RESUMO
Resumo A baixa adesão ao tratamento medicamentoso constitui grave entrave para o sucesso do controle de doenças como o diabetes e a hipertensão arterial. Este artigo trata de um estudo que partiu da identificação do analfabetismo como importante causa de não adesão ao tratamento medicamentoso para diabéticos e hipertensos participantes do programa Hiperdia em unidade de saúde do município de Colombo, no estado do Paraná. Teve como objetivo avaliar o impacto de prescrição pictórica na adesão ao tratamento. Analisou-se um grupo de 63 diabéticos e hipertensos que participavam do Hiperdia, para os quais aplicou-se uma entrevista estruturada, com posterior análise do conteúdo, antes e depois da implantação de uma prescrição pictográfica. Como resultado, entre os analfabetos, observou-se a elevação da adesão de 60% para 93,33% em relação ao tratamento medicamentoso. No grupo de alfabetizados não houve mudança na adesão. Conclui-se, no entanto, que esse tipo de intervenção é limitado para a melhora da condição de saúde dos pacientes, pois o aumento da adesão se dá em relação tanto ao tratamento medicamentoso quanto à precariedade.
Abstract The low levels of compliance with drug therapy is a serious obstacle to the successful control of diseases such as diabetes and hypertension. This article addresses a study that was based on the identification of illiteracy as a major cause of non-compliance with a drug treatment among diabetic and hypertensive patients participating in the Hiperdia program at a health unit in the city of Colombo, state of Paraná, Brazil. The goal was to assess the impact of pictorial prescriptions on compliance with treatment. A group of 63 diabetic and hypertensive patients participating in Hiperdia was analyzed. They answered a structured interview, the content of which was subsequently analyzed before and after the implementation of a pictographic prescription. As a result, compliance with the drug treatment among the illiterate rose from 60 percent to 93.33 percent. There was no change in compliance in the literate group. It was concluded, however, that this type of intervention is limited to the improvement of the patients' health condition, because the increase in compliance occurs both with regard to the drug treatment and precariousness.
Resumen La baja adhesión al tratamiento medicamentoso constituye un grave obstáculo para el éxito del control de enfermedades como la diabetes y la hipertensión arterial. Este artículo trata de un estudio que partió de la identificación del analfabetismo como importante causa de la no adhesión al tratamiento medicamentoso para diabéticos e hipertensos participantes en el programa Hiperdia en una unidad de salud del municipio de Colombo, estado de Paraná, Brasil. Éste tuvo como objetivo evaluar el impacto de la prescripción pictórica en la adhesión al tratamiento. Se analizó un grupo de 63 diabéticos e hipertensos que participaban en el Hiperdia, para los cuales se aplicó una entrevista estructurada, con posterior análisis del contenido, antes y después de la implantación de una prescripción pictográfica. Como resultado, entre los analfabetos, se observó la elevación de la adhesión del 60% para el 93,33% con relación al tratamiento medicamentoso. En el grupo de alfabetizados, la adhesión no presentó cambios. Se concluyó, sin embargo, que este tipo de intervención es limitado para la mejora de la condición de salud de los pacientes, pues el aumento de la adhesión se da con relación al tratamiento medicamentosos en cuanto a la precariedad.
Assuntos
Humanos , Adesão à Medicação , Determinantes Sociais da Saúde , AlfabetizaçãoRESUMO
<b>Introduction: </b>A health assessment sheet was developed to establish a new method for post marketing surveillance (PMS) for nonprescription drugs, the status of which has recently been switched from prescription (Rx) to over-the-counter (OTC) to confirm the efficacy and safety of Rx-to-OTC switched drugs. The assessment sheet was designed to evaluate adverse reactions that may be possibly induced by the drugs and to elicit spontaneous complaints from consumers. An investigation using the assessment sheet had been conducted earlier for famotidine tablets. While the earlier investigation suggested the effectiveness of the assessment method, it also revealed some issues. After making improvements in the assessment sheet, another investigation was conducted for Loxonin®S.<br><b>Method: </b>Purchasers of Loxonin®S were asked to tick symptoms that were applicable to them among those listed in the sheet. They were asked to revisit the pharmacy and complete the sheet for the second time after drug administration. The possibility of adverse reactions was considered for the symptoms additionally chosen at the second visit and they were then compared with the adverse reactions described in the package insert of Loxonin®S.<br><b>Results: </b>Total 284 people completed the health assessment sheet at their first and second visits. Of them, 44 people (15.5%) reported additional symptoms at the second visit. Commonly reported symptom was “frequent experience of sleepiness,” “persistent headaches” and “fatigability.”<br><b>Conclusion: </b>The study suggested that the health assessment sheet can be an effective tool for PMS for nonprescription drugs immediately after the Rx-to-OTC switch and contributes to detecting adverse reactions of the drugs.
RESUMO
<b>Objective: </b>Currently, post marketing surveillance (PMS) for prescription-only to over-the-counter (OTC) switched products is conducted based on questionnaires to patients. These questionnaires appear in the form of postcards and are completed and posted voluntarily by patients. With such a method, however, it is not possible to select samples randomly and there may be a bias in respondents. In addition, the response rate of questionnaire postcards tends to be low. It is not really credible that the efficacy and safety of OTC switches are confirmed by such a method. An investigation was therefore conducted with the aim of developing an effective method of PMS for OTC switches in order to achieve the intended objective of PMS.<br><b>Method and Subjects: </b>Famotidine purchasers were asked to complete a questionnaire form. The pharmacists asked the subjects to complete the questionnaire form again on their second visit and also checked patient compliance with drug treatment. The effectiveness of this method was evaluated by reviewing responses to the questionnaire on the first and second visits.<br><b>Results and Discussion: </b>It was suggested that the method tested in this investigation may possibly facilitate evaluation of the efficacy of OTC switched products, detection of adverse drug reactions and monitoring of patient compliance with drug treatment. However, the questionnaire used in the investigation was not suited for detecting symptoms that triggered patients to purchase famotidine. It was considered necessary to prepare additional questions specifically designed to detect such symptoms.
