Self-medication practices in riverside communities in the Brazilian Amazon Rainforest.

OBJECTIVES: to analyze the practice of self-medication and the associated factors in the riverside population of the Middle Solimões river region - Amazon rainforest. METHODS: a cross-sectional population-based study conducted between April and July 2015, through interviews at home. RESULTS: the prevalence of self-medication among the riverside population was 76.3%. Analgesics and antibacterials were the main therapeutic classes used in self-medication. Self-medication proved to be associated with the male gender, young people, not having sought the health service in the last month, longer commuting from the community to the urban area and the habit of consuming allopathic medicines on their own. CONCLUSIONS: self-medication among the riverside population of Coari - Amazon may reflect the need to seek self-care by people, with the use of allopathic medicines without prescription, mainly due to the restricted access to health services.

Self-Medicating for Pain: A Public Health Perspective.

BACKGROUND: Pain is one of the symptoms for which any man is willing not only to go to the doctor but also to resort to any means, including self-medication, to "get rid" of it. Self-medication is not only a current practice but also a public health problem, under the circumstances that it can influence the way in which a disease is diagnosed and/or treated in a timely manner, and, consequently, repercussions may occur on the cost of treatment, in the case of severe forms. Pain is a vital symptom, and the diminution until the disappearance of pain is a fundamental right of each individual; the analysis of ethical issues in the case of self-administration of analgesic medication has not been a major concern. AREAS OF UNCERTAINTY: Understanding the problem is important to realize whether self-medicating for pain is a necessity or an abuse, and in this respect, we review scientific articles from international databases: PubMed and ProQuest. DATA SOURCES: The study is based on the consultation of scientific articles from international databases-PubMed and ProQuest, the main keywords in the search being pain and self-medication, to which a stigma or public health is sequentially added. RESULTS: Pain is becoming more and more a global problem and the extent of its spread can substantiate our assertion about pathology with pandemic impact. Under the pressure of patient associations, of the media, and of nonmedical authorities, the opinion about the need for a stoic approach to pain has long become an outdated theory, and chronic pain, beyond a multidimensional approach, is increasingly considered not only a useless element but also even a destructive one. CONCLUSIONS: Pain and self-medication must be addressed, including in medical practice, starting from their multidimensionality from the following perspectives: medicobiological, sociocultural, instructive-educational, legal-political, and especially ethical. They are not only individual health problems but also become, when connected with a stigma, a public health problem.

The role of pharmacists in community education to promote responsible self-medication in Indonesia: an application of the spiral educational model.

Background Community empowerment is one key strategy to improve the health of Indonesians. In 2015, the Government initiated the 'Smart Use of Medications Campaign' to empower Indonesians to practice responsible self-medication. Analysis of a pilot training program established in 2016 identified that improvements were needed in the content and organisation of the module. Objective To evaluate a revised module (applying a spiral model approach) to guide community training as part of the 'Smart Use of Medications Campaign'. Setting The Ngawi District, Indonesia in May 2018. Method Eight pharmacists (trainers) and 39 community representatives (participants) were involved in the training based on the revised module. The module adopted the spiral approach and consisted of three progressive steps: (1) understanding basic concepts of information on the label/package of one medication product; (2) re-enforcing that concept to understand medication classification (applied using three products); and (3) expanding the concept to understand medication classification (applied using a pack of 40 products). Pre-/post-test scores were used, and Focus Group Discussions were conducted to explore the participants' knowledge gain. Main outcome measure: participants' and trainers' views on the spiral process. Result Participants' mean overall knowledge gain increased from 12.53/15 to 13.44/15 (p = 0.001). Six focus groups of participants and two focus groups of trainers perceived that both trainers and participants found the spiral model better facilitated understanding, as it involved step-by-step learning. They also indicated the importance of the role of pharmacists as suitably qualified trainers as well as the development of appropriate training aids/media and arrangements. Conclusion Training based on the spiral model has the potential to be implemented in community training to improve self-medication literacy among the Indonesian public. Support from pharmacists as well as the relevant national and professional bodies is essential for successful implementation of the training.

