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1.
Rev Saude Publica ; 53: 92, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31644723

RESUMO

OBJECTIVE: To estimate the use of the first dose of antibiotics in the health care unit in children from the 2015 Pelotas Birth Cohort at 24 months. METHODS: A total of 4,014 children were monitored. We used descriptive statistics and Poisson regression to analyze the association between socioeconomic and demographic variables, participation in daycare units, in the activities of the Pastoral da Criança and in the Primeira Infância Melhor program, low birth weight, hospitalization between 12 and 24 months, place of medical appointment, prevalence of medical appointment in the last 30 days, prescription of antibiotics, and administration of the first dose in the health care unit. RESULTS: A total of 1,044 children had medical appointments in the last 30 days, of which 45% were prescribed antibiotics and only 10.5% were administered the first dose of this medication in the health care unit. Children with brown, yellow or indigenous skin color were administered 2.5 times more antibiotics than white children. Children whose mothers had 12 years or more of education were administered 83.0% fewer antibiotics than those whose mothers had up to 4 years of education. Among those who were hospitalized for 12 to 24 months, the use of antibiotics was almost four times higher than among those who were not. Among the children served by the Brazilian Unified Health System (SUS), only 15.3% were administered the first dose of antibiotic in the health care unit. When compared with children served by private health care or health plan, administration of the first dose in the SUS was 76.0% higher. CONCLUSIONS: Despite the efforts related to the Pastoral da Criança campaign "Antibiotic: first dose immediately," adherence to the provision of antibiotics in the health care unit is still low. Strategies are necessary and urgent so children have access to the first dose of antibiotics in the health care unit.


Assuntos
Antibacterianos/administração & dosagem , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Adulto , Agendamento de Consultas , Brasil/epidemiologia , Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Estudos de Coortes , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Masculino , Mães , Programas Nacionais de Saúde , Prevalência , Fatores Socioeconômicos , Fatores de Tempo , Adulto Jovem
2.
BMC Public Health ; 19(1): 1260, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31510953

RESUMO

BACKGROUND: We evaluated the prevalence and the factors associated with repeated high systolic (SBP) and diastolic blood pressure (DBP) at 6- and 11-year follow-ups of children from the Pelotas (Brazil) 2004 Birth Cohort. METHODS: All live births to mothers living in the urban area of Pelotas were enrolled in the cohort. Blood pressure (BP) values were transformed into Z-scores by sex, age, and height. High SBP and DBP were defined as repeated systolic and diastolic BP Z-scores on the ≥95th percentile at the two follow-ups. Prevalence (95% confidence interval) of repeated high SBP, DBP, and both (SDBP) were calculated. Associations with maternal and child characteristics were explored in crude and adjusted logistic regression analyses. RESULTS: A total of 3182 cohort participants were analyzed. Prevalence of repeated high SBP, DBP and SDBP was 1.7% (1.2-2.1%), 2.3% (1.8-2.9%) and 1.2% (0.9-1.6%), respectively. Repeated high SBP was associated with males, gestational diabetes mellitus (2.92; 1.13-7.58) and obesity at 11 years (2.44; 1.29-4.59); while repeated high DBP was associated with females, family history of hypertension from both sides (3.95; 1.59-9.85) and gestational age < 34 weeks (4.08; 1.52-10.96). Repeated high SDBP was not associated with any of the characteristics investigated. CONCLUSION: Prevalence of repeated high SBP, DBP, and SDBP were within the expected distribution at the population level. Nonetheless, gestational diabetes mellitus, obesity, family history of hypertension, and prematurity increased the risk of repeated high blood pressure measured at two occasions 5 years apart.


Assuntos
Hipertensão/epidemiologia , Brasil/epidemiologia , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco
3.
Rev. saúde pública (Online) ; 53: 92, jan. 2019. tab
Artigo em Inglês | LILACS-Express | ID: biblio-1043338

RESUMO

ABSTRACT OBJECTIVE To estimate the use of the first dose of antibiotics in the health care unit in children from the 2015 Pelotas Birth Cohort at 24 months. METHODS A total of 4,014 children were monitored. We used descriptive statistics and Poisson regression to analyze the association between socioeconomic and demographic variables, participation in daycare units, in the activities of the Pastoral da Criança and in the Primeira Infância Melhor program, low birth weight, hospitalization between 12 and 24 months, place of medical appointment, prevalence of medical appointment in the last 30 days, prescription of antibiotics, and administration of the first dose in the health care unit. RESULTS A total of 1,044 children had medical appointments in the last 30 days, of which 45% were prescribed antibiotics and only 10.5% were administered the first dose of this medication in the health care unit. Children with brown, yellow or indigenous skin color were administered 2.5 times more antibiotics than white children. Children whose mothers had 12 years or more of education were administered 83.0% fewer antibiotics than those whose mothers had up to 4 years of education. Among those who were hospitalized for 12 to 24 months, the use of antibiotics was almost four times higher than among those who were not. Among the children served by the Brazilian Unified Health System (SUS), only 15.3% were administered the first dose of antibiotic in the health care unit. When compared with children served by private health care or health plan, administration of the first dose in the SUS was 76.0% higher. CONCLUSIONS Despite the efforts related to the Pastoral da Criança campaign "Antibiotic: first dose immediately," adherence to the provision of antibiotics in the health care unit is still low. Strategies are necessary and urgent so children have access to the first dose of antibiotics in the health care unit.


