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Background: Success after liver transplantation involves different particularities. As important as the surgical procedure is the need for health information for patients, fundamental educational strategies facilitate the understanding of the guidelines provided by the health team. Objectives: To describe the process of elaboration and validation of an educational booklet for a liver transplant recipient. Materials and Methods: Methodological research, for the elaboration and validation of an educational technology, developed in three stages: bibliographic survey, elaboration of the booklet and validation of the material. Validation took place between May and August 2021 with professionals from the care team and patients from a specialized outpatient clinic of a university hospital. To analyze the validity, the Content Validity Index (CVI) and the Research Electronic Data Capture (REDCap) program were adopted for data storage and analysis. Results: The CVI obtained with the 17 expert judges was 0.98, and with 20 patients, 0.99, which proves to be valid material. Conclusion: The booklet is valid and adequate for information to transplant patients, suggesting its implementation in the post-liver transplant routine as a guiding resource for care in order to make the process more effective. [ABSTRACT FROM AUTHOR]

Background: Patients that are subjected to transplants undergo various changes in their lifestyle, including a complex pharmacological treatment that needs adequate management. Therefore this study aims to analyze the potential drug interactions found in the prescriptions corresponding to transplant patients after liver transplants. Materials and Methods: A crosssectional and descriptive study with a quantitative approach, developed in the Liver Transplant Outpatient Service of the Walter Cantídio University Hospital (Hospital Universitário Walter Cantídio, HUWC) belonging to the Federal University of Ceará (Universidade Federal do Ceará, UFC). A total of 31 prescriptions corresponding to patients recently subjected to transplants between July 2019 and December 2020 were analyzed. The study participants were adult patients recently subjected to transplants and aged between 18 and 75 years old at the time of the first pharmaceutical consultation, who had their medical records available, containing the medical prescriptions. The patients’ pharmaco-epidemiological and clinical profile was outlined and the drug interactions were analyzed by resorting to the Micromedex 2.0® database. Statistical analysis used: The data were analyzed in the Research Electronic Data Capture (REDCap) statistical program. Results: There was prevalence of male patients aged between 40 and 60 years old, and the most frequent etiology of the transplants was alcoholic cirrhosis with no associated comorbidities (31.43%). The most frequent potential drug interactions were the following: tacrolimus + prednisone (27.45%), tacrolimus + omeprazole (22.55%), and tacrolimus + amlodipine (7.84%). The interactions were considered: a) regarding severity, as of ‘moderate severity’ (57.58%) and as of ‘major severity’ (39.39%); b) regarding documentation, predominantly as ‘deficient’ (54.55%); c) regarding the latency period: the majority was not specified (63.64%); and d) regarding the mechanism of action, the following were observed: those of a ‘pharmacokinetic’ origin (41.67%) and those of a of ‘pharmacodynamic’ origin (41.67%). Conclusion: Analysis of the potential drug interactions in transplanted patients is fundamental for the identification of risks, improving the safety of these patients and more assertively guiding the courses of action. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the utilization of benzodiazepines (BZD) in Brazilian older adults, based on the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey of Access, Use and Promotion of Rational Use of Medicines). METHODS: The PNAUM is a cross-sectional study conducted between 2013 and 2014, representing the Brazilian urban population. In the present study, we included 60 years or older (n = 9,019) individuals. We calculated the prevalence of BZD utilization in the 15 days prior to survey data collection according to independent variables, using a hierarchical Poisson regression model. A semistructured interview performed empirical data collection (household interview). RESULTS: The prevalence of BZD utilization in the older adults was 9.3% (95%CI: 8.3-10.4). After adjustments, BZD utilization was associated with female sex (PR = 1.88; 95%CI: 1.52-2.32), depression (PR = 5.31; 95%CI: 4.41-6, 38), multimorbidity (PR = 1.44; 95%CI: 1.20-1.73), emergency room visit or hospitalization in the last 12 months (PR = 1.42; 95%CI: 1.18-1.70 ), polypharmacy (PR = 1.26; 95%CI: 1.01-1.57) and poor or very poor self-rated health (PR = 4.16; 95%CI: 2.10-8.22). Utilization was lower in the North region (PR = 0.18; 95%CI: 0.13-0.27) and in individuals who reported abusive alcohol consumption in the last month (PR = 0.42; 95%CI: 0.19-0.94). CONCLUSION: Despite contraindications, results showed a high prevalence of BZD utilization in older adults, particularly in those with depression, and wide regional and sex differences. [ABSTRACT FROM AUTHOR]