Self-medication practices in riverside communities in the Brazilian Amazon Rainforest / Prácticas de automedicación en las comunidades de ribereña en la Amazonía brasileña / Práticas de automedicação em comunidades ribeirinhas na Amazônia brasileira

ABSTRACT Objectives: to analyze the practice of self-medication and the associated factors in the riverside population of the Middle Solimões river region - Amazon rainforest. Methods: a cross-sectional population-based study conducted between April and July 2015, through interviews at home. Results: the prevalence of self-medication among the riverside population was 76.3%. Analgesics and antibacterials were the main therapeutic classes used in self-medication. Self-medication proved to be associated with the male gender, young people, not having sought the health service in the last month, longer commuting from the community to the urban area and the habit of consuming allopathic medicines on their own. Conclusions: self-medication among the riverside population of Coari - Amazon may reflect the need to seek self-care by people, with the use of allopathic medicines without prescription, mainly due to the restricted access to health services.

RESUMEN Objetivos: analizar la práctica de la automedicación y los factores asociados en la población ribereña de la región de Solimões Medio - Amazonas. Métodos: estudio transversal basado en la población realizado entre abril y julio de 2015, a través de entrevistas en el hogar. Resultados: la prevalencia de la automedicación entre los habitantes de la ribera fue del 76,3%. Los analgésicos y los antibacterianos fueron las principales clases terapéuticas utilizadas en la automedicación. Se demostró que la automedicación estaba asociada con el género masculino, los jóvenes, que no habían buscado el servicio de salud en el último mes, el mayor tiempo de viaje al área urbana y el hábito de consumir medicamentos alopáticos por su cuenta. Conclusiones: automedicación entre la población ribereña de Coari - Amazonas puede reflejar la necesidad de buscar el autocuidado de las personas, con el uso de medicamentos alopáticos sin receta, principalmente debido al acceso restringido a los servicios de salud.

RESUMO Objetivos: analisar a prática de automedicação e os fatores associados na população ribeirinha da região do Médio Solimões - Amazonas. Métodos: estudo transversal de base populacional realizado entre abril a julho de 2015, por meio de entrevistas em domicílio. Resultados: a prevalência da automedicação entre os ribeirinhos foi de 76,3%. Analgésicos e antibacterianos foram as principais classes terapêuticas consumidas na prática de automedicação. A automedicação mostrou-se associada ao sexo masculino, jovens, não ter procurado pelo serviço de saúde no último mês, maior tempo de deslocamento da comunidade à zona urbana e o hábito de consumo de medicamentos alopáticos por conta própria. Conclusões: a automedicação entre a população ribeirinha de Coari - Amazonas pode refletir a necessidade de busca do autocuidado pelas pessoas, com o uso de medicamentos alopáticos sem prescrição, sobretudo decorrente do restrito acesso aos serviços de saúde.

Recomendaciones sobre el uso de metrotexato parenteral en enfermedades reumáticas / Recommendations for the use of parenteral methotrexate in rheumatic diseases

Objetivos. Desarrollar recomendaciones sobre el uso de metrotexato (MTX) parenteral en pacientes con enfermedades reumáticas, fundamentalmente en la artritis reumatoide, basadas en la mejor evidencia y experiencia. Métodos. Se seleccionó un grupo de 21 expertos reumatólogos en el manejo de MTX. El coordinador generó 13 preguntas sobre el uso de MTX parenteral (perfiles de indicación, eficacia, seguridad, costo-eficacia y biodisponibilidad) para ser contestadas mediante una revisión sistemática de la literatura. Con base en las preguntas se definieron los criterios de inclusión y exclusión, y las estrategias de búsqueda (en Medline, EMBASE y la Cochrane Library). Tres revisores seleccionaron los artículos resultantes de la búsqueda. Se generaron tablas de evidencia. Paralelamente se evaluaron abstracts de congresos de la European League Against Rheumatism (EULAR) y del American College of Rheumatology (ACR). Con toda esta evidencia el coordinador generó 13 recomendaciones preliminares que se evaluaron, discutieron y votaron en una reunión del grupo nominal con los expertos. Para cada recomendación se estableció el nivel de evidencia y grado de recomendación, y el grado de acuerdo mediante un Delphi. Se definió acuerdo si al menos el 80% de los participantes contestaron sí a la recomendación (sí o no). Resultados. La mayoría de la evidencia proviene de la artritis reumatoide. De las 13 recomendaciones preliminares se aceptaron 11 recomendaciones sobre el uso de MTX parenteral en reumatología. Dos no se llegaron a votar y se decidió no incluirlas, pero se comentan en el texto final. Conclusiones. Este documento pretende resolver algunos interrogantes clínicos habituales y facilitar la toma de decisiones con el uso de MTX parenteral