RESUMO OBJETIVO Estimar o uso da primeira dose do antibiótico no local de atendimento nas crianças da Coorte de Nascimentos de Pelotas de 2015 aos 24 meses. MÉTODOS Foram acompanhadas 4.014 crianças. A associação entre variáveis socioeconômicas e demográficas, participação em creche, nas ações da Pastoral da Criança e no programa Primeira Infância Melhor, baixo peso ao nascer, internação entre 12 e 24 meses, local da consulta, prevalência de consulta nos últimos 30 dias, prescrição de antibióticos e recebimento da primeira dose no local de atendimento foi analisada por meio de estatística descritiva e regressão de Poisson. RESULTADOS Tiveram consulta nos últimos 30 dias 1.044 crianças, das quais 45% receberam prescrição de antibiótico e apenas 10,5% receberam a primeira dose dessa medicação no local de atendimento. Crianças de cor da pele parda, amarela ou indígena tiveram um uso de antibiótico 2,5 vezes maior que o das brancas. Já as crianças cujas mães tinham 12 anos ou mais de escolaridade usaram 83,0% menos antibióticos que aquelas cujas mães tinham até quatro anos de estudo. Entre aquelas que foram internadas entre 12 e 24 meses, o uso de antibiótico foi quase quatro vezes maior do que entre as que não foram. Entre as crianças atendidas pelo Sistema Único de Saúde (SUS), apenas 15,3% receberam a primeira dose do antibiótico no local de atendimento. Quando comparado com o de crianças atendidas por financiamento particular ou convênio, o recebimento da primeira dose no SUS chegou a ser 76,0% superior. CONCLUSÕES Apesar dos esforços relacionados à campanha da Pastoral da Criança "Antibiótico: primeira dose imediata", ainda é baixa a adesão ao fornecimento de antibióticos no local de atendimento. Estratégias são necessárias e urgentes para que as crianças tenham acesso à primeira dose de antibióticos no local de atendimento.

4.
J. bras. econ. saúde (Impr.) ; 9(3): 260-266, Dez. 2017.
Artigo em Português | LILACS, ECOS | ID: biblio-883011

RESUMO

Objetivo: Avaliar a influência de cinco estilos de vida sobre a autoavaliação da saúde como boa no Brasil. Métodos: Estudo transversal utilizando dados da Pesquisa Nacional de Saúde (PNS) realizada em 2013, com amostra de 46.785 indivíduos. O desfecho principal foi a autoavaliação de saúde como boa e utilizou-se a regressão logística para analisar os estilos de vida saudáveis associados a melhor autoavaliação de saúde. Resultados: Encontramos que o tabagismo, o consumo de álcool, a atividade física e a alimentação saudável são comportamentos que estão associados à autoavaliação de saúde. Pessoas que apresentam múltiplos comportamentos saudáveis apresentam chances maiores de avaliar positivamente sua saúde. Conclusão: Políticas de conscientização devem ser realizadas informando a população dos benefícios da adoção de hábitos de vida saudáveis.


Objective: Evaluating the influence of five lifestyles on health self-assessment as good in Brazil. Methods: Cross-sectional descriptive study using data from the National Health Survey (PNS 2013) conducted in 2013, with a sample of 46,785 individuals. The main outcome was self-rated health as good and logistic regression was used to analyze healthy lifestyles associated with better self-rated health. Results: We found that smoking, drinking, physical activity and healthy eating are behaviors that are associated with self-rated health. People who have multiple healthy behaviors are more likely to positively evaluate their health. Conclusion: Awareness policies should be carried out to inform the population of the benefits of adopting a healthy lifestyle.


Assuntos
Humanos , Autoavaliação Diagnóstica , Estilo de Vida Saudável
5.
Rev Bras Epidemiol ; 20(2): 310-323, 2017.
Artigo em Português, Inglês | MEDLINE | ID: mdl-28832853

RESUMO

Introduction:: Well-planned and executed pharmaceutical services (PS) are important for proper treatment of the population's health needs, thus enabling the access to essential drugs and promoting their rational use. Objective:: To assess the situation of PS in the city of Uruguaiana (State of Rio Grande do Sul), Brazil. Methods:: This cross-sectional study was applied to 650 interviews between June and September of 2013 in 11 Basic Health Units (UBS) and in the Main Pharmacy of the city. The indicators of prescription, of patient's care, and of service, were assessed according to the recommendations of the World Health Organization (WHO).The Instrument of Self-Assessment for Pharmaceutical Services Planning (IAPAF) from the Brazilian Department of Health was used to assess the management and planning capacity of the PS, which was then applied in the Main Pharmacy and in the medicine stockroom. Results:: The number of drugs per prescription varied from 1 to 10 (mean = 1.7). The percentages of prescribed drugs by generic name, and included in the City List of Essential Drugs (REMUME) were, respectively, 75.5 and 67.7%; antibiotics were prescribed in 9.7% of the medical appointments. The average time of medical appointment was 6 minutes; 51.4% of the users obtained their prescription; only 18.9% of the patients completely understood their prescriptions. Of the 24 items analyzed in the IAPAF, 12 were found in stage 1 (worst rating), 12 in stage 2, and none in stage 3 (ideal situation). Conclusion:: Results seem to show the lack of PS in Uruguaiana with regard to planning, management, and patient's care. The absence of effective management may result in waste and incorrect use of drugs.


