Adesão ao tratamento farmacológico e não farmacológico e fatores associados na atenção primária da hipertensão arterialAdherence to pharmacological and non pharmacological treatment for arterial hypertension and associated factors in primary care

The aim of this study was to summarise the scientific evidence on the prevalence of psychoactive substance use and on the factors associated with their intake among truck drivers. A systematic review was performed in the databases PubMed, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences, and Cochrane and 36 cross-sectional studies were identified with quantitative results about the use of psychoactive substances by truck drivers. Out of these, 28 were carried out in countries with large land areas and 23 obtained their information through self-reporting. The most frequently studied substances were alcohol (n=25), amphetamines (n=17), marijuana (n=16) and cocaine (n=13). The prevalence of the use of these substances greatly varied: alcohol (0.1–91.0%); amphetamines (0.2–82.5%), marijuana (0.2–29.9%), cocaine (0.1–8.3%). The frequency of substance use was lower in studies that investigated the presence of these substances in biological samples than in those based on self-reported use. In 12 studies that evaluated factors associated with the intake of psychoactive substances, the following stood out: younger age, higher income, longer trips, alcohol consumption, driving in the night shift, travelling interstate routes, long or short sleep, fewer hours of rest, little experience of the driver, connection with small and medium sized companies, income below levels determined by labour agreements, productivity-based earnings and prior involvement in accidents. The frequency of psychoactive substance use by truck drivers seems to be high, although that greatly varies according to the type of substance and the method of collecting the information. The use of these substances was mainly associated with indicators of poor working conditions.

INTRODUÇÃO: No setor saúde, os medicamentos representam um instrumento essencial para a capacidade resolutiva dos serviços prestados. Neste processo, dá-se grande importância à política de medicamentos, que regulamenta um dos maiores gastos nos serviços públicos de saúde, em especial os medicamentos essenciais, que são aqueles considerados indispensáveis para atender a maior parte da população assistida pelo Sistema Único de Saúde, e que são distribuídos gratuitamente. OBJETIVO: Identificar os indicadores de prescrição do município de Ibiporã, PR. METODOLOGIA: Para tal, foram recolhidas 3.119 prescrições médicas de Clínica Geral, Pediatria e Ginecologia do município. A partir destas receitas, foram calculados os indicadores de prescrição propostos pela Organização Mundial da Saúde (OMS) e os medicamentos prescritos foram classificados obedecendo à classificação da Anatomical Therapeutic Chemical, também da OMS. RESULTADOS: No município de Ibiporã, PR, são prescritos, em média, dois medicamentos por receita médica. Do total de medicamentos prescritos, 70,2% são prescritos por seus nomes genéricos. Em 22,0% das prescrições foi encontrada a indicação de antibióticos. Houve prescrição de injetáveis em 7,0% das receitas médicas. Em relação à lista municipal de medicamentos, 58,4% dos medicamentos fazem parte desta lista. CONSIDERAÇÕES FINAIS: Tais resultados sugerem dificuldades na implantação de uma política de medicamentos essenciais. Neste contexto, estes indicadores podem contribuir para a formulação de políticas voltadas para a reorientação dos serviços farmacêuticos, promovendo a melhoria do acesso e o uso racional dos medicamentos.

Adesão ao tratamento farmacológico e não farmacológico e fatores associados na atenção primária da hipertensão arterialAdherence to pharmacological and non pharmacological treatment for arterial hypertension and associated factors in primary care

BackgroundCombined oral contraceptive (COC) use is the most commonly used reversible method of birth control. The incorrect use of COCs is frequent and one of the most common causes of unintended pregnancies. Community pharmacists (CPs) are in a strategic position to improve COC use because they are the last health professional to interact with patients before drug use.ObjectiveTo evaluate the COC dispensing practices of CPs in a developing country.MethodA cross-sectional study was conducted in community pharmacies of Assis and Ourinhos microregions, Brazil, between June 1, 2012, and October 30, 2012. Four simulated patients (SPs) (with counseled audio recording) visited community pharmacies with a prescription for Ciclo 21® (a COC containing ethinyl estradiol 30 mcg + levonorgestrel 15 mcg). The audio recording of every SP visit was listened to independently by 3 researchers to evaluate the COC dispensing practice. The percentage of CPs who performed a screening for safe use of COCs (i.e., taking of patients’ medical and family history, and measuring of blood pressure) and provided counseling, as well as the quality of the screening and counseling, were evaluated.ResultsOf the 185 CPs contacted, 41 (22.2%) agreed to participate in the study and finished the study protocol. Only 3 CPs asked the SP a question (1 question asked by each professional), and all of the questions were closed-ended, viz., “do you smoke?” (n = 2) and “what is your age?” (n = 1). None of the CPs measured the patient’s blood pressure. Six CPs provided counseling when dispensing COCs (drug dosing, 5 CPs; possible adverse effects, 2 CPs), and one CP provided counseling regarding both aspects.ConclusionThe CPs evaluated did not dispense COC appropriately and could influence in the occurrence of negatives therapeutic outcomes such as adverse effects and treatment failure.