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Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2019-05-10T18:25:37Z No. of bitstreams: 1 ARTIGO1 SUSAN PEREIRA. 2018..pdf: 814025 bytes, checksum: 3630378855ecf4e6ec5998be4b78af03 (MD5) Approved for entry into archive by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2019-05-20T18:16:12Z (GMT) No. of bitstreams: 1 ARTIGO1 SUSAN PEREIRA. 2018..pdf: 814025 bytes, checksum: 3630378855ecf4e6ec5998be4b78af03 (MD5) Made available in DSpace on 2019-05-20T18:16:12Z (GMT). No. of bitstreams: 1 ARTIGO1 SUSAN PEREIRA. 2018..pdf: 814025 bytes, checksum: 3630378855ecf4e6ec5998be4b78af03 (MD5) Tuberculosis; Treatment Outcome; Social Welfare; Public Policy Tuberculosis (TB) is a poverty infectious disease that affects millions of people worldwide. Evidences suggest that social protection strategies (SPS) can improve TB treatment outcomes. This study aimed to synthesize such evidences through systematic literature review and meta-analysis. We searched for studies conducted in low- or middle-income and in high TB-burden countries, published during 1995-2016. The review was performed by searching PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect and LILACS. We included only studies that investigated the effects of SPS on TB treatment outcomes. We retained 25 studies for qualitative synthesis. Meta-analyses were performed with 9 randomized controlled trials, including a total of 1,687 participants. Pooled results showed that SPS was associated with TB treatment success (RR = 1.09; 95%CI: 1.03-1.14), cure of TB patients (RR = 1.11; 95%CI: 1.01-1.22) and with reduction in risk of TB treatment default (RR = 0.63; 95%CI: 0.45-0.89). We did not detect effects of SPS on the outcomes treatment failure and death. These findings revealed that SPS might improve TB treatment outcomes in lower-middle-income economies or countries with high burden of this disease. However, the overall quality of evidences regarding these effect estimates is low and further well-conducted randomized studies are needed. Rio de Janeiro

RESUMO Objetivo Estimar a frequência de prescrição de medicamentos potencialmente inapropriados (MPI) para idosos institucionalizados em um hospital psiquiátrico. Métodos Estudo descritivo, transversal, baseado em análise de prescrições médicas para indivíduos com idade igual ou superior a 65 anos (n = 40), elaboradas no mês de janeiro de 2013 e coletadas de prontuários médicos em uma instituição hospitalar pública, especializada em saúde mental. Foram analisadas variáveis sociodemográficas e clínicas relativas ao idoso. Os medicamentos prescritos foram categorizados pelos Critérios de Beers (CB), em: 1) MPI que devem ser evitados em qualquer condição clínica; 2) MPI nas condições clínicas identificadas no estudo; 3) medicamentos que devem ser utilizados com precaução em idosos. Resultados Houve predomínio do sexo feminino (62,5%, n = 25/40). Em relação à idade, a média foi de 73 anos (66-93 anos). O tempo médio de internamento foi de 15 anos e o principal diagnóstico foi esquizofrenia (56,4%; n = 22/39). A prevalência de polifarmácia foi 70%. Os medicamentos mais prescritos foram prometazina e haloperidol. Em relação aos CB, observou-se que 40,2% (n = 90/224) dos medicamentos prescritos foram classificados como MPI em qualquer condição clínica; 38,8% (n = 87/224) MPI em determinadas condições clínicas e 23,7% (n = 53/224) pertenciam a categoria dos medicamentos que devem ser utilizados com cautela em idosos. Conclusão Obteve-se uma elevada prevalência de MPI para idosos, quando comparada com estudos semelhantes. Os CB contribuíram para a análise das prescrições, possibilitando a identificação de medicamentos que podem potencializar os riscos de desenvolvimento de iatrogenias ou agravamento de patologias preexistentes. ABSTRACT Objective To estimate the frequency of prescription of potentially inappropriate medications (PIM) for institutionalized older adults in a psychiatric hospital. Methods Descriptive study, transversal, based on analysis of prescriptions for individuals aged over 65 years (n = 40), drawn up in January 2013 and collected from medical records in a public hospital. Sociodemographic and clinical variables were analyzed. Medications were categorized by Beers Criteria (BC): 1) PMI which should be avoided in any clinical condition; 2) MPI to avoid in older adults with certain diseases identified on the study; 3) medications to be used with caution in older adults. Results There was a predominance of females (62.5%, n = 25/40). Regarding age, the average was 73 years (66-93 years). The inpatient average time was 15 years and the main diagnosis was schizophrenia (56.4%; n = 22/39). The prevalence of polypharmacy was 70%. The most commonly prescribed drugs were promethazine and haloperidol. Regarding the CB, it was observed that 40.2% (n = 90/224) of the prescribed drugs have been classified as PIM in any clinical condition; 38.8% (n = 87/224) PIM in specific clinical conditions and 23.7% (n = 53/224) belonged to the category of drugs that should be used with caution in the older adults. Conclusion We obtained a high prevalence of PMI for older adults compared with similar studies. The BC contributed to the analysis of the requirements, enabling the identification of drugs that may enhance the risk of developing iatrogenic or worsening of preexisting conditions.

