Utilização do Programa Farmácia Popular do Brasil por idosos

OBJETIVO Avaliar a prevalência e os fatores associados à utilização do Programa Farmácia Popular do Brasil – modelo expansão entre idosos e os motivos de não utilização. MÉTODOS Neste estudo transversal de base populacional, realizado na zona urbana de Pelotas, RS, foram avaliados 1.305 idosos (60 anos ou mais) que utilizaram medicamentos nos últimos 15 dias. Como variáveis independentes foram caracterizados fatores socioeconômicos, nível econômico, renda familiar em salários mínimos, escolaridade em anos de estudo e status ocupacional. As variáveis demográficas foram sexo, idade, situação conjugal e cor da pele autorreferida. Para análise dos fatores associados à utilização do PFPB-E, utilizou-se regressão de Poisson. RESULTADOS A prevalência de utilização do programa foi de 57,0% e a de conhecimento foi de 87,0%. Nos indivíduos com 80 anos ou mais, a utilização do programa foi de 41,0%. Quanto à origem das prescrições utilizadas pelos idosos, 46,0% eram oriundas do SUS. Os principais motivos para não utilização foram: dificuldade em conseguir receita, falta do medicamento, desconhecimento sobre os medicamentos ofertados e sobre o programa. Maior idade, menor renda, ter doença crônica e usar quatro ou mais medicamentos estiveram associados à utilização. CONCLUSÕES É preciso ampliar o conhecimento e a utilização do Programa Farmácia Popular do Brasil, especialmente entre os mais idosos, e melhorar a divulgação da lista de medicamentos do programa aos usuários e aos médicos. Dessa forma, será possível reduzir gastos com medicamentos de uso contínuo, que são especialmente importantes para essa população.OBJECTIVE To assess the prevalence and factors associated with the use of the expanded Brazilian People’s Pharmacy Program among older adults and the reasons for not using it. METHODS In this population-based cross-sectional study conducted in the urban area of Pelotas, RS, Southern Brazil, we evaluated 1,305 older adults (aged 60 years or over) who had used medication in the last 15 days. Independent variables were socioeconomic factors, economic status, household income in minimum wages, educational attainment in years of schooling and occupational status. Demographic variables were sex, age, marital status, and self-reported skin color/race. Poisson regression was employed to analyze the factors associated with the use of the program. RESULTS The prevalence of use was 57.0% whilst the prevalence of knowledge of the program was 87.0%. In individuals aged 80 years or over, use of the program was 41.0%. As to the origin of the prescriptions used by older adults, 46.0% were from the Brazilian Unified Health System. The main reasons for not using the program were: difficulty in getting prescriptions, medication shortage, and ignorance about the medications offered and about the program. Higher age, lower income, presence of chronic diseases, and use of four or more medications were associated with use of the program. CONCLUSIONS It is necessary to expand the knowledge and use of the Brazilian People’s Pharmacy Program, especially among older adults, and to improve the dissemination of its list of medications to users and physicians. Thus it will be possible to reduce spending on long-term medications, which are especially important for this population

Potentially inappropriate medications among older adults in Pelotas, Southern Brazil

OBJECTIVE To assess the use of potentially inappropriate medications among older adults. METHODS This is a population-based cross-sectional study with 1,451 older individuals aged 60 years or more in the city of Pelotas, State of Rio Grande do Sul, Brazil, in 2014. We have investigated the use of medications in the last 15 days. Using the Beers criteria (2012), we have verified the use of potentially inappropriate medications and their relationship with socioeconomic and demographic variables, polypharmacy, self-medication, and burden of disease. RESULTS Among the 5,700 medications used, 5,651 could be assessed as to being inappropriate. Of these, 937 were potentially inappropriate for the older adults according to the 2012 Beers criteria (16.6%). Approximately 42.4% of the older adults studied used at least one medication considered as potentially inappropriate. The group of medications for the nervous system accounted for 48.9% of the total of the potentially inappropriate medications. In the adjusted analysis, the variables female, advanced age, white race, low educational level, polypharmacy, self-medication, and burden of disease were associated with the use of potentially inappropriate medications. CONCLUSIONS It is important to known the possible consequences of the use of medication among older adults. Special attention should be given to the older adults who use polypharmacy. Specific lists should be created with more appropriate medications for the older population in the National Essential Medicine List.OBJETIVO Avaliar o uso de medicamentos potencialmente inadequados entre idosos. MÉTODOS Estudo transversal de base populacional com 1.451 idosos com 60 anos ou mais em Pelotas, RS, em 2014. Investigou-se o uso de medicamentos nos últimos 15 dias. Utilizando os critérios de Beers (2012), verificou-se a potencial inadequação dos medicamentos e sua relação com variáveis socioeconômicas e demográficas, polifarmácia, automedicação e carga de doença. RESULTADOS Dentre os 5.700 medicamentos utilizados, 5.651 puderam ser avaliados quanto à inadequação. Destes, 937 eram potencialmente inadequados para idosos segundo os critérios de Beers de 2012 (16,6%). Cerca de 42,4% dos idosos usaram no mínimo um medicamento considerado potencialmente inapropriado. O grupo de medicamentos para o sistema nervoso correspondeu a 48,9% do total de medicamentos potencialmente inadequados. Na análise ajustada, as variáveis sexo feminino, idade avançada, cor da pele branca, baixa escolaridade, polifarmácia, automedicação e carga de doença mostraram-se associadas ao uso de medicamentos potencialmente inadequados. CONCLUSÕES É importante que sejam bem conhecidas as possíveis consequências do uso de medicamentos entre idosos. Atenção especial deve ser dada aos idosos que fazem uso de polifarmácia. É necessário existir listas específicas com medicamentos mais adequados para uso em idosos na Relação Nacional de Medicamentos Essenciais

