self-medication was associated to young adults and those with problems in performing daily activities.

OBJECTIVE To evaluate the prevalence of self-medication in Brazil’s adult population.METHODS Systematic review of cross-sectional population-based studies. The following databases were used: Medline, Embase, Scopus, ISI, CINAHL, Cochrane Library, CRD, Lilacs, SciELO, the Banco de teses brasileiras (Brazilian theses database) (Capes) and files from the Portal Domínio Público (Brazilian Public Domain). In addition, the reference lists from relevant studies were examined to identify potentially eligible articles. There were no applied restrictions in terms of the publication date, language or publication status. Data related to publication, population, methods and prevalence of self-medication were extracted by three independent researchers. Methodological quality was assessed following eight criteria related to sampling, measurement and presentation of results. The prevalences were measured from participants who used at least one medication during the recall period of the studies.RESULTS The literature screening identified 2,778 records, from which 12 were included for analysis. Most studies were conducted in the Southeastern region of Brazil, after 2000 and with a 15-day recall period. Only five studies achieved high methodological quality, of which one study had a 7-day recall period, in which the prevalence of self-medication was 22.9% (95%CI 14.6;33.9). The prevalence of self-medication in three studies of high methodological quality with a 15-day recall period was 35.0% (95%CI 29.0;40.0, I2 = 83.9%) in the adult Brazilian population.CONCLUSIONS Despite differences in the methodologies of the included studies, the results of this systematic review indicate that a significant proportion of the adult Brazilian population self-medicates. It is suggested that future research projects that assess self-medication in Brazil standardize their methods.

Objetivos: O presente artigo tem por objetivo descrever o processo de atualização da Relação Nacional de Medicamentos Essenciais (RENAME), contextualizando-o à luz de novos marcos legais do Sistema Único de Saúde (SUS). Métodos: Trata-se de um estudo descritivo, de natureza crítica-reflexiva, estruturado em dois momentos: a) o processo de atualização da RENAME com a instituição dos novos marcos legais e b) discussão dos avanços, desafios e perspectivas da RENAME com o advento dos marcos legais descritos. Resultados: Discute-se a nova concepção da RENAME e sua harmonização com as diretrizes do SUS, discorrendo sobre aspectos dos processos de incorporação, de responsabilização pelo financiamento e de pactuação interfederativa, e seus impactos no acesso aos medicamentos. Conclusões: As mudanças nos marcos legais contribuíram para a aproximação das políticas de incorporação tecnológica e de assistência farmacêutica no âmbito do SUS, tornando a nova RENAME um instrumento importante para a qualificação da gestão e para a garantia do acesso a medicamentos eficazes, efetivos e seguros à população brasileira. Descritores: Medicamentos Essenciais; Assistência Farmacêutica; Gestão em Saúde; Financiamento da Assistência à Saúde; Sistema Único de Saúde.

were conducted in South America (92%), particularly in Brazil (64%). The mean age was 60 ± 9 years and the mean ejection fraction was 36 ± 9%. Most studies evaluated more than one etiology (79%) but the etiology more studies exclusively was Chagas disease (13%). The incidence of HF ranged from 199 to 557 cases per 100,000 person-years and the pooled prevalence was 1%, being higher in older populations. Hospitalization rates in patients with HF ranged from 28 to 31% at different time points, and the median length of stay was 7.0 days. In-hospital mortality was 11.7%, being higher in patients with worse ejection fraction, with ischemic and with Chagas disease. Mortality at one year was 24.52% (95%CI 19.42 to 30.02). ConClusions: This SR of HF in Latin America, could help decision-makers to design better preventive strategies, and guide effective patient-centered care.

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