Assuntos
Assistência Farmacêutica/normas , Adulto , Idoso , Brasil , Cidades , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
Cien Saude Colet ; 22(8): 2627-2644, 2017 Aug.
Artigo em Português, Inglês | MEDLINE | ID: mdl-28793078

RESUMO

The need to increase access to medicines, coupled with the limited acceptance of generics has sparked the search for effective interventions to promote it. This systematic review aimed to conduct a survey on interventions to promote the use of generic drugs and its impact. Randomized clinical trials, non-randomized controlled trials, controlled before-after studies and interrupted time series were included. The analysis of the impact of interventions and quality of evidence followed Cochrane's guidelines. Impact of interventions was rated from "very large" to "very small" and the quality of evidence was rated from "high" to "very low". Seventeen papers addressing prescribers, pharmacists and users were selected. There were educational, financial incentives and use of electronic prescription and managerial interventions. Interventions applied to prescribers had little to medium impact, with very low-to-low quality evidence. Interventions applied to pharmacists had small impact with very low quality evidence. Interventions applied to users had medium and large impact with very low-to-low quality evidence. Further studies with good quality addressing interventions are required.


Assuntos
Medicamentos Genéricos/uso terapêutico , Acesso aos Serviços de Saúde , Padrões de Prática Médica/estatística & dados numéricos , Atitude do Pessoal de Saúde , Humanos , Motivação , Aceitação pelo Paciente de Cuidados de Saúde , Assistência Farmacêutica/organização & administração , Farmacêuticos/organização & administração , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Ciênc. Saúde Colet ; 22(8): 2627-2644, Ago. 2017. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-890424

RESUMO

Resumo A necessidade de aumento do acesso aos medicamentos, aliada à limitada aceitação dos genéricos, tem suscitado a busca de intervenções eficazes para a sua promoção. Esta revisão sistemática realizou levantamento de intervenções voltadas à promoção do uso dos medicamentos genéricos e seus impactos. Foram incluídos ensaios randomizados, ensaios controlados não randomizados, estudos tipo antes e depois e séries temporais interrompidas. As análises quanto ao impacto das intervenções e qualidade das evidências seguiram as orientações da Cochrane. A classificação do impacto das intervenções variou de muito grande a muito pequeno e da qualidade da evidência de alta a muito baixa. Selecionou-se 17 artigos com público alvo de prescritores, farmacêuticos e usuários. As intervenções utilizadas foram educativas, de incentivo financeiro, uso de prescrição eletrônica e gerencial. Intervenções aplicadas aos prescritores tiveram impacto pequeno a médio, com qualidade muito baixa a baixa; aos farmacêuticos, impacto pequeno e qualidade muito baixa; aos usuários mostraram impacto médio e grande com qualidade muito baixa e baixa. São necessários mais estudos de boa qualidade abordando as intervenções.


Abstract The need to increase access to medicines, coupled with the limited acceptance of generics has sparked the search for effective interventions to promote it. This systematic review aimed to conduct a survey on interventions to promote the use of generic drugs and its impact. Randomized clinical trials, non-randomized controlled trials, controlled before-after studies and interrupted time series were included. The analysis of the impact of interventions and quality of evidence followed Cochrane's guidelines. Impact of interventions was rated from "very large" to "very small" and the quality of evidence was rated from "high" to "very low". Seventeen papers addressing prescribers, pharmacists and users were selected. There were educational, financial incentives and use of electronic prescription and managerial interventions. Interventions applied to prescribers had little to medium impact, with very low-to-low quality evidence. Interventions applied to pharmacists had small impact with very low quality evidence. Interventions applied to users had medium and large impact with very low-to-low quality evidence. Further studies with good quality addressing interventions are required.

8.
Rev Saude Publica ; 51: 59, 2017 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-28678909

RESUMO

OBJECTIVE: The objective of this study is to identify factors associated with the preference for purchasing generic drugs in a medium-sized municipality in Southern Brazil. METHODS: We have analyzed data from a population-based cross-sectional study conducted in 2012 with a sample of 2,856 adults (≥ 20 years old). The preference for purchasing generic drugs was the main outcome. The explanatory variables were the demographic and socioeconomic variables. Statistical analyses included Poisson regressions. RESULTS: The preference for purchasing generic drugs was 63.2% (95%CI 61.4-64.9). The variables correlated with this preference in the fully adjusted models were: male (prevalence ratio [PR] = 1.08; 95%CI 1.03-1.14), age of 20-39 years (PR = 1.10; 95%CI 1.02-1.20), low socioeconomic status (PR = 1.15; 95%CI 1.03-1.28), and good knowledge about generic drugs (PR= 4.66; 95%CI 2.89-7.52). Among those who preferred to purchase generic drugs, 55.1% have reported accepting to replace the prescribed drug (if not a generic) with the equivalent generic drug. Another correlate of the preference for purchasing generic drugs was because individuals consider their quality equivalent to reference medicines (PR = 2.15; 95%CI 1.93-2.41). CONCLUSIONS: Knowledge about generic drugs was the main correlate of the preference for purchasing generic drugs. The greater the knowledge or positive perception about generic drugs, the greater is the preference to purchase them. Therefore, educational campaigns for healthcare professionals and consumers appear to be the best strategy for expanding the use of generic drugs in Brazil.