Objective of this article is to evaluate aspects related to the services provided in SUS pharmacies in Brazil, according to users' perception. Data from the National Survey of Access, Use and Promotion of Rational Use of Medicines carried out between 2013 and 2014 were used. Individuals who obtained drugs from public pharmacies were analyzed. To calculate prevalence estimates, the total number of users of drugs with 95%CI was used as denominator. From the age group of 20 to 24 years up to 60 to 64 years, there were significant differences between men and women in terms of use of public pharmacies. More than 30% of people from all socioeconomic classes who did not obtain drugs from SUS pharmacies never thought about this possibility. Not having to wait much time to obtain the medication and a positive evaluation of the opening hours had a strong association with the positive evaluation of users of SUS pharmacies. Opening hours and waiting time are potential barriers in SUS pharmacies. The evaluation of users of SUS was positive, but it pointed to regional differences, and the identification of the magnitude of such differences can contribute to the planning of more effective and equitable policies. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: To analyze variations in the prevalence of chronic use of medicines by older adults in Brazil according to its possible association with the most prevalent chronic diseases and demographic and health factors, and to identify risk factors for polypharmacy. METHODS: A study based on data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), a cross-sectional, population-based survey with probability sampling in Brazilian urban areas. The independent variable was the number of chronic-use medicines taken by older adults, linked to eight chronic diseases investigated. The intervening variables were gender, age group, marital status, level of education, socioeconomic status, Brazilian region, body mass index, smoking, self-perceived health, hospitalization in the previous year and having health insurance, besides the investigated chronic diseases. A multivariable analysis identified risk factors for polypharmacy. RESULTS: Prevalence of at least one chronic-use medicines among older adults was 93.0%. Of the total number of older adults, 18.0% used at least five medications (polypharmacy). Polypharmacy was higher among the oldest individuals (20.0%), in the South region (25.0%), in those with poor self-perceived health (35.0%), in obese individuals (26.0%), in those with reported health insurance (23.0%) or hospitalization in the previous year (31.0%), and among those who reported any of the investigated diseases, particularly diabetes (36.0%) and heart diseases (43.0%). The variables remaining in the final risk model for polypharmacy were age, region, perceived health, health insurance, hospitalization in the previous year and all investigated diseases except stroke. CONCLUSIONS: Older adults with specific diseases have risk factors for polypharmacy modifiable by actions aimed at the rational use of medicines. With the current population aging and successful drug access policy, the trend is an increase in drug use by older adults, which should feature as a priority in the planning agenda of the Brazilian Unified Health System (SUS). [ABSTRACT FROM AUTHOR]

OBJECTIVE: To analyze the prevalence and associated factors regarding the use of medicines by self-medication in Brazil. METHODS: This cross-sectional population-based study was conducted using data from the PNAUM (National Survey on Access, Use and Promotion of Rational Use of Medicines), collected between September 2013 and February 2014 by interviews at the homes of the respondents. All people who reported using any medicines not prescribed by a doctor or dentist were classified as self-medication practitioners. Crude and adjusted prevalence ratios (Poisson regression) and their respective 95% confidence intervals were calculated in order to investigate the factors associated with the use of self-medication by medicines. The independent variables were: sociodemographic characteristics, health conditions and access to and use of health services. In addition, the most commonly consumed medicines by self-medication were individually identified. RESULTS: The self-medication prevalence in Brazil was 16.1% (95%CI 15.0-17.5), with it being highest in the Northeast region (23.8%; 95%CI 21.6-26.2). Following the adjusted analysis, self-medication was observed to be associated with females, inhabitants from the North, Northeast and Midwest regions and individuals that have had one, or two or more chronic diseases. Analgesics and muscle relaxants were the therapeutic groups most used for self-medication, with dipyrone being the most consumed medicines. In general, most of the medicines used for self-medication were classified as non-prescriptive (65.5%). CONCLUSIONS: Self-medication is common practice in Brazil and mainly involves the use of non-prescription medicines; therefore, the users of such should be made aware of the possible risks. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To describe methodological aspects of the household survey National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM) related to sampling design and implementation, the actual obtained sample, instruments and fieldwork. METHODS: A cross-sectional, population-based study with probability sampling in three stages of the population living in households located in Brazilian urban areas. Fieldwork was carried out between September 2013 and February 2014. The data collection instrument included questions related to: information about households, residents and respondents; chronic diseases and medicines used; use of health services; acute diseases and events treated with drugs; use of contraceptives; use of pharmacy services; behaviors that may affect drug use; package inserts and packaging; lifestyle and health insurance. RESULTS: In total, 41,433 interviews were carried out in 20,404 households and 576 urban clusters corresponding to 586 census tracts distributed in the five Brazilian regions, according to eight domains defined by age and gender. CONCLUSIONS: The results of the survey may be used as a baseline for future studies aiming to assess the impact of government action on drug access and use. For local studies using a compatible method, PNAUM may serve as a reference point to evaluate variations in space and population. With a comprehensive evaluation of drug-related aspects, PNAUM is a major source of data for a variety of analyses to be carried out both at academic and government level. [ABSTRACT FROM AUTHOR]