DEFAR - Departamento de Farmácia
URI permanente desta comunidadehttp://www.hml.repositorio.ufop.br/handle/123456789/530
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Resultados da Pesquisa
Item Polypharmacy among adult and older adult users of primary care services delivered through the Unified Health System in Minas Gerais, Brazil.(2020) Moreira, Thais; Teodoro, Juliana Alvares; Barbosa, Mariana Michel; Nascimento, Renata Cristina Rezende Macedo do; Guerra Júnior, Augusto Afonso; Acúrcio, Francisco de AssisObjectives: To estimate the prevalence of polypharmacy (≥5 drugs) among adults and to analyze related factors. Methods: Cross-sectional study with 1,159 interviewees distributed across 104 cities and 253 primary healthcare services delivered through the Brazilian Unified Health System. Polypharmacy-related factors were identified using logistic regression model. Results: 949 (81.8%) interviewees were using at least one medication and were included in this analysis. The prevalence of polypharmacy among them was 13.7% (95%CI:11.7–16.0%) in the general population and 33.3%(95%CI:26.1–41.4%) in older adults(≥65 years). Polypharmacy was positively associated with age (45 to 64 years, OR=2.02; 95%CI:1.03–3.94; ≥65 years, OR=4.17; 95%CI:1.92–9.17) and the following chronic diseases: stroke (OR=4.20; 95%CI:1.53–11.55); diabetes mellitus (OR=4.03; 95%CI:2.43–6.68); heart disease (OR=3.18; 95%CI:1.92–5.29); depression (OR=2.85; 95%CI:1.80–4.53); hypertension (OR=2.13; 95%CI:1.17–3.86); and dyslipidemia (OR=1.73; 95%CI:1.07–2.80). Conclusion: This study revealed that polypharmacy is a real concern in primary health care and affects older and middle-aged adults alike. Groups of patients that are more likely to experience polypharmacy were identified. Our findings emphasize the relevance of an appropriate approach to polypharmacy driven by aging and multimorbidity.Item Statin use in Brazil : findings and implications.(2018) Nascimento, Renata Cristina Rezende Macedo do; Guerra Júnior, Augusto Afonso; Teodoro, Juliana Alvares; Gomes, I. C.; Godman, Brian; Bennie, Marion; Kurdi, Amanj Baker; Acúrcio, Francisco de AssisIntroduction and objectives: Stains have become an integral part of treatment to reduce cardiac events in patients with cardiovascular disease. However, their use within the public healthcare system in Brazil is unknown. Consequently, we sought to determine and characterize statin use in primary healthcare delivered by the public health system (SUS) in Brazil and evaluate associated patient factors to improve future use. Methods: Cross-sectional study with a national representative sample from five Brazilian regions, derived from the National Survey on Access, Use and Promotion of Rational Use of Medicines using a multi-stage complex sampling plan. Patients over 18 years old were interviewed from July/2014 to May/2015. Prevalence of statin use and statins’ self-reported adherence were determined amongst medicine users. The association between statin use and sociodemographic/health condition variables were assessed using logistic regression. Results: 8,803 patients were interviewed; of which, 6,511 were medicines users. The prevalence of statins use was 9.4% with simvastatin (90.3%), atorvastatin (4.7%) and rosuvastatin (1.9%) the most used statins. Poor adherence was described by 6.5% of patients. Statins use was significantly associated with age ≥65 years old, higher educational level, residence in the South, metabolic and heart diseases, alcohol consumption and polypharmacy. Conclusions: This is the first population based study in Brazil to assess statin use in SUS primary healthcare patients. Addressing inequalities in access and use of medicines including statins is an important step in achieving the full benefit of statins in Brazil, with the findings guiding future research and policies.Item Ongoing activities to optimize the quality and efficiency of lipid-lowering agents in the Scottish National Health System : influence and implications.(2018) Leporowski, Axel; Godman, Brian; Kurdi, Amanj Baker; MacBride-Stewart, Sean; Ryan, Margaret; Hurding, Simon; Nascimento, Renata Cristina Rezende Macedo do; Bennie, Marion; Morton, AlecBackground: Prescribing of lipid-lowering agents (LLAs) has increased worldwide including in Scotland with increasing prevalence of coronary heart disease, and higher dose statins have been advocated in recent years. There have also been initiatives to encourage prescribing of generic versus patented statins to save costs without compromising care. There is a need to document these initiatives and outcomes to provide future direction. Method: Assessment of utilization (items dispensed) and expenditure of key LLAs (mainly statins) between 2001 and 2015 in Scotland alongside initiatives. Results: Multiple interventions over the years have increased international nonproprietary name prescribing (99% for statins) and preferential prescribing of generic versus patented statins, and reduced inappropriate prescribing of ezetimibe. This resulted in a 50% reduction in expenditure of LLAs between 2001 and 2015 despite a 412% increase in utilization, increased prescribing of higher dose statins (71% in 2015) especially atorvastatin following generic availability, and reduced prescribing of ezetimibe (reduced by 72% between 2010 and 2015). As a result, the quality of prescribing has improved. Conclusion: Generic availability coupled with multiple measures has resulted in appreciable shifts in statin prescribing behavior and reduced ezetimibe prescribing, resulting in improvements in both the quality and efficiency of prescribing.Item Queda entre idosos no Brasil e sua relação com o uso de medicamentos : revisão sistemática.(2012) Rezende, Cristiane de Paula; Gaede Carrillo, Maria Ruth Gonçalves; Sebastião, Elza Conceição de OliveiraFalls in the elderly, often classified as accidental, are frequently related to medication, generally involving poor prognosis and thus becoming a public health issue. The purpose of this systematic review was to identify published Brazilian studies on medication as a risk factor for falls or fall-related fractures in the elderly. The search covered the LILACS, PubMed, and SciELO indexes using the descriptors falls, elderly, and pharmaceutical preparations/medications/medicines/ drugs or specific drug classes. A total of 340 articles presented data on prevalence, incidence, and risk factors associated with medication and falls or fall-related fractures, but only 6 pharmacoepidemiological studies were examined because they were conducted specifically in Brazilian samples. The main drug classes associated with increased risk of falls: antidepressants, sedatives, anxiolytics, and diuretics. The promotion of rational drug use in geriatrics requires well-designed studies to produce robust scientific data.