Objective. To develop recommendations for the use of parenteral methotrexate (MTX) in rheumatic diseases, mainly rheumatoid arthritis, based on best evidence and experience. Methods. A group of 21 experts on parenteral MTX use was selected. The coordinator formulated 13 questions about parenteral MTX (indications, efficacy, safety and cost-effectiveness). A systematic review was conducted to answer the questions. Using this information, inclusion and exclusion criteria were established, as were the search strategies (involving Medline, EMBASE and the Cochrane Library). Three different reviewers selected the articles. Evidence tables were created. Abstracts from the European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR) were evaluated. Based on this evidence, the coordinator proposed preliminary recommendations that the experts discussed and voted in a nominal group meeting. The level of evidence and grade of recommendation were established using the Oxford Center for Evidence-Based Medicine and the level of agreement with the Delphi technique (2 rounds). Agreement was established if at least 80% of the experts voted yes (yes/no). Results. Most of the evidence involved rheumatoid arthritis. A total of 13 preliminary recommendations on the use of parenteral MTX were proposed; 11 of them were accepted. Two of the 13 were not voted and are commented on in the main text. Conclusions. The manuscript aims to solve frequent questions and help in decision-making strategies when treating patients with parenteral MTX

Antibiotic Self-Medication for Oral Conditions: Characteristics and Associated Factors

Objective: To investigate the prevalence and contributing factors of antibiotic selfmedication for oral conditions in dental patients. Material and Methods: A questionnaire was distributed to 501 patients attending Taibah University Dental College and Hospital, Al Madinah, Saudi Arabia during late 2016. Questions were on socio-demographic characteristics, and pattern of antibiotic self-medication for oral disease. Statistical analysis was performed using IBM SPSS software version 21. Statistical significance level was set at p ≤.05. Results: Age range was 15-64 years (29.08±9.32 years) with 297 females (59.3%) and 204 males (40.7%). 135 patients (27%) self-medicated with antibiotics for oral disease. This practice was statistically significantly associated with the older adults (p=0.001), lack of medical or dental insurance (p=0.014 and 0.007, respectively), and poor dental attendance (p=0.021). A number of 26 (25.7%) perceived analgesics as antibiotics. Amoxicillin-clavulanic acid was the most commonly cited antibiotic by 18 patients (17.8%). Dental pain was the most frequently reported oral condition. Pharmacists were the most common source for antibiotic prescription cited by 58 (57.4%). Conclusion: Antibiotic self-medication for oral disease is associated with the use of broad-spectrum antibiotics for non-indicated clinical oral conditions. The practice was encouraged by lenient behavior of pharmacists, lack of health insurance, and poor dental attendance.

Oral Hygiene: Knowledge and Practices of Students in Three Quranic Schools in Koutiala, Mali

Objective: To evaluate the knowledge, attitudes, and practices on oral hygiene (OH) of students of three Quranic schools of Koutiala, Mali. Material and Methods: It was carried out a descriptive prospective study with 300 students in three Quranic schools in the city of Koutiala, Mali. The data analyzed with the Epi Info 3.5.4 software. Results: The male sex was the most represented with 57.7% and the sex ratio = 0.73. The most represented age group was 8-12 with 52% with an average age of 17 years and minimum and maximum age of was 8 and 26 years. It was observed that 98.3% of students had a notion of knowledge about oral hygiene and this information was given by parents / elders in 60% of cases. They claimed that people who do not brush their teeth properly are the most likely to get tooth decay in 93.3% of cases. Regarding dental caries, 61.3% of students said that caries is transmitted by lack of oral hygiene; 33.3% of students said that using toothbrushes and having good oral hygiene are ways to avoid oral diseases. It was thought in 93.3% of cases that a good oral hygiene prevents oral diseases. The students brushed their teeth every day (98%) and they had a consultation with the dental surgeon in 8.7% of the cases. Conclusion: This study shows that students had knowledge of oral hygiene and preventive measures. Efforts should be made to promote, prevent, screen and manage oral diseases in Quranic schools while involving parents in the processes.

