Self-medication and non-doctor prescription practices in Pokhara valley, Western Nepal: a questionnaire-based study

BACKGROUND: Self-medication and non-doctor prescribing of drugs is common in developing countries. Complementary and alternative medications, especially herbs, are also commonly used. There are few studies on the use of these medications in Pokhara Valley, Western Nepal. METHODS: Previously briefed seventh semester medical students, using a semi-structured questionnaire, carried out the study on 142 respondents. Demographic information and information on drugs used for self-medication or prescribed by a non-allopathic doctor were collected. RESULTS: Seventy-six respondents (54%) were aged between 20 to 39 years. The majority of the respondents (72 %) stayed within 30 minutes walking distance of a health post/medical store. 59% of these respondents had taken some form of self-medication in the 6-month period preceding the study. The common reasons given for self-medication were mild illness, previous experience of treating a similar illness, and non-availability of health personnel. 70% of respondents were prescribed allopathic drugs by a non-allopathic doctor. The compounder and health assistant were common sources of medicines. Paracetamol and antimicrobials were the drugs most commonly prescribed. A significantly higher proportion of young (<40 years) male respondents had used self-medication than other groups. CONCLUSIONS: Self-medication and non-doctor prescribing are common in the Pokhara valley. In addition to allopathic drugs, herbal remedies were also commonly used for self-medication. Drugs, especially antimicrobials, were not taken for the proper duration. Education to help patients decide on the appropriateness of self-medication is required

Physical activity and medicine use: evidence from a population-based study

BACKGROUND: Few studies have investigated the association between physical activity practice and medicine use; data from these studies are inconsistent. The aim of this study was to evaluate the association between level of physical activity and medicine use in adults aged 20 years or more. METHODS: A population-based cross-sectional study was carried out in the first semester of 2002 in the urban area of Pelotas; a medium-sized Southern Brazilian city. Physical activity was assessed with the short version of the International Physical Activity Questionnaire. A physical activity score was created as the weekly time spent in moderate-intensity activities plus twice the weekly time spent in vigorous-intensity activities. Medicine use in the 15 days prior to the interview was also assessed. Adjusted analyses taking into account the sampling design was carried out using Poisson regression. Wald tests for heterogeneity and linear trend were used to calculate significance. RESULTS: Out of the 3,182 individuals interviewed, 41% were not sufficiently active according to current physical activity guidelines. Only 34% of the subjects did not use medicines in the previous 15 days, and 18% used three or more drugs in the same period. Level of physical activity was inversely associated with the number of medicines used both in the crude and in the adjusted analyses. CONCLUSION: There are well-documented benefits of physical activity for several chronic diseases in the literature. Data from the present study suggest that medicine use is also positively affected by physical activity behavior

"Bomba hormonal": os riscos da contracepção de emergência na perspectiva dos balconistas de farmácias no Rio de Janeiro, Brasil

Resumo: A pesquisa objetivou conhecer a perspectiva dos balconistas de farmácias sobre a contracepção de emergência na Região Metropolitana do Rio de Janeiro, Brasil. O material empírico advém de pesquisa socioantropológica com vinte entrevistas semiestruturadas com balconistas dos sexos feminino (8) e masculino (12). Os entrevistados apresentam concepções negativas sobre a contracepção de emergência, enfatizando os riscos que ela pode provocar à saúde. O medicamento é considerado uma "bomba hormonal" que pode causar danos aos órgãos reprodutivos femininos e outros sistemas do corpo. Eles destacam os riscos do uso "descontrolado" ou "indiscriminado", especialmente por adolescentes e mulheres jovens. Por ser considerado "perigoso" aos corpos femininos, eles atribuem a responsabilidade de orientação e aconselhamento sobre o uso do método aos médicos ginecologistas e não aos farmacêuticos. Discute-se a necessidade de ampliação do debate público sobre contracepção de emergência no Brasil, incluindo-se os farmacêuticos e balconistas de farmácia, além dos profissionais de saúde e educadores

Avaliação da qualidade do uso de medicamentos em idosos Quality assessment of drug use in the elderly

OBJETIVO: Avaliar a qualidade do uso de medicamentos através da análise do padrão do uso, do grau de concordância com listas de medicamentos essenciais, do valor terapêutico e das interações medicamentosas encontradas entre mulheres com mais de 60 anos. MÉTODOS: Foram pesquisadas 634 mulheres que freqüentam a Universidade Aberta da Terceira Idade da Universidade do Estado do Rio de Janeiro. Os dados foram coletados através de questionário padronizado e testado. As variáveis utilizadas foram relativas aos medicamentos e a seu modo de utilização. As unidades de análise foram o medicamento e o indivíduo. RESULTADOS: Das 634 mulheres estudadas, 9,1% não tomam qualquer tipo de medicamento. A média de medicamentos consumidos foi de 4,0 por mulher. Das 2.510 especialidades farmacêuticas citadas, há 538 princípios ativos diferentes. Cerca de 26% dos medicamentos são concordantes com as recomendações da Organização Mundial da Saúde, e 17%, com as da Relação Nacional de Medicamentos Essenciais. Cerca de 17% dos medicamentos são inadequados para o uso. No que diz respeito a redundâncias, 14,1% das mulheres podem sofrer conseqüências decorrentes desse evento. Quanto às interações medicamentosas, 15,5% das entrevistadas estão expostas às principais interações. CONCLUSÕES: Os dados sugerem que o padrão do uso dos medicamentos entre as idosas é bastante influenciado pela prescrição médica e que sua qualidade é prejudicada pela baixa seletividade do mercado farmacêutico.<br>INTRODUCTION: The objective is to evaluate the quality of medication utilization through the analysis of the pattern of usage, the degree of compliance to essential drug lists, therapeutic value and by drug interactions found among women over 60 years of age. METHODS: Six hundred thirty-four women enrolled at the Open University of the Third Age were studied. Data was collected through pattern-oriented, tested questionnaires. The variables examined were related to drugs and to drug utilization. The units of analysis used were the drugs and the individual. RESULTS: Of 634 women that participated in the study, 9,1% did not use drugs. The number of medications taken vary from 1 to 17. The average is 4,0 drugs/woman. Among the 2.510 pharmaceutical specialties mentioned by the interviewed, 538 different substances were identified. About 26% of the medications were in agreement with the recommendations of the World Health Organization and 17% with recommendations of the "Relação Nacional de Medicamentos Essenciais". Seventeen percent of the drugs are inappropriate for use in seniors; 14,1% of the women may suffer consequences for taking drugs of the same therapeutic class, and 15,5% are exposed to interactions. CONCLUSIONS: The data suggest that the pattern of the medication utilization is considerably influenced by the medical prescription and that their quality is harmed by the low selectiveness of the pharmaceutical market