La prescripció emocional : emocions rere les receptes mèdiques

Sembla que l'ús dels medicaments tant als hospitals com a l'atenció primària podria millorar substancialment quant a la idoneïtat del fàrmac triat, tant pel que fa a la despesa com pel que fa a la salut del pacient. Investigadors de la UAB s'han plantejat el perquè d'aquesta situació i han analitzat la prescripció mèdica des del punt de vista dels estudis de presa de decisions. La seva recerca demostra que sovint la prescripció es veu influenciada per l'emotivitat, afavorint els fàrmacs de laboratoris "de confiança" o les novetats en detriment dels genèrics o "antics", a causa de l'associació amb ells d'emocions positives o negatives de manera més o menys subliminal, i adverteixen que caldria tenir en compte aquest factor a l'hora de dissenyar campanyes per a millorar l'ús dels medicaments.Parece que el uso de los medicamentos tanto en los hospitales como en lla atención primaria podría mejorar sustancialmente en cuanto a la idoneidad del fármaco elegido, tanto en lo referente al gasto como a la salud del paciente. Investigadores de la UAB se han planteado el porqué de esta situación y han analizado la prescripción médica desde el punto de vista de los estudios de toma de decisiones. Su investigación demuestra que a menudo la prescripción se ve influenciada por la emotividad, favoreciendo los fármacos de laboratorios "de confianza" o las novedades en detrimento de los genéricos o "antiguos", debido a la asociación con ellos de emociones positivas o negativas de manera más o menos subliminal, y advierten que habría que tener en cuenta este factor a la hora de diseñar campañas para mejorar el uso de los medicamentos

Analysis of the Antimicrobial Market in Pakistan : Is It Really Necessary Such a Vast Offering of "Watch" Antimicrobials?

Understanding antimicrobials (AM) on offer in a pharmaceutical market, with a particular reference to drugs categorized as "Watch" active ingredients, is one of the important first steps to prevent their potentially inappropriate use. The March 2019 data of all AM containing registered brands and presentations currently being sold in the country for the J01 Anatomical Therapeutic Chemical (ATC) subgroup from IQVIA Pakistan was used. Each AM was categorized as "Access," "Watch," or "Reserve," according to the WHO AWaRe classification. There were 59 single chemical entities and 14 combinations with 1869 brands and 4648 presentations. The WHO Essential Medicines List included 35 J01 AM while an additional 38 single and combination AM with 425 brands and 977 presentations were present in the country. Looking at the whole list of marketed AM, 8 of the 10 AM with more than 60 brands were classified as "Watch", offering 962 brands and 2418 presentations. Most AM marketed in Pakistan, of which there are an excessive number of brands, belong to the "Watch" AWaRe category. The higher the number of brands, the higher the marketing pressure on prescribers and pharmacists will be which implies more potential confusion. One vital step to rationalize the use of AM lies in reviewing their market offer

Continuous rise in cephalosporin and fluoroquinolone consumption in Pakistan : a 5 year analysis (2014-18)

Pakistan was third on the list of the highest antibiotic-consuming countries among low- and middle-income countries in 2015. Studies have suggested that areas with higher consumption of antibiotics are likely to have higher antibiotic resistance rates. With limited surveillance data on consumption and resistance in Pakistan, this study investigated the 5 year trends (April 2014 to March 2019) in consumption of the two highest-sold antibiotic classes, cephalosporins [Anatomical Therapeutic Chemical (ATC) group J01D] and fluoroquinolones (ATC group J01MA). IQVIA Pakistan data (retail) on antibiotic sales presented in units were used. These data were standardized and a DDD was assigned to all formulations, based on WHO's ATC/DDD index, and the data expressed as DIDs (DDDs per 1000 inhabitants per day). WHO's AWaRe classification of antimicrobials was used for the analyses, especially of those categorized as 'Watch'. The findings showed a significant increase in consumption trends for 'Watch' cephalosporins (61.5%) while the use of 'Reserve' cephalosporins doubled during the studied period. In 2018, combined consumption of second- and third-generation cephalosporins (both in the 'Watch' group) was nearly five times higher than that of the first-generation cephalosporins. For fluoroquinolones, the total consumption only showed a major increase for ciprofloxacin, with 127 820 more persons per day. The consumption of cephalosporins and fluoroquinolones in Pakistan increased by 1.86 DIDs in just 5 years. It is urgent to establish a National Antimicrobial Commission in Pakistan, to critically analyse the pharmaceutical market offerings and implement surveillance systems and antimicrobial stewardship

Analysis of the evidence of efficacy and safety of over-the-counter cough medications registered in Brazil

