: Ejercicios Localizados de Resistencia-RML; Control n=53 (masculino) y n=53 (femenino) que no realizó actividad física, y considerados sedentarios. Las variables investigadas fueron: Indice de masa corporal-IMC, Relación cintura cadera-RCC, Frecuencia cardíaca en reposo-FCrep, Presión arterial sistólica-PAS, Presión arterial diatólica-PAD, Presión arterial media-PAM y Producto Doble-DP. Se utilizaron estadísticas descriptivas e inferenciales, y comparación intra y entre grupos. Los datos obtenidos y la prueba de la hipótesis muestran los beneficios de la actividad física, en los parámetros elegidos para observación. Resultados Se demostró la existencia de un significativa diferencia (p<0.05) en las variables estudiadas. Conclusiones En las edades avanzadas se requiere la adhesión a la actividad física de amplio espectro.

Estado nutricional alterado e sua associação com perfil lipídico e hábitos de vida em idosos hipertensos / Altered nutritional status and its association with lipid profile and lifestyle in hypertensive elders

O objetivo desta pesquisa foi verificar a frequência de obesidade central e generalizada e sua associação com perfil lipídico e hábitos de vida em idosos hipertensos, cadastrados no Sistema Hiper Dia em Campina Grande, Paraíba, Brasil. Trata-se de um estudo transversal, comparativo e associativo realizado em uma população de 131 sujeitos (60 a 92 anos), os quais foram divididos em grupos, por sexo; masculino (n=34) e feminino (n=97), e por idade; 60 a 69 (n=59), 70 a 79 (n=58) e = 80 (n=14). Foram realizadas avaliações bioquímicas e antropométricas e entrevista contendo informações sobre diagnóstico médico, dados sócio-econômicos, demográficos e hábitos de vida. Utilizou-se estatística descritiva e na análise comparativa, Teste t de Student ou ANOVA One-Way. Para associação utilizou-se o Teste Exato de Fisher ou Qui-quadrado. Dos entrevistados, 75,8 por cento eram sedentários. Entre os homens, a frequência de sobrepeso foi de 14,7 por cento e de obesidade de 11,8 por cento, já entre as mulheres, de 24,7 por cento e 21,6 por cento, respectivamente. Na análise da Relação-Cintura-Quadril - RCQ observou-se que 76,3 por cento das mulheres e 26,5 por cento dos homens apresentaram valores acima dos recomendados. Para a Circunferência da Cintura - CC, 95,9 por cento das mulheres e 52,9 por cento homens mostraram risco elevado. A Circunferência Abdominal - CA de 95,9 por cento das mulheres e 38,2 por cento dos homens apresentou valores de indicativos de risco. Somente os homens apresentaram associação estatisticamente significativa da RCQ e CA com Índice de Massa Corpórea (= 30 Kg/m2), indicando obesidade centralizada (p=0.0480) e (p=0.0040), respectivamente. Os resultados apontam uma alta frequência de sobrepeso e obesidade centralizada associada com sedentarismo.

The objective of this study was to verify the frequency of central and generalized obesity and its association with lipid profile and lifestyle in hypertensive elders enrolled in HiperDia System in Campina Grande, Paraíba, Brazil. This cross-sectional comparative and associative study was performed on a sample of 131 hypertensive elders (range: 60 to 92 years). They were divided into groups by sex (masculine) n=34 and (feminine) n=97, and by age (60 to 69) n=59, (70 to 79) n=58 and (= 80) n=14. Anthropometric and biochemical assessments and interviews containing information about medical diagnosis and socioeconomic, demographic, and lifestyle characteristics were performed. A descriptive statistics analysis was used and in the comparative analysis we used Student´s t test or One-way Anova. To the association we used Fisher´s Exact test or Chi-square test. Seventy-five point eight percent of who were interviewed were sedentarians. Men showed frequencies of 14.7 percent of overweight and 11.8 percent of obesity, and women showed frequencies of 24.7 percent and 21.6 percent, respectively. In the Waist-to-hip ratio - WHR analysis it was observed that 76.3 percent of women and 26.5 percent of men showed inadequate values. Considering the Waistline measurement - WM, 95.9 percent of women and 52.9 percent of men showed high risk. Considering the Abdominal circumference - AC, 95.9 percent of women and 38.2 percent of men showed values that indicated risk. Only men showed significative association between WHR, AC and Body Mass Index = 30 Kg/m2, that indicated central obesity, (p=0.0480) and (p=0.0040), respectively. Results point to a high frequency of overweight and central obesity associated with sedentarism.

[Altered nutritional status and its association with lipid profile and lifestyle in hypertensive elders]. / Estado nutricional alterado e sua associação com perfil lipídico e hábitos de vida em idosos hipertensos.

The objective of this study was to verify the frequency of central and generalized obesity and its association with lipid profile and lifestyle in hypertensive elders enrolled in HiperDia System in Campina Grande, Paraíba, Brazil. This cross-sectional comparative and associative study was performed on a sample of 131 hypertensive elders (range: 60 to 92 years). They were divided into groups by sex (masculine) n = 34 and (feminine) n = 97, and by age (60 to 69) n = 59, (70 to 79) n = 58 and (= 80) n =14. Anthropometric and biochemical assessments and interviews containing information about medical diagnosis and socioeconomic, demographic, and lifestyle characteristics were performed. A descriptive statistics analysis was used and in the comparative analysis we used Student's t test or One-way Anova. To the association we used Fisher's Exact test or Chi-square test. Seventy-five point eight percent of who were interviewed were sedentarians. Men showed frequencies of 14.7% of overweight and 11.8% of obesity, and women showed frequencies of 24.7% and 21.6%, respectively. In the Waist-to-hip ratio--WHR analysis it was observed that 76.3% of women and 26.5% of men showed inadequate values. Considering the Waistline measurement--WM, 95.9% of women and 52.9% of men showed high risk. Considering the Abdominal circumference--AC, 95.9% of women and 38.2% of men showed values that indicated risk. Only men showed significative association between WHR, AC and Body Mass Index = 30 Kg/ m2, that indicated central obesity, (p = 0.0480) and (p = 0.0040), respectively. Results point to a high frequency of overweight and central obesity associated with sedentarism.