Assuntos
Medicamentos Genéricos/uso terapêutico , Conhecimento do Paciente sobre a Medicação , Adulto , Idoso , Brasil , Comportamento do Consumidor , Estudos Transversais , Prescrições de Medicamentos/economia , Medicamentos Genéricos/economia , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , População Urbana , Adulto Jovem
9.
Rev. bras. epidemiol ; 20(2): 310-323, Abr.-Jun. 2017. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-898588

RESUMO

RESUMO: Introdução: A Assistência Farmacêutica (AF) bem planejada e conduzida é importante para o adequado atendimento às necessidades de saúde da população, facilitando o acesso aos medicamentos essenciais e promovendo seu uso racional. Objetivo: Avaliar a situação da AF no município de Uruguaiana (RS). Métodos: Estudo transversal, com realização de 650 entrevistas, entre junho e setembro de 2013, em 11 Unidades Básicas de Saúde (UBS) e na Farmácia Central. Os indicadores de prescrição, de assistência ao paciente e de serviço foram avaliados de acordo com as recomendações da Organização Mundial da Saúde (OMS). Para avaliar a capacidade gerencial e de planejamento da AF, foi utilizado o Instrumento de Autoavaliação para o Planejamento da Assistência Farmacêutica (IAPAF) do Ministério da Saúde, o qual foi aplicado na Farmácia Central e no almoxarifado de medicamentos. Resultados: O número de medicamentos por prescrição variou de 1 a 10 (média = 1,7). Os percentuais de medicamentos prescritos pelo nome genérico e que constam na Relação Municipal de Medicamentos Essenciais (REMUME) foram de 75,5 e 67,7%, respectivamente; em 9,7% das consultas médicas foram prescritos antibióticos. O tempo médio de consulta médica foi de 6 minutos; 51,4% dos usuários tiveram sua prescrição atendida; apenas 18,9% dos pacientes compreenderam totalmente a prescrição. Dos 24 itens analisados no IAPAF, 12 encontravam-se no estágio 1 (pior avaliação), 12 no estágio 2 e nenhum no estágio 3 (situação considerada ideal). Conclusão: Os resultados encontrados parecem demonstrar a deficiência da AF em Uruguaiana quanto ao planejamento, à gerência e à assistência ao paciente. A ausência de gestão efetiva pode resultar em desperdícios e no uso incorreto de medicamentos.


ABSTRACT: Introduction: Well-planned and executed pharmaceutical services (PS) are important for proper treatment of the population's health needs, thus enabling the access to essential drugs and promoting their rational use. Objective: To assess the situation of PS in the city of Uruguaiana (State of Rio Grande do Sul), Brazil. Methods: This cross-sectional study was applied to 650 interviews between June and September of 2013 in 11 Basic Health Units (UBS) and in the Main Pharmacy of the city. The indicators of prescription, of patient's care, and of service, were assessed according to the recommendations of the World Health Organization (WHO).The Instrument of Self-Assessment for Pharmaceutical Services Planning (IAPAF) from the Brazilian Department of Health was used to assess the management and planning capacity of the PS, which was then applied in the Main Pharmacy and in the medicine stockroom. Results: The number of drugs per prescription varied from 1 to 10 (mean = 1.7). The percentages of prescribed drugs by generic name, and included in the City List of Essential Drugs (REMUME) were, respectively, 75.5 and 67.7%; antibiotics were prescribed in 9.7% of the medical appointments. The average time of medical appointment was 6 minutes; 51.4% of the users obtained their prescription; only 18.9% of the patients completely understood their prescriptions. Of the 24 items analyzed in the IAPAF, 12 were found in stage 1 (worst rating), 12 in stage 2, and none in stage 3 (ideal situation). Conclusion: Results seem to show the lack of PS in Uruguaiana with regard to planning, management, and patient's care. The absence of effective management may result in waste and incorrect use of drugs.

10.
Rev. saúde pública (Online) ; 51: 59, 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-903215

RESUMO

ABSTRACT OBJECTIVE The objective of this study is to identify factors associated with the preference for purchasing generic drugs in a medium-sized municipality in Southern Brazil. METHODS We have analyzed data from a population-based cross-sectional study conducted in 2012 with a sample of 2,856 adults (≥ 20 years old). The preference for purchasing generic drugs was the main outcome. The explanatory variables were the demographic and socioeconomic variables. Statistical analyses included Poisson regressions. RESULTS The preference for purchasing generic drugs was 63.2% (95%CI 61.4-64.9). The variables correlated with this preference in the fully adjusted models were: male (prevalence ratio [PR] = 1.08; 95%CI 1.03-1.14), age of 20-39 years (PR = 1.10; 95%CI 1.02-1.20), low socioeconomic status (PR = 1.15; 95%CI 1.03-1.28), and good knowledge about generic drugs (PR= 4.66; 95%CI 2.89-7.52). Among those who preferred to purchase generic drugs, 55.1% have reported accepting to replace the prescribed drug (if not a generic) with the equivalent generic drug. Another correlate of the preference for purchasing generic drugs was because individuals consider their quality equivalent to reference medicines (PR = 2.15; 95%CI 1.93-2.41). CONCLUSIONS Knowledge about generic drugs was the main correlate of the preference for purchasing generic drugs. The greater the knowledge or positive perception about generic drugs, the greater is the preference to purchase them. Therefore, educational campaigns for healthcare professionals and consumers appear to be the best strategy for expanding the use of generic drugs in Brazil.