How does the general public view antibiotic use in China? Result from a cross-sectional survey.

Background Resistance to antibiotics is a major threat to global health and general public play a significant role in the fight against antimicrobial resistance. Objective The present study aimed to identify the knowledge, attitudes, and practice of the general public towards antibiotic use in China. Setting Randomly selected parks in three cities of western, central and eastern China: Xi'an, Changsha, and Nanjing. Method A cross-sectional survey was conducted on a sample of 1400 residents, from January to June 2015. Main outcome measures Knowledge, attitudes and practices scores toward self-medication with antibiotics and compliance with antibiotic regimens. Results The response rate was 86.0% (n = 1204). Only 192 (19.5%) respondents gained a score of 3 or above, and the maximum score of 4, reflecting poor knowledge towards antibiotics. Just over half (54.8%) of respondents incorrectly believed antibiotics were effective against viral infections and only one-third (34.3%) knew that antibiotics were not anti-inflammatories. Nearly half of the respondents (49.0%) had changed the dosage when taking antibiotics, 35.6% switched to another class, 33.4% had not finished the full treatment course and over 60.0% kept leftover antibiotics for future use. Almost half of the respondents (45.7%) stated they had used antimicrobials during the last 6 months and 64.4% of them had self-medicated. Conclusion This study identified serious misconceptions regarding antibiotics use in the Chinese general public. Effective interventions should be developed to provide practical and appropriate advice to effect behaviour change within this population.

Antibiotic use practices of pharmacy staff: a cross-sectional study in Saint Petersburg, the Russian Federation.

BACKGROUND: Non-prescription access to antimicrobials is common, and self-prescribing is increasingly popular in Russian society. The aim of this study was to assess the attitudes of community pharmacists regarding antibiotic use and self-medication. METHODS: We conducted a cross-sectional study from September-December 2015 of community pharmacists in the Saint-Petersburg and Leningrad region, Russia. A self-administered questionnaire was used to assess antibiotic use and self-medication practices. The data were analysed using logistic regression and Pearson chi-squared tests. RESULTS: Of the 316 pharmacists (77.07%) who completed the questionnaire, 230 (72.8%) self-medicated with antibiotics. Antibiotics were mostly used to self-treat upper (53.3%) and lower respiratory tract infections (19.3%), relying on their own knowledge (81.5%), previous treatment experience (49%) and patients' prescriptions (17%). The most commonly used antibiotics were macrolides (33.2%). Characteristics such as age, education and experience were related to antibiotic use and self-medication. CONCLUSIONS: The study confirmed that self-prescription of antibiotics is a common practice amongst pharmacists in Saint Petersburg and also identified personal and professional characteristics of pharmacists strongly associated with self-medication.

Quality supply of nonprescription medicines in Portuguese community pharmacy: An exploratory case study.

BACKGROUND: Inappropriate use of non-prescription medicines (NPM) can increase morbidity, mortality and health care associated costs. Pharmacists have a well-established role in self-medication; however, the literature shows that pharmacies performance in the supply of NPM is often suboptimal. OBJECTIVE: To explore the interaction and dependability of pharmacy staff use of oral language, as well as staff's own assessment of reasons underlying their behavior during consultation regarding NPM. METHODS: In a case-study design, a high street urban community pharmacy was purposively selected as the setting. Covert patient simulation, using trained simulated patients (SPs), was used to ascertain staff's performance in dispensing NPM, via 4 symptom-based scenarios (SbS) and 3 product-based scenarios (PbS). Performance data were converted into 2 composite indexes: the Interpersonal Performance Index (IPI) and Technical Performance Index (TPI). Audiotaped interactions were transcribed verbatim and participants' utterances were identified, time stamped and coded employing the eight higher level categories of a framework inspired by the Roter interaction analysis system (RIAS). The transcripts of the in-depth interviews were analyzed using the Framework Approach. The tripartite model of attitudes was employed to develop the thematic framework. RESULTS: Ten SP visits were considered for analysis. Overall, the mean TPI score was 50% and the mean IPI score was 78%. TPI was higher for SbS (63%) than PbS (31%), whilst there was little difference IPI between SbS (79%) and PbS (76%). The mean number of questions in the evaluation section of technical performance was 4 for SbS and 1 for PbS. There was a clear predominance of closed questions (32%), when compared with open questions (5.5%). Providing advice was more frequent (23.5%) than giving information (12.5%). In line with the SPs data, comparison of information-gathering in SbS and PbS shows that more questions were asked in the former (44% versus 31%), which resulted in more information given by SPs (56% and 49%, respectively). Staff's reaction to their performance showed all the 3 dimensions of attitude: affective, cognitive and behavioral. Divergence between staff's views on what should be done in NPM consultations and performance data surfaced in the interviewees' accounts on direct product requests. While performance data shows that information gathering was scarce, its importance was overtly acknowledged. CONCLUSIONS: The supply of NPM appears to be influenced by both cognitive and emotional issues. This suggests that multimodal improvement interventions are needed, targeting not only technical and interpersonal communication skills but also the organizational context. Managerial tools such as the balanced scorecard, may prove valuable in addressing improvement in the quality supply of NPM.