The objective of this study was to analyze the level of evidence regarding the efficacy, effectiveness and safety of over-the-counter (OTC) cough medications registered in Brazil. The National Health Surveillance Agency database was used to identify the drugs. Clinical trials, systematic reviews, meta-analyses, and studies on safety were searched on the Medline baseline, the Cochrane Library and SIETES (System of Essential Information in Therapeutics and Health; database in Spanish). Most drugs (62.5%) were sold as a fixed-dose combination of two or more drugs. Randomized clinical trials were found for only three drugs: bromhexine, dextromethorphan and guaifenesin. No clinical trials were found for fixed-dose combinations. Systematic reviews on Cochrane did not report any evidence in favor of or against the effectiveness of cough drugs. Efficacy is also unclear, especially regarding fixed-dose combinations. The evidence for the efficacy of OTC cough medications available in Brazil is poor due to the lack of quality studies. Pharmacovigilance of OTC cough medications should be encouraged.O objetivo deste trabalho foi analisar o nível de evidências sobre a eficácia, a efetividade e a segurança dos medicamentos para tosse registrados no Brasil. A base de dados da Agência Nacional de Vigilância Sanitária foi empregada para identificar os medicamentos. Os ensaios clínicos, as revisões sistemáticas, as metanálises e os estudos de segurança foram pesquisados no Medline, the Cochrane Library e SIETES (Sistema de Informações Essenciais em Terapêutica e Saúde, base de dados em espanhol). A maioria dos medicamentos (62,5%) eram comercializados como associação em dose fixa com dois ou mais fármacos. Ensaios clínicos randomizados foram encontrados apenas para três fármacos: bromexina, dextrometorfano e guaifenesina; para associações a dose fixa não foram encontrados ensaios clínicos. Revisões sistemáticas publicadas pela Cochrane não encontraram evidências favoráveis ou contrárias à efetividade dos medicamentos para tosse. Essa eficácia não é clara, especialmente a das associações a dose fixa. As evidências sobre a eficácia dos medicamentos para tosse isentos de prescrição disponíveis no mercado brasileiro são fracas, devido à falta de pesquisas de boa qualidade. A farmacovigilância de medicamentos para tosse isentos de prescrição deve ser incentivada

Design and development of experiments with emotional stimulation techniques by means of image and sound to improve the individual's resilience against stress

The World Health Organization has defined stress as the "Health Epidemic of the 21st Century". Chronic stress is found to be one of the main causes of growing numbers of physical chronic diseases. Even though there are some challenges, there is a lot of evidence to support the use of sound, images and resonant breathing to combat stress. However, music and image therapy are not easily integrated in our daily lives as it is largely based on personal preferences that may also be linked to cultural sensitivity. The search for reliable stress biomarkers has established heart rate variability (HRV) as a suitable, cost-effective, non-invasive index for stress and stress vulnerability in mammals. The focus of this project will be to study how rhythmic sonic emotional stimulation techniques, rhythmic visual emotional stimulation and resonant breathing can be used to control the HRV performance with the intention of reducing and controlling stress2022/202

Efectes no desitjats dels medicaments : podríem prevenir-los?

Els efectes adversos, sobretot els greus i mortals, provocats principalment per medicaments d'ús habitual tenen un gran impacte sobre la salut pública. En aquest article es reflexiona sobre quin ús es dóna als medicaments i es planteja quines estratègies podrien evitar aquestes reaccions adverses, començant pel disseny de campanyes efectives per a promore l'ús prudent dels medicaments.Los efectos adversos, sobre todo los graves y mortales, provocados principalmente por medicamentos de uso habitual, tienen un gran impacto sobre la salud pública. En este artículo se reflexiona sobre qué uso se da a estos medicamentos y se plantea cuáles podrían ser algunas de las estrategias para evitar las reacciones adversas, empezando por el diseño de campañas que promuevan el uso prudente de los medicamentos.Most serious and fatal adverse effects are caused by well-known and commonly prescribed medicines, and have a great public health impact. This article reflects on what use is given to these drugs and considers what strategies could be used to avoid the adverse reactions, starting with the design of campaigns to promote the prudent use of medicines

Internet com a eina en farmacologia clínica

Internet té tres utilitats per al món de la farmacologia: la comunicació, la formació i la recerca. En aquest treball de la Fundació Institut Català de Farmacologia es revisen breument aquestes aplicacions i es descriu l'experiència d'organització virtual d'un treball de recerca adreçat a promoure l'ús racional de medicaments en països llatinoamericans.Internet tiene tres utilidades en el mundo de la farmacología: la comunicación, la formación y la investigación. En este trabajo de la "Fundació Institut Català de Farmacologia" se revisan, brevemente, algunas de estas aplicaciones y se describe la experiencia de organización virtual de un trabajo de investigación dirigido a promover el uso racional de medicamentos en países latinoamericanos