11.
Rev. saúde pública (Online) ; 51: 59, 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-903335

RESUMO

ABSTRACT OBJECTIVE The objective of this study is to identify factors associated with the preference for purchasing generic drugs in a medium-sized municipality in Southern Brazil. METHODS We have analyzed data from a population-based cross-sectional study conducted in 2012 with a sample of 2,856 adults (≥ 20 years old). The preference for purchasing generic drugs was the main outcome. The explanatory variables were the demographic and socioeconomic variables. Statistical analyses included Poisson regressions. RESULTS The preference for purchasing generic drugs was 63.2% (95%CI 61.4-64.9). The variables correlated with this preference in the fully adjusted models were: male (prevalence ratio [PR] = 1.08; 95%CI 1.03-1.14), age of 20-39 years (PR = 1.10; 95%CI 1.02-1.20), low socioeconomic status (PR = 1.15; 95%CI 1.03-1.28), and good knowledge about generic drugs (PR= 4.66; 95%CI 2.89-7.52). Among those who preferred to purchase generic drugs, 55.1% have reported accepting to replace the prescribed drug (if not a generic) with the equivalent generic drug. Another correlate of the preference for purchasing generic drugs was because individuals consider their quality equivalent to reference medicines (PR = 2.15; 95%CI 1.93-2.41). CONCLUSIONS Knowledge about generic drugs was the main correlate of the preference for purchasing generic drugs. The greater the knowledge or positive perception about generic drugs, the greater is the preference to purchase them. Therefore, educational campaigns for healthcare professionals and consumers appear to be the best strategy for expanding the use of generic drugs in Brazil.

12.
Cad Saude Publica ; 32(7)2016 Aug 01.
Artigo em Português | MEDLINE | ID: mdl-27487440

RESUMO

This study compared the perception, knowledge, and use of generic drugs by adults in Pelotas, Rio Grande do Sul State, Brazil, using two cross-sectional population-based studies from 2002 and 2012. Study outcomes were: (a) prevalence of use of generics; (b) generics as a proportion of all medication; (c) users' perceptions of prices and quality; (d) users' knowledge of generics; and (e) strategies for acquisition of medicines. Prevalence of generics use increased from 3.6% (95%CI: 3.0-4.3) to 26.1% (95%CI: 24.5-27.7) in the 10-year period. Perceptions of prices and quality of generics remained stable, identification of characteristics that distinguish generics from other drugs improved (p < 0.001), and drug classification errors decreased (p < 0.001). There was a significant increase in acquiring medication by replacing prescribed drugs with generics. Between 2002 and 2012 there was an increase in knowledge and use of generics, while perception of lower prices and equivalent quality remained high.


Assuntos
Prescrições de Medicamentos/estatística & dados numéricos , Substituição de Medicamentos/estatística & dados numéricos , Substituição de Medicamentos/tendências , Medicamentos Genéricos/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Percepção , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
13.
Cad. Saúde Pública (Online) ; 32(7): e00070215, 2016. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-952290

RESUMO

Resumo: Este estudo compara a percepção, conhecimento e uso de medicamentos genéricos em adultos de Pelotas, Rio Grande do Sul, Brasil, por meio de dois estudos transversais de base populacional realizados em 2002 e 2012. Os desfechos estudados foram: (a) prevalência de utilização de medicamentos genéricos; (b) proporção de uso de medicamentos genéricos entre os demais medicamentos; (c) percepção dos usuários sobre preço e qualidade dos medicamentos genéricos; (d) conhecimento dos usuários sobre medicamentos genéricos; e (e) estratégias de aquisição de medicamentos. A prevalência de uso de medicamentos genéricos aumentou de 3,6% (IC95%: 3,0-4,3) para 26,1% (IC95%: 24,5-27,7) no período de dez anos. A percepção sobre preço e qualidade dos medicamentos genéricos se manteve estável, a identificação das características que diferenciam os medicamentos genéricos dos demais medicamentos melhorou (p < 0,001) e o erro de classificação de medicamento diminuiu (p < 0,001). Houve um aumento significativo na estratégia de aquisição de medicamentos pela substituição do medicamento prescrito pelo medicamento genérico. Entre 2002 e 2012, aumentou o conhecimento e uso de medicamentos genéricos, enquanto a percepção quanto ao menor preço e qualidade equivalente mantiveram-se elevadas.


Abstract: This study compared the perception, knowledge, and use of generic drugs by adults in Pelotas, Rio Grande do Sul State, Brazil, using two cross-sectional population-based studies from 2002 and 2012. Study outcomes were: (a) prevalence of use of generics; (b) generics as a proportion of all medication; (c) users' perceptions of prices and quality; (d) users' knowledge of generics; and (e) strategies for acquisition of medicines. Prevalence of generics use increased from 3.6% (95%CI: 3.0-4.3) to 26.1% (95%CI: 24.5-27.7) in the 10-year period. Perceptions of prices and quality of generics remained stable, identification of characteristics that distinguish generics from other drugs improved (p < 0.001), and drug classification errors decreased (p < 0.001). There was a significant increase in acquiring medication by replacing prescribed drugs with generics. Between 2002 and 2012 there was an increase in knowledge and use of generics, while perception of lower prices and equivalent quality remained high.