A comparison of usual care, a patient-centred education intervention and motivational interviewing to improve medication adherence and readmissions of adults in an acute-care setting.

AIM: To compare medication adherence and readmissions in patients who received usual care vs. patient-centred interventions. BACKGROUND: Medication adherence is a complex behaviour that may be improved with patient-centred strategies. METHOD: A non-concurrent convenience sample of 303 hospitalised patients received either usual care (n = 98) or patient-centred interventions (n = 205). Intervention patients received teach-back and medication tools (n = 137) or motivational interviewing (n = 68). Data were collected at discharge (T1), at 48-72 hours (T2) and 30 days after discharge (T3). RESULTS: No significant differences were found in medication adherence, therapeutic alliance, patients' experience and readmissions between groups. Patients in the motivational interview group reported lower confidence with medication adherence at T1 (P = 0.01) and T2 (P = 0.00) than the patient-centred intervention group. Motivational interviewing was a significant predictor (ß = -1.55, P = 0.01, OR 0.21, 95% CI 0.06, 0.72) of fewer readmissions. CONCLUSION: Overall, patients reported very low levels of non-adherence and very high levels of confidence and importance of medication adherence. IMPLICATIONS FOR NURSING MANAGEMENT: Medication adherence continues to be an important area for clinical inquiry. For those patients who lack confidence for medication adherence, comprehensive patient-centred strategies such as motivational interviewing may improve treatment outcomes.

Evaluación de las necesidades de actualización de conocimientos en materia de fitoterapia de los farmacéuticos de la ciudad de Madrid / Evaluation of the needs of updating knowledge in the field of phytotherapy for the pharmacists from madrid city

El consumo de productos de plantas medicinales, para la prevención y/o tratamiento de diversos problemas de salud, ha experimentado un notable incremento en el estado español, especialmente en las farmacias. Esto es debido entre otros factores a la constatación científica de su eficacia y seguridad y a la labor profesional realizada por parte de los farmacéuticos en la recomendación de estos preparados. En este trabajo se realiza una evaluación de las necesidades de formación de los farmacéuticos en la ciudad de Madrid como base fundamental para realizar una buena dispensación de plantas medicinales, en res- puesta a la demanda de los pacientes. Respecto a estudios anteriores, los resultados obtenidos indican un incremento en la demanda de preparados de plantas medicinales por parte de los pacientes, principalmente mujeres. Asimismo se aprecia una mayor tendencia a elegir la oficina de farmacia como lugar de adquisición, al reconocer la mejor cualificación del farmacéutico en esta materia. No se observa una modificación sustancial en cuanto a la demanda por grupos terapéuticos, si bien la crisis económica parece influir en un incremento de la dispensación de plantas para el tratamiento de la ansiedad. Los farmacéuticos encuestados muestran su interés por ampliar y actualizar los conocimientos en fitoterapia mediante acciones formativas directas y próximas (AU)

The consumption of herbal products for the prevention and / or treatment of various health problems, has seen a remarkable increase in the Spanish state, especially in pharmacies, this is due among other factors to the scientific findings of its effectiveness and safety and the great effort made by pharmacists in the recommendation of these preparations. This paper assesses the training needs of pharmacists in the city of Madrid as the foundation for a good dispensing of medicinal plants, in response to patient demand. The results we get indicate an increase in the demand of natural preparations on the part of patients, ainly women. Also there is a greater tendency to choose the pharmacy as a place to buy it, recognizing that the pharmacist is more qualified in this area. We do not find a substantial change in the demand for treatment groups, but the economic crisis seems to influence in the consume of phytotherapy plant ìs for the treatment of anxiety. The pharmacists of the study show their interest in increase and update their knowledge in herbal drug with compatible courses with their professional life’s (AU)

Canadian allergists' and nonallergists' perception of epinephrine use and vaccination of persons with egg allergy.

