Universidade de São Paulo. Faculdade de Saúde Pública
Abstract
The consumption of medicines among a population-based cohort of 4,746 children bom in 1982 in Pelotas, Brazil, was studied when the children were aged 3-4,5 years. Fifty six percent of the mothers reported that their children had taken one or more medicines during a two-week period; 29.5% of the products were fixed combinations of three or more components, (which was taken as an indicator of poor quality). Almost 10% of the children had used a given medicine for one month or more. Aspirin, combinations of vitamins and mineral supplements and cough and cold combinations were the medicines most frequently used. The commonest reasons for taking medicines were colds, fevers and lack of appetite. The latter was the commonest reason for longterm use and also for that of combinations. Physicians' prescriptions were responsible for more than 60% of the medicines used (including dipyrone and appetite stimulants). In all social classes the consumption was above 50%. Children classified in the fifth quintile of family income consumed 14% more medicines than those in the first quintile. Children with two or more older siblings consumed 12% less medicines than the elder ones. Malnourished children, according to weight for age, consumed 30% more medicines than the well-nourished. Children consulting a doctor four times or more during the three-month period before the interview were using two times more medicines than children who had had no consultation during the same period. The frequent use of aspirin is a reason for concern as it has been associated with Reye's syndrome in children. It is also important to stress the danger of poisoning resulting from medicines available at home. Another noteworthy aspect concerns the messages transmitted to the children regarding the use of medicines for almost every conceivable reason which could possibly lead to medicine or illicit drug addiction.Foram investigados os padrões do consumo de medicamentos em uma coorte de 4.746 crianças de Pelotas, RS, Brasil e as influências de variáveis socioeconômicas, biológicas e de utilização de serviços de saúde. O delineamento foi transversal aninhado em estudo longitudinal e o período investigado foi 15 dias. O consumo global alcançou 56% das crianças, sendo mais de 50% em todas as classes sociais. Os medicamentos mais utilizados foram ácido acetil salicílico, vitaminas com sais minerais, associações antigripais, mebendazole e estimulantes do apetite. Mais de 60,0% dos medicamentos eram indicados por médicos (inclusive dipirona e estimulantes do apetite). Os principais motivos do consumo foram gripe, febre e falta de apetite. Ser primogênito foi fator de risco para o consumo. As crianças com pouco apetite na semana anterior consumiam duas vezes mais do que aquelas com bom apetite. É preocupante o alto consumo de aspirina, principalmente devido à associação desse produto com a Síndrome de Reye em crianças. Outro ponto a ser questionado a respeito é a mensagem que talvez inadvertida ou inconscientemente possa estar sendo passada a essas crianças: o consumo de medicamentos é uma rotina e a resposta para qualquer problema. Nesse sentido, parece que se estará preparando o terreno para a dependência de medicamentos e drogas ilícitas