Resumen: Este estudio compara la percepción, conocimiento y uso de medicamentos genéricos en adultos de Pelotas, Río Grande do Sul, Brasil, a través de dos estudios transversales de base poblacional, realizados en 2002 y 2012. Los resultados estudiados fueron: (a) prevalencia de utilización de medicamentos genéricos; (b) proporción de uso de medicamentos genéricos entre los demás medicamentos; (c) percepción de los usuarios sobre el precio y calidad de los medicamentos genéricos; (d) conocimiento de los usuarios sobre medicamentos genéricos y (e) estrategias de adquisición de medicamentos. La prevalencia de uso de medicamentos genéricos aumentó de 3,6% (IC95%: 3,0-4,3) a 26,1% (IC95%: 24,5-27,7) en un período de 10 años. La percepción sobre el precio y calidad de los medicamentos genéricos se mantuvo estable, la identificación de las características que diferencian los medicamentos genéricos de los demás medicamentos mejoró (p < 0,001) y el error de clasificación de medicamentos disminuyó (p < 0,001). Hubo un aumento significativo en la estrategia de adquisición de medicamentos, a través de la sustitución del medicamento prescrito por el medicamento genérico. Entre 2002 y 2012 aumentó el conocimiento y uso de medicamentos genéricos, mientras que la percepción en lo referente al menor precio y calidad equivalente, se mantuvieron elevadas.

14.
Rev. bras. epidemiol ; 18(1): 25-41, Jan-Mar/2015. tab, graf
Artigo em Português | LILACS | ID: lil-736430

RESUMO

OBJETIVO: Avaliar a prevalência de início da vida sexual até os 14 anos de idade e fatores sociodemográficos e comportamentais relacionados à sua ocorrência. MÉTODOS: Em 2008, 4.325 adolescentes dos 5.249 pertencentes ao estudo de coorte de nascimentos de Pelotas, Rio Grande do Sul (1993) foram entrevistados. O início da vida sexual foi definido como primeira relação sexual ocorrida até os 14 anos. As informações foram obtidas através de questionários durante o acompanhamento de 2008, com entrevistas realizadas nos domicílios. As varáveis analisadas foram: cor da pele, índice de bens, escolaridade materna e do adolescente, uso experimental de cigarro e de álcool, episódio de embriaguez, uso de alguma droga ilícita pelo adolescente ou pelos amigos e envolvimento em brigas no último ano. Além dessas, foram analisados o uso de preservativos e contraceptivos, número de parceiros(as) e idade de iniciação sexual. RESULTADOS: A prevalência de iniciação sexual foi de 18,6%, sendo maior no sexo masculino, nos adolescentes com menor escolaridade, de baixo nível econômico e naqueles cujas mães tinham baixa escolaridade e tiveram filhos na adolescência. A prática sexual esteve relacionada às variáveis comportamentais analisadas. Na última relação sexual, 30% das entrevistadas não haviam usado métodos contraceptivos e 18% não usaram preservativos. Meninos referiram maior número de parceiros(as) sexuais do que meninas. CONCLUSÃO: Resultados apontam uma relação entre iniciação sexual (≤ 14 anos) e comportamentos vulneráveis à saúde. O não uso de preservativos e contraceptivos pode torná-los vulneráveis a experimentarem situações não desejadas. Estratégias educativas e socioculturais em saúde devem ser praticadas desde o início da adolescência. .


OBJECTIVE: To assess the prevalence of sexual initiation until the age of 14 years old, as well as sociodemographic and behavioral factors. METHODS: In 2008, 4,325 from the 5,249 adolescents of the 1993 birth cohort in Pelotas, Rio Grande do Sul, were interviewed. Sexual initiation was defined as the first intercourse up to the age of 14 years old. The information was obtained by interviewing adolescents in their houses, during the 2008 follow-up. The analyzed variables were: skin color, asset index, maternal and adolescents' schooling, experimental use of tobacco and alcohol, drunkenness episode, use of any illicit drug, illegal drug use by friends and involvement in fights during the past year. Use of condoms and contraceptive methods, number of partners and the age of sexual initiation were also analyzed. RESULTS: The prevalence of sexual initiation by the age of 14 was of 18.6%. Lower schooling, asset index and maternal education were related to higher prevalence of sexual initiation until the age of 14, as well as being male or being born to adolescent mothers. Sexual intercourse was also related to the behavioral variables analyzed. Among adolescent girls who had intercourse up to the age of 14, 30% did not use contraception and 18% did not use condoms in the last sexual intercourse. Boys reported a higher number of sexual partners than girls. CONCLUSION: The results suggest a relationship between sexual intercourse (≤ 14 years) and some health-risk behaviors. The non-use of condoms and contraceptives may make them vulnerable to experiencing unwanted situations. Education and sociocultural strategies for health should be implemented from the beginning of adolescence. .