BACKGROUND: Studies suggest knowledge gaps about epinephrine use and vaccination of persons with egg allergy. OBJECTIVE: We compared the perception of Canadian allergists and nonallergists on issues related to epinephrine use and vaccination of persons with egg allergy. METHODS: Canadian allergists, pediatricians, general practitioners/family physicians and emergency room physicians were recruited through medical associations and surveyed on these issues. Multivariate logistic regression models were used to identify determinants of specific responses. RESULTS: One-hundred fourteen allergists and 613 nonallergists participated. For most issues with accepted best practices, allergists were more likely to adhere to recommendations. Allergists versus nonallergists were more likely to recommend intramuscular epinephrine for anaphylaxis (odds ratio [OR] = 3.8; 95% CI, 1.43-10.11). Older physicians (OR = 0.98; 95% CI, 0.97-0.99), Canadian-Paediatric-Surveillance-Program participants (OR = 0.48; 95% CI, 0.24-0.96), family physicians (OR = 0.39; 95% CI, 0.16-0.96), and general practitioners (OR = 0.14; 95% CI, 0.04-0.52) were less likely to recommend intramuscular use. However, in severe anaphylaxis, >25% of both groups would not give epinephrine for patients presenting with breathing difficulties or hypotension. Use of epinephrine for severe anaphylaxis was less likely in older physicians (OR = 0.97; 95% CI, 0.95-0.99), female physicians (OR = 0.60; 95% CI, 0.39-0.89), and those practicing in Ontario (OR = 0.56; 95% CI, 0.36-0.86), Manitoba (OR = 0.42; 95% CI, 0.19-0.90), or Nova-Scotia (OR = 0.31; 95% CI, 0.12-0.78). Allergists (OR = 6.22; 95% CI, 3.60-10.72) and physicians treating mainly children (OR = 3.41; 95% CI, 1.87-6.25), or practicing in Quebec (OR = 1.68; 95% CI, 1.12-2.55) were more likely to recommend measles-mumps-rubella vaccination in a community facility. CONCLUSION: Knowledge gaps about mode and indications for epinephrine administration and vaccination policies need to be addressed in future education programs to ensure prompt epinephrine use and to avoid unnecessary restriction of vaccines.

[Blood glucose self monitoring]. / Blutzuckerselbstkontrolle.

Self monitoring of blood glucose contributes to the integrated management of diabetes mellitus. It, thus, should be available for all patients with diabetes mellitus type-1 and type-2. Self monitoring of blood glucose improves patients safety, quality of life and glucose control. The current article represents the recommendations of the Austrian Diabetes Association for the use of blood glucose self monitoring according to current scientific evidence.

Factores que influyen en la automedicación del personal de enfermería a nivel técnico y de estudiantes / Factors influencing self medication nursing staff and students technical level

La automedicación, es “el consumo de medicamentos, hierbas y remedios caseros por iniciativa o consejo de otra persona, sin consultar al médico”, considerada también como un fenómeno que se ha incrementado a través del tiempo, convirtiéndose en un serio problema de salud pública. En México no existen estudios o publicaciones que permitan valorar la real magnitud de esta práctica en la población. Objetivo: Conocer los factores que influyen en la automedicación del personal de enfermería a nivel técnico y estudiantes del Instituto Nacional de Neurología y Neurocirugía.

Self-medication, is “the use of drugs, herbs and home remedies or advice on the initiative of another person, without consulting a doctor”, also regarded as a phenomenon that has been increasing over time, becoming a serious public health problem. In Mexico, there are no studies or publications to assess the real magnitude of this practice in the population. Objective: Understanding the factors that influence self-medication nursing staff technical level, and students of the National Institute of Neurology and Neurosurgery.