Submitted by Bruno Matos Nascimento (brunomatos@uefs.br) on 2021-07-19T21:08:20Z No. of bitstreams: 1 DISSERTA??O VERSAO FINAL KAIO ANDRADE.pdf: 710081 bytes, checksum: 3b2d2d0bb291ec9c9deecfdb627ea30f (MD5) Made available in DSpace on 2021-07-19T21:08:20Z (GMT). No. of bitstreams: 1 DISSERTA??O VERSAO FINAL KAIO ANDRADE.pdf: 710081 bytes, checksum: 3b2d2d0bb291ec9c9deecfdb627ea30f (MD5) Previous issue date: 2009-03-10 The medical prescription is used as a parameter in studies that evaluate the use of medicines in human populations, especially for pediatric patients. For this purpose, the World Health Organization created indicators to describe general medicine prescription practices. This study aimed at describing the profile of the pediatric prescriptions in public primary health care centers, in Feira de Santana, Bahia State, Brazil. The study analyzed 3,167 prescriptions, 53% for the male sex, 76.1% including the age of the patient, higher frequency of systemically used anti-infective, antiparasitic and respiratory system medicines. The average of medicines per prescription was 2.2, 83.8% of generic drugs, 51.5% of antibiotics, 0.6% injecting medicines, 66.9% of essential drugs. Of 4,700 medicines, 69.4% were dispensed. There were no lists of essential medicines in health care services and the key drug availability was of 77%. The results showed a high frequency of antibiotic prescription and na unsatisfactory percentage of essential drugs prescription, showing the necessity of adopting prescriptive practices based on the rational use of drugs and the spread of the local essential drug list. A prescri??o m?dica ? utilizada como par?metro em estudos que avaliam o uso de medicamentos nas popula??es humanas, em particular para pacientes pedi?tricos. Com essa finalidade, a Organiza??o Mundial de Sa?de criou indicadores para descrever pr?ticas gerais de prescri??o de medicamentos. Esse estudo buscou descrever o perfil das prescri??es pedi?tricas em Unidades B?sicas de Sa?de, no munic?pio de Feira de Santana, Bahia. Foram analisadas 3.167 prescri??es, sendo 53% para o sexo masculino, 76,1% com presen?a da idade do paciente, maior freq??ncia de antiinfeciosos sist?micos, antiparasit?rios e de medicamentos para o sistema respirat?rio. A m?dia de medicamentos por prescri??o foi 2,2, sendo 83,8% medicamentos gen?ricos, 51,5% antibi?ticos, 0,6% injet?veis, 66,9% medicamentos essenciais. Do total de 4.700 medicamentos, 69,4% foram dispensados. N?o havia c?pias de listas de medicamentos essenciais nos servi?os e a disponibilidade de medicamentos-chave foi de 77%. Os resultados apontaram uma alta freq??ncia de prescri??es de antibi?ticos e um percentual insatisfat?rio de prescri??es de medicamentos essenciais, evidenciando a necessidade de ado??o de pr?ticas prescritivas pautadas no uso racional de medicamentos e divulga??o da lista local de medicamentos essenciais.