Assuntos
Humanos , Feminino , Criança , Adolescente , Adulto , Adulto Jovem , Comportamentos Relacionados com a Saúde , Comportamento Sexual , Seguimentos , Nascimento Vivo , Prevalência , Fatores de Risco
15.
Rev Bras Epidemiol ; 18(1): 25-41, 2015.
Artigo em Inglês, Português | MEDLINE | ID: mdl-25651009

RESUMO

OBJECTIVE: To assess the prevalence of sexual initiation until the age of 14 years old, as well as sociodemographic and behavioral factors. METHODS: In 2008, 4,325 from the 5,249 adolescents of the 1993 birth cohort in Pelotas, Rio Grande do Sul, were interviewed. Sexual initiation was defined as the first intercourse up to the age of 14 years old. The information was obtained by interviewing adolescents in their houses, during the 2008 follow-up. The analyzed variables were: skin color, asset index, maternal and adolescents' schooling, experimental use of tobacco and alcohol, drunkenness episode, use of any illicit drug, illegal drug use by friends and involvement in fights during the past year. Use of condoms and contraceptive methods, number of partners and the age of sexual initiation were also analyzed. RESULTS: The prevalence of sexual initiation by the age of 14 was of 18.6%. Lower schooling, asset index and maternal education were related to higher prevalence of sexual initiation until the age of 14, as well as being male or being born to adolescent mothers. Sexual intercourse was also related to the behavioral variables analyzed. Among adolescent girls who had intercourse up to the age of 14, 30% did not use contraception and 18% did not use condoms in the last sexual intercourse. Boys reported a higher number of sexual partners than girls. CONCLUSION: The results suggest a relationship between sexual intercourse (≤ 14 years) and some health-risk behaviors. The non-use of condoms and contraceptives may make them vulnerable to experiencing unwanted situations. Education and sociocultural strategies for health should be implemented from the beginning of adolescence.


Assuntos
Comportamentos Relacionados com a Saúde , Comportamento Sexual , Adolescente , Adulto , Criança , Feminino , Seguimentos , Humanos , Nascimento Vivo , Prevalência , Fatores de Risco , Adulto Jovem
16.
AIDS Behav ; 18 Suppl 1: S75-84, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23975474

RESUMO

A non-blinded randomized controlled trial evaluated efficacy of pharmaceutical care (PC) (Dáder method) on self-reported antiretroviral adherence and undetectable plasma viral load (UPVL), compared with usual care (UC) in HIV-positive patients in Brazil. Most were male (63 %), mean age 40.3 years (SD = 10). After 12 months, 79.8 % of those receiving PC versus 73.8 % in UC were adherent (RR 1.05, 95 % CI 0.95-1.15, P = 0.35), and 50.3 versus 49.8 % (PC vs. UC, respectively) had UPVL (RR 1.08, 95 % CI 0.97-1.20, P = 0.15). Factors associated with self-reported adherence were regular employment, UPVL, no depressive symptoms, and lower pill load in the treatment regimen. Older age, education, CD4 count <200 cells/mm(3), and shorter treatment duration were associated with UPVL. Of 94 reported drug-related problems, 43 % resolved. In subgroup analyses of patients who experienced therapeutic failure and who were non-adherent at the beginning of the trial (N = 50), no differences were found in UPVL (HR 1.35, 95 % CI 0.57-3.19). Only education level (>12 years) was independently predictive of viral suppression (HR 7.47, 95 % CI 1.69-32.91). In conclusion, PC was not associated with increased self-reported adherence to ART or UPVL in patients treated at a health care facility in southern Brazil. The study suggests, however, that PC could be effective for the subgroup of patients with poor adherence.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adesão à Medicação , Assistência Farmacêutica/estatística & dados numéricos , Farmacêuticos , Adolescente , Adulto , Idoso , Fármacos Anti-HIV/efeitos adversos , Brasil , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/etiologia , Infecções por HIV/virologia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Assistência Farmacêutica/organização & administração , Papel Profissional , Autorrelato , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários , Resultado do Tratamento , Carga Viral/efeitos dos fármacos , Adulto Jovem
17.
AIDS Behav ; 18 Suppl 1: S85-8, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23955660

RESUMO

Pharmaceutical care (PC) has been shown to improve adherence to therapeutic interventions as well as improve clinical outcomes. We assessed the predictors of non-adherence to clinical follow-up (i.e., not attending three scheduled routine clinical visits over a 1 year period) among patients who participated in a clinical trial of PC intervention on adherence to HIV antiretroviral therapy uptake (the PC-HIV trial). A total of 332 patients participated: median age was 39 years, 63 % were male, 76 % had CD4 count ≥200 cells/mm³, and 52 % had undetectable viral load. About half, 52.7 %, were non-adherent to clinical follow-up. Identified risk factors for non-adherence were male gender, age <40 years, and being in the trial's "control" group (adjusted odds ratio [AOR] 1.67, 95 % CI 1.05-2.66; AOR 2.21, 95 % CI 1.42-3.47; AOR 1.67, 95 % CI 1.07-2.61, respectively). Younger, male patients may benefit from interventions such as PC, which facilitates engagement in care.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adesão à Medicação , Assistência Farmacêutica/estatística & dados numéricos , Farmacêuticos , Adulto , Brasil , Contagem de Linfócito CD4 , Feminino , Seguimentos , Infecções por HIV/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Assistência Farmacêutica/organização & administração , Valor Preditivo dos Testes , Papel Profissional , Fatores de Risco , Resultado do Tratamento , Carga Viral/efeitos dos fármacos
18.
Braz J Psychiatry ; 34(2): 162-7, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22729412