Actuaciones profesionales realizadas en la farmacia comunitaria / Professional services carried out in the community pharmacy

Objetivo: Describir todas las actuaciones profesionales (AP) que se llevan a cabo como respuesta a las demandas realizadas por los usuarios en la farmacia comunitaria (FC). Material y métodos: Estudio observacional, descriptivo y transversal, realizado durante 6 meses en dos farmacias comunitarias de Denia (Alicante). La población de estudio fueron todas las demandas de servicio que realizaron los usuarios de ambas farmacias. La variable de estudio fue la AP, es decir, cada uno de los servicios demandados por el usuario en la FC: dispensación, indicación, automedicación, consultas y ventas, clasificándose cada uno en sus resoluciones e incidencias. Resultados: En el estudio se realizaron 30.617 AP, correspondiendo un 42% a la dispensación con receta, y se registró casi un 23% de incidencias. Las indicaciones farmacéuticas supusieron un 9% del total, resolviéndose en la mayoría de casos con la recomendación de un medicamento. Un 33% fueron demandas de automedicación, cursando con casi un 20% de incidencias. Un 7% fueron consultas y un 10% ventas de productos sanitarios. Conclusiones: Del total de AP realizadas, el 90% se consideran farmacéuticas. El 83% fueron dispensaciones de medicamentos, más de la mitad de éstas sin prescripción médica, lo que revela la importancia del asesoramiento farmacéutico en las dispensaciones sin receta. El hecho de que 9 de cada 10 incidencias que se producen en la dispensación con receta y en la automedica ción sean por la falta de información del paciente nos pone en alerta sobre la necesidad de implementar medidas que mejoren esta carencia(AU)

Objective: To describe all the professional actions (PA) carried out by the community pharmacy in response to the requests made by pharmacy users. Methods: Observational, cross-sectional, descriptive study in two pharmacies in Spain, over a 6 month-period. Population: all service requests made by pharmacy users. Study variable: Professional action, each of the services requested by pharmacy users: prescription-drug-dispensing, patient-counseling in minor ailments, self-medication, pharmacist-consultations, and sales-services. Classifying each of them in their decisions and incidents. Results: The study involved 30,617 PA, of which 42% were requests for prescription-drug-dispensing. Incidences were also recorded (23%). Nine percent of requests were for patient-counseling in minor ailments, and these were solved in 99% of cases with recommending of a drug, herbal or homeopathy product. Of the total PA, 33% were self-medication cases, with 20% of incidences. Seven percent were inquiries to the pharmacist and 10% of total requests were sales-services. In one out of four prescription-drug-dispensing event an incidence was detected, and in self-medication cases, in one out of every five. Conclusions: Of all the PA performed in the pharmacies under study, 90% were pharmaceutical activities. Most of these (83%) are directly associated with drug delivery (with/without prescription). The fact that more than a half of the total PA requested were without medical prescription should be further analyzed. The fact that nine out of ten incidents that occur in prescription-drug-dispensing and self-medication are the lack of patient information, it alerts us to implement measures to improve this shortcoming(AU)

[Household storage and use of medications in a population served by the family health strategy in Brazil]. / Estoque doméstico e uso de medicamentos em uma população cadastrada na estratégia saúde da família no Brasil.

OBJECTIVE: To identify families served by the family health strategy (FHS) storing medicines at home, to evaluate storage conditions, and to investigate medicine use practices. METHODS: The study was conducted in a municipality in the state of São Paulo with two FHS units serving 1 867 households. The sample was selected by means of stratified random sampling. Data collection was conducted through semistructured interviews from July to October 2008. RESULTS: One resident was interviewed in each of the 280 households visited. Medicines were found in 255 households (91.1%). Of 326 storage locations, 217 (75.8%) were inadequate (easily accessible to children or exposed to moisture, light). Of the 2 578 medicines identified, 2 059 medicines (79.9%) in 236 (84.3%) households had safety or identification problems. Of the 280 respondents, 179 (63.9%) used medications. Of these, 24 were self-medicating, only one with an over-the-counter drug. Only 44 users had the prescription for their medication, and 21 did not follow the prescription in terms of dosage or had interrupted the treatment. CONCLUSIONS: Non-adherence to recommended treatment can lead to negative outcomes, such as inefficiency (using dosages lower than prescribed), poisoning (using dosages higher than prescribed), and other adverse reactions.

