Objetivos: determinar a proporção de crianças com cadernetas de saúde com preenchimento adequado e analisar associações com características geográficas, socioeconômicas e biológicas maternas e da criança e com o percentual de utilização de serviços de saúde em dois municípios do semi-árido brasileiro. Métodos: estudo transversal de base populacional com crianças até cinco anos de idade. A coleta de dados foi realizada mediante aplicação de questionários domiciliar entre julho e setembro de 2008. A presença de todos os registros na caderneta, relativos à identificação, crescimento, desenvolvimento e status vacinal da criança foi definida como preenchimento adequado. Calcularam-se as razões de prevalência brutas e ajustadas pela Regressão de Poisson, seguindo modelo hierarquizado. Resultados: entre as 342 crianças estudadas, 22,2% (IC95% 17,5 a 26,2) apresentavam cadernetas de saúde preenchidas de forma adequada. A alta escolaridade materna esteve associada a este evento, após ajuste do efeito das variáveis no modelo hierarquizado. Conclusões: os resultados demonstraram baixo percentual de cadernetas de saúde adequadamente preenchidas. A maior prevalência de cadernetas com preenchimento inadequado nas mães de baixa escolaridade pode denotar iniquidade no sistema de saúde local. O preenchimento adequado da caderneta um direito da criança, a sua inadequação indicou despreparo dos profissionais de saúde e dos pais às necessidades da atenção básica.
The results of this review suggest that access to insurance or another program that assists with medication costs was a protection factor for non-adherence. On the other hand, a high frequency of dosing was a risk factor for non-adherence. Therefore, these characteristics of pharmacotherapy must be considered to improve medication adherence among CVD patients.
OBJECTIVE : To analyze if the demographic and socioeconomic variables, as well as percutaneous coronary intervention are associated with the use of medicines for secondary prevention of acute coronary syndrome.METHODS : In this cohort study, we included 138 patients with acute coronary syndrome, aged 30 years or more and of both sexes. The data were collected at the time of hospital discharge, and after six and twelve months. The outcome of the study was the simultaneous use of medicines recommended for secondary prevention of acute coronary syndrome: platelet antiaggregant, beta-blockers, statins and angiotensin-converting-enzyme inhibitor or angiotensin receptor blocker. The independent variables were: sex, age, education in years of attending, monthly income in tertiles and percutaneous coronary intervention. We described the prevalence of use of each group of medicines with their 95% confidence intervals, as well as the simultaneous use of the four medicines, in all analyzed periods. In the crude analysis, we verified the outcome with the independent variables for each period through the Chi-square test. The adjusted analysis was carried out using Poisson Regression.RESULTS : More than a third of patients (36.2%; 95%CI 28.2;44.3) had the four medicines prescribed at the same time, at the moment of discharge. We did not observe any differences in the prevalence of use in comparison with the two follow-up periods. The most prescribed class of medicines during discharge was platelet antiaggregant (91.3%). In the crude analysis, the demographic and socioeconomic variables were not associated to the outcome in any of the three periods.CONCLUSIONS : The prevalence of simultaneous use of medicines at discharge and in the follow-ups pointed to the under-utilization of this therapy in clinical practice. Intervention strategies are needed to improve the quality of care given to patients that extend beyond the hospital discharge, a critical point of transition in care.
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