RESUMO

INTRODUCTION: The prevalence of depressive disorders in HIV-infected patients ranges from 12% to 66% and is undiagnosed in 50% to 60% of these patients. Depression in HIV-infected individuals may be associated with poor antiretroviral treatment (ART) outcomes, since it may direct influence compliance. OBJECTIVE: To assess the presence of symptoms and risk factors for depression in patients on ART. METHODS: Cross-sectional study. Certified interviewers administered questionnaires and the Beck Depression Inventory (BDI), and participants' self-reported compliance to ART. Clinical and laboratory variables were obtained from clinical records. Patients with BDI > 12 were defined as depressed. RESULTS Out of the 250 patients invited to participate, 246 (98%) consented. Mean age was 41 ± 9.9 years; most were male (63%). Income ranged from 0-14 Brazilian minimum wages. AIDS (CDC stage C) had been diagnosed in 97%, and 81% were in stable immune status. One hundred ninety-one (78%) reported compliance, and 161 (68%) had undetectable viral loads. The prevalence of depressive symptoms was 32% (95% CI 26-40). In multivariate analysis, depressive symptoms were significantly associated with income (prevalence ratio [PR] = 0.85; 95% CI 0.74-0.97; p = 0.02). CONCLUSIONS: Depressive symptoms are frequent in patients on ART, and are associated with low income.


Assuntos
Terapia Antirretroviral de Alta Atividade/psicologia , Depressão/epidemiologia , Infecções por HIV/psicologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Depressão/diagnóstico , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
19.
Rev. bras. psiquiatr ; 34(2): 162-167, June 2012. ilus, tab
Artigo em Inglês | LILACS | ID: lil-638697

RESUMO

INTRODUCTION: The prevalence of depressive disorders in HIV-infected patients ranges from 12% to 66% and is undiagnosed in 50% to 60% of these patients. Depression in HIV-infected individuals may be associated with poor antiretroviral treatment (ART) outcomes, since it may direct influence compliance. OBJECTIVE: To assess the presence of symptoms and risk factors for depression in patients on ART. METHODS: Cross-sectional study. Certified interviewers administered questionnaires and the Beck Depression Inventory (BDI), and participants' self-reported compliance to ART. Clinical and laboratory variables were obtained from clinical records. Patients with BDI > 12 were defined as depressed. RESULTS Out of the 250 patients invited to participate, 246 (98%) consented. Mean age was 41 ± 9.9 years; most were male (63%). Income ranged from 0-14 Brazilian minimum wages. AIDS (CDC stage C) had been diagnosed in 97%, and 81% were in stable immune status. One hundred ninety-one (78%) reported compliance, and 161 (68%) had undetectable viral loads. The prevalence of depressive symptoms was 32% (95% CI 26-40). In multivariate analysis, depressive symptoms were significantly associated with income (prevalence ratio [PR] = 0.85; 95% CI 0.74-0.97; p = 0.02). CONCLUSIONS: Depressive symptoms are frequent in patients on ART, and are associated with low income.


INTRODUÇÃO:A prevalência de transtornos depressivos em pacientes infectados pelo HIV varia de 12% a 66% e não é diagnosticada em 50% a 60% desses pacientes. A depressão em indivíduos HIV positivo pode se associar a resultados fracos do tratamento antirretroviral (TAR) porque pode influenciar diretamente a aderência ao regime. OBJETIVO: Avaliar a presença de sintomas e de fatores de risco de depressão em pacientes em TAR. MÉTODOS: Estudo em corte transverso. Entrevistadores certificados administraram questionários e o Beck Depression Inventory (BDI), e os participantes fizeram o autorrelato da aderência ao TAR. Variáveis clínicas e laboratoriais foram obtidas dos prontuários clínicos. Os pacientes com escore ao BDI > 12 foram definidos como deprimidos. RESULTADOS: Dos 250 pacientes convidados a participar, 246 (98%) concordaram. A média de idade foi de 41 ± 9,9 anos; a maioria dos pacientes era do sexo masculino (63%). A renda variou de 0-14 salários mínimos brasileiros. A AIDS (estágio C dos CDC) havia sido diagnosticada em 97% e 81% estavam em estado imune estável. Dos pacientes, 191 (78%) relataram aderência e 161 (68%) tinham carga viral não detectável. A prevalência dos sintomas depressivos foi de 32% (IC 95% 26-40). Em análise multivariada, os sintomas depressivos se associaram significativamente à renda (razão de prevalência [RP] = 0,85, IC 95% 0,74-0,97; p = 0,02). CONCLUSÕES: Os sintomas depressivos são frequentes em pacientes em TAR e se associam a uma renda baixa.


Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Terapia Antirretroviral de Alta Atividade/psicologia , Depressão/epidemiologia , Infecções por HIV/psicologia , Brasil/epidemiologia , Estudos Transversais , Depressão/diagnóstico , Infecções por HIV/tratamento farmacológico , Prevalência , Fatores de Risco , Fatores Socioeconômicos
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