[Family pharmacy: survey of a sample of patients in Midi-Pyrénées]. / La pharmacie familiale : enquête auprès d'un échantillon de patients en Midi-Pyrénées.

OBJECTIVE: Possession of drugs at home in the family pharmacy and self-medication are at risk. METHOD: Appraisal based upon an analysis of 247 questionnaires completed by patients and 116 questionnaires completed by general practitioners in the French department of Haute Garonne (Southwestern, France). RESULTS: Two hundred and forty-four patients were involved in the study. In 80% of cases, women were in charge of family pharmacy who was located in 66% of cases in a unsecurise room and could be reached by children in 17% of cases. Drugs most frequently found: antiseptics (97%), paracetamol (91%), anti-inflammatory drugs (68%), anti-diarrhea (60%). For the physicians 52 useable questionnaires, 80% of physician were confronted with one of three risks: self-medication, drug autolysis, poisoning in children. CONCLUSION: Women are the referent of the family pharmacy. The doctors seem best placed to a message of prevention through minimal advice.

Estoque doméstico e uso de medicamentos em uma população cadastrada na estratégia saúde da família no Brasil / Household storage and use of medications in a population served by the family health strategy in Brazil

OBJETIVO: Identificar domicílios atendidos pela estratégia saúde da família (ESF) que possuíam estoque de medicamentos, avaliar as condições de armazenamento e conhecer o modo de uso dos medicamentos. MÉTODOS: O estudo foi conduzido em um município do Estado de São Paulo que possui duas unidades da ESF, com 1 867 domicílios cadastrados; a amostra foi definida por meio de sorteio aleatório estratificado. A coleta de dados foi realizada por meio de entrevistas semiestruturadas de julho a outubro de 2008. RESULTADOS: Foi entrevistado um morador em cada um dos 280 domicílios visitados. Foram encontrados medicamentos em 255 domicílios (91,1 por cento). Dos 326 locais de guarda de medicamentos, 217 (75,8 por cento) eram inadequados (de fácil acesso a crianças ou expostos a umidade, luz). Das 2 578 especialidades farmacêuticas encontradas, 2 059 (79,9 por cento) tinham algum problema de segurança ou identificação, o que foi observado em 236 (84,3 por cento) domicílios. Dos 280 entrevistados, 179 (63,9 por cento) eram usuários de medicamentos. Desses, 24 estavam se automedicando, apenas um com medicamento que não exigia prescrição. Somente 44 usuários tinham a prescrição do medicamento. O medicamento era usado de forma diferente da prescrição por 21 entrevistados, por desacordo posológico ou interrupção do tratamento. CONCLUSÕES: A maioria dos domicílios estudados armazenava os medicamentos de forma inadequada. As discordâncias em relação às orientações médicas prescritas podem levar a resultados negativos, como ineficácia por uso de doses abaixo do prescrito, intoxicações por doses acima do prescrito, reações adversas e não adesão terapêutica.

OBJECTIVE: To identify families served by the family health strategy (FHS) storing medicines at home, to evaluate storage conditions, and to investigate medicine use practices. METHODS: The study was conducted in a municipality in the state of São Paulo with two FHS units serving 1 867 households. The sample was selected by means of stratified random sampling. Data collection was conducted through semistructured interviews from July to October 2008. RESULTS: One resident was interviewed in each of the 280 households visited. Medicines were found in 255 households (91.1 percent). Of 326 storage locations, 217 (75.8 percent) were inadequate (easily accessible to children or exposed to moisture, light). Of the 2 578 medicines identified, 2 059 medicines (79.9 percent) in 236 (84.3 percent) households had safety or identification problems. Of the 280 respondents, 179 (63.9 percent) used medications. Of these, 24 were self-medicating, only one with an over-the-counter drug. Only 44 users had the prescription for their medication, and 21 did not follow the prescription in terms of dosage or had interrupted the treatment. CONCLUSIONS: Non-adherence to recommended treatment can lead to negative outcomes, such as inefficiency (using dosages lower than prescribed), poisoning (using dosages higher than prescribed), and other adverse reactions.