Iron salt supplementation during gestation and gestational diabetes mellitus

OBJETIVE: To evaluate the association between the use of iron salts during the first two trimesters of gestation in non-anemic women and the development of gestational diabetes mellitus. METHODS: The study used maternal data from the 2015 Pelotas Birth Cohort. All non-anemic women at the 24th week of gestation (n = 2,463) were eligible for this study. Gestational diabetes mellitus was self-reported by women. Crude and adjusted logistic regression were performed considering level of significance = 0.05. RESULTS: Among the women studied, 69.7% were exposed to prophylactic iron supplementation in the first two trimesters of gestation. The prevalence of gestational diabetes mellitus among those exposed was 8.7% (95%CI: 7.4–10.1) and 9.3% (95%CI: 7.4–11.6) among those who were not exposed. Iron supplementation was not associated with increased risk of gestational diabetes mellitus in crude (OR = 0.9; 95%CI: 0,7–1,3) and adjusted analysis (OR = 1.1; 95%CI :0,8–1,6). CONCLUSIONS: The results suggest that routine iron use in non-anemic pregnant women does not increase the risk of developing gestational diabetes. This evidence supports the existing national and international guidelines, in which prophylactic iron supplementation is recommended for all pregnant women as soon as they initiate antenatal care in order to prevent iron deficiency anemia

Medication use among pregnant women from the 2015 Pelotas (Brazil) birth cohort study

Background: Medication use during pregnancy is a common practice that has been increasing in recent years. The aim of this study is to describe medication use among pregnant women from the 2015 Pelotas (Brazil) Birth Cohort Study. Methods: This paper relies on a population-based cohort study including 4270 women. Participants completed a questionnaire about the antenatal period, including information about medication use. We performed descriptive analyses of the sample and the medications used and adjusted analyses for the use of medications and self-medication. Results: The prevalence of medication use was 92.5% (95% CI 91.7–93.3), excluding iron salts, folic acid, vitamins, and other minerals. The prevalence of self-medication was 27.7% (95% CI 26.3–29.1). In the adjusted analysis, women who had three or more health problems during pregnancy demonstrated higher use of medicines. Self-medication was higher in lower income groups and among smokers and multiparous women (three pregnancies or more). Acetaminophen, scopolamine, and dimenhydrinate were the medications most commonly used. Conclusions: This study describes the pattern of drug use among pregnant women in a population-based cohort study, with a high prevalence of self-medication. Greater awareness of the risks of self-medication during pregnancy is required, focusing on groups more prone to this practice, as well as ensuring qualified multidisciplinary prenatal care

Spring Commencement, 2017

Program for the One Hundred Eightieth Commencement of Marshall University

Suplementação de ácido fólico na gestação e sintomas depressivos pós-parto

OBJECTIVE: To verify whether folic acid supplementation during pregnancy is associated with the occurrence of maternal depressive symptoms at three months postpartum, in the 2015 Pelotas Birth Cohort. METHODS: This study included 4,046 women, who were classified into three groups: did not use folic acid supplementation during pregnancy; used during only one trimester of pregnancy; and used for two or three trimesters. Depressive symptoms were assessed at three months postpartum using the Edinburgh Postnatal Depression Scale (EPDS), at cutoff points ≥ 10 (mild symptoms) and ≥ 13 (moderate to severe intensity). RESULTS: The overall prevalence of mild symptoms was of 20.2% (95%CI 19.0–21.5), and moderate and severe was 11% (95%CI 10.0–12.0). The prevalence of EPDS ≥ 10 was of 26.8% (95%CI 24.0–29.5) among women who did not use folic acid and 18.1% for both those who used it during one trimester of pregnancy (95%CI 16.1–20.1) and those who used it for two or three trimesters (95%CI 16.0–20.2). The prevalence of EPDS ≥ 13 was of 15.7% (95%CI 13.5–17.9) in those who did not use folic acid, 9.1% (95%CI 7.5–10.6) in those who used it for one trimester, and 9.4% (95%CI 7.8–11.0) in those who used it for two or three trimesters. In the adjusted analyses, there was no statistically significant association between the use of folic acid during pregnancy and the occurrence of depressive symptoms at three months postpartum. CONCLUSION: Th ere w as n o a ssociation b etween f olic a cid s upplementation d uring pregnancy and postpartum depression at three months.OBJETIVO: Verificar se a suplementação de ácido fólico durante a gestação está associada com a ocorrência de sintomas depressivos maternos aos três meses pós-parto, na Coorte de Nascimentos de Pelotas de 2015. MÉTODOS: Este estudo incluiu 4.046 mulheres, que foram classificadas em três grupos: sem suplementação de ácido fólico na gestação; uso durante apenas um trimestre da gestação; e uso durante dois ou três trimestres. Os sintomas depressivos foram avaliados aos três meses pós-parto, através da Escala de Depressão Pós-Natal de Edimburgo (EPDS), nos pontos de corte ≥ 10 (sintomas leves) e ≥ 13 (intensidade moderada a grave). RESULTADOS: A prevalência geral de sintomas leves foi de 20,2% (IC95% 19,0–21,5), e moderados e graves de 11% (IC95% 10,0–12,0). Entre as mulheres que não fizeram uso de ácido fólico, a prevalência de EPDS ≥ 10 foi de 26,8% (IC95% 24,0–29,5) e 18,1% tanto entre as que utilizaram durante um trimestre da gestação (IC95% 16,1–20,1), quanto entre as que utilizaram por dois ou três trimestres (IC95% 16,0–20,2). Já a prevalência de EPDS ≥ 13 foi 15,7% (IC95% 13,5–17,9) entre as que não utilizaram ácido fólico, 9,1% (IC95% 7,5–10,6) entre as que utilizaram durante um trimestre e 9,4% (IC95% 7,8–11,0) entre as que utilizaram por dois ou três trimestres. Nas análises ajustadas, não houve associação estatisticamente significativa entre o uso de ácido fólico na gestação e a ocorrência de sintomas depressivos aos três meses pós-parto. CONCLUSÃO: Não se observou associação entre a suplementação de ácido fólico na gestação e depressão pós-parto aos três meses

Use of the Brazilian People’s Pharmacy Program by older adults

ABSTRACT OBJECTIVE To assess the prevalence and factors associated with the use of the expanded Brazilian People’s Pharmacy Program among older adults and the reasons for not using it. METHODS In this population-based cross-sectional study conducted in the urban area of Pelotas, RS, Southern Brazil, we evaluated 1,305 older adults (aged 60 years or over) who had used medication in the last 15 days. Independent variables were socioeconomic factors, economic status, household income in minimum wages, educational attainment in years of schooling and occupational status. Demographic variables were sex, age, marital status, and self-reported skin color/race. Poisson regression was employed to analyze the factors associated with the use of the program. RESULTS The prevalence of use was 57.0% whilst the prevalence of knowledge of the program was 87.0%. In individuals aged 80 years or over, use of the program was 41.0%. As to the origin of the prescriptions used by older adults, 46.0% were from the Brazilian Unified Health System. The main reasons for not using the program were: difficulty in getting prescriptions, medication shortage, and ignorance about the medications offered and about the program. Higher age, lower income, presence of chronic diseases, and use of four or more medications were associated with use of the program. CONCLUSIONS It is necessary to expand the knowledge and use of the Brazilian People’s Pharmacy Program, especially among older adults, and to improve the dissemination of its list of medications to users and physicians. Thus it will be possible to reduce spending on long-term medications, which are especially important for this population

Inadequação do uso de medicamentos entre idosos na cidade de Pelotas, RS.

The present study aimed to evaluate the use of potentially inappropriate medications among the elderly in the city of Pelotas using the Beers Criteria (2012)...Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESO presente trabalho teve como objetivo avaliar o uso de medicamentos potencialmente inadequados entre idosos na cidade de Pelotas utilizando os Critérios de Beers (2012). Métodos: Estudo transversal de base populacional com 1451 idosos com 60 anos ou mais, em Pelotas, RS. Resultados: Dentre os 5700 medicamentos utilizados, 5651 puderam ser avaliados quanto à inadequação. Destes, 937 eram potencialmente inadequados para idosos segundo os critérios de Beers de 2012 (16,6%). Cerca de 42,4% dos idosos usaram no mínimo um medicamento considerado potencialmente inapropriado. O grupo de medicamentos para o sistema nervoso correspondeu a 48,9% do total de medicamentos potencialmente inadequados. Na análise ajustada, as variáveis sexo feminino, idade avançada, cor da pele branca, baixa escolaridade, polifarmácia, automedicação e carga de doença mostraram-se associadas ao consumo de medicamentos potencialmente inadequados. Conclusão: É de suma importância que sejam bem conhecidas as possíveis consequências do uso de medicamentos entre idosos. Atenção especial deve ser dada aos idosos que fazem uso de polifarmácia. Destacamos também a necessidade de existir na RENAME listas específicas com medicamentos mais adequados para uso em idosos

Dor em baixo ventre: caso clínico

Uma paciente vai à consulta solicitando um exame de urina em função de apresentar uma dor abdominal em baixo ventre

Pré-natal de baixo risco

Paciente com atraso menstrual e aumento do volume abdominalMinistério da Saúd