Neracionalus antimikrobinių vaistų (AMV) vartojimas didina mikroorganizmų atsparumą, gydymo kaštus ir hospitalizacijos trukmę. Didėjantis atsparumas AMV yra svarbi visuomenės sveikatos problema. Magistro darbo tikslas - kokybiškai ir kiekybiškai įvertinti AMV skyrimo KMU klinikose paplitimą bei jo pokyčius ir atitikimo racionalaus AMV vartojimo rekomendacijoms ypatumus ir dėsningumus. Tyrimas atliktas naudojant „skersinio pjūvio“ metodiką. 2007 m. kovo mėnesį vienmomentinio apžvalginio tyrimo metu (2 savaičių laikotarpyje) atrinktos ir išanalizuotos pacientų, kurie gauna AMV, ligos istorijos ir paskyrimai 32-iuose KMU klinikų skyriuose. AMV vartojimas yra racionalus, jei jų skyrimas atitinka racionalaus AMV vartojimo rekomendacijoms. Peržiūrėta 1213 paskyrimų, AMV buvo skirti 265 pacientams. Rekomendacijų neatitiko pusė (54 proc.) visų AMV paskyrimų. Daugiau kaip pusė (58 proc.) gydymo tikslu skirtų empirinių AMV paskyrimų vertinti kaip neatitinkantys racionalaus AMV rekomendacijų. Vertinant AMV skyrimo atitikimą rekomendacijoms atskiruose skirtingo profilio skyriuose daugiausia neatitikusių paskyrimų nustatyta chirurginio (74 proc.) ir terapinio (55 proc.) profilio skyriuose, atitikusių – pediatrinio (71proc.) ir intensyvios terapijos (60 proc.) profilių skyriuose. Ryšio tarp skyriaus profilio ir atitikimo rekomendacijoms nenustatyta. (r = 0,5387 , p = 0,4613, Spearmano koreliacija). Didžiąją dalį neatitinkančių rekomendacijų paskyrimų atvejų (56,86 proc.) sudarė... [toliau žr. visą tekstą] / Irrational and excessive use of antibiotics increases resistance to these preparations. Antimicrobial resistance is a serious public health problem worldwide. The main goal of our study was to evaluate and to compare the non-adherence (NA) to guidelines (NfG) on rational antibiotic therapy and prophylaxis (ABT/P) in tertiary hospital setting among two years (2006 and 2007). A cross-sectional study was performed in order to collect the data for patients receiving prescriptions for antimicrobial agents in March, 2007. Descriptive and comparative data were processed and evaluated using Graph Pad Prism 4 statistics program. Rationality of antibiotic therapy was evaluated according for adherence to published guidelines. A total of 265 (21%) patients recieved antibiotic therapy. 54% of all events were considered as non-adherent.The majority of NA cases was determined in the departments of therapeutic profile (55%) and in surgical profile (74%). The adherent events - in paediatric profile(71%) and in the intensive therapy profile (60%). No dependence between the type of profile and adherence to guidelines was determined (r = 0,5387, p = 0,4613, Spearman correlation). The main reasons of NA were inapropriate dosage (57%) and choice of drug (43% ). NA case analysis revealed too high dose prescribed in 40/87 (46%) cases, too low dose 47/87 (54%)cases; too broad spectrum in 28/61 (46%) cases, too narrow - in 9/61(15%), 2/61 ( 3 %) case as unsafe and 22/61 (36%) cases... [to full text]

Neracionalus vaistų vartojimas yra viena svarbiausių problemų pasaulyje. PSO duomenimis, maždaug pusė visų pacientų medikamentus vartoja netinkamai ir nesilaiko gydytojo nurodymų. Ypač didelė problema yra netinkamas vaistų vartojimas namuose tiek pagal gydytojo paskyrimą, tiek savarankiškai. Iki šiol Lietuvoje dar nebuvo atliktas tyrimas, kokius vaistus žmonės turi savo namų vaistinėlėse ir ar tinkamai juos vartoja. Nežinoma, kokios yra racionaliai ar neracionaliai vaistus vartojančių Lietuvos žmonių savybės. Šiuo tyrimu buvo siekiama nustatyti galimus rizikos veiksnius, lemiančius neracionalų ambulatorinių vaistų vartojimą. Buvo atrinkti ir namuose apklausti 36 pacientai, kuriems KMUK buvo paskirtas antibiotikų kursas namuose. Su gautais duomenimis buvo atlikta aprašomoji ir lyginamoji statistinė analizė pagal Pirsono chi kvadrato kriterijų (statistiškai patikimu rezultatu laikoma reikšmė, kai chi kvadratas > 4, p < 0,05). Namų vaistinėlėse pacientai turėjo daugiau receptinių vaistų nei nereceptinių. Daugiausiai turima receptinių širdies ir kraujagyslių sistemą veikiančių vaistų. Savigydai dažniausiai naudojami nereceptiniai virškinimo sistemą ir metabolizmą veikiantys vaistai ir analgetikai. Nustatyta, kad 31 proc. pacientų paskirtuosius antimikrobinius vaistus vartojo nedrausmingai. Vartojimo drausmingumas gydymo atveju buvo geresnis nei profilaktikos atveju. Jei vaistus reikia vartoti ilgai, 48 proc. pacientų teigė esantys nedrausmingi. Taigi, trumpalaikės terapijos... [toliau žr. visą tekstą] / Irrational drug use is one of the biggest problems in the world. According to WHO, about half of all the patients don‘t use their medicine properly and fail to adhere to prescribed therapy. Irrational drug treatment at home (including use of prescribed medicines and self-medication) is a great problem. There have been no researches made in Lithuania up till now about what kind of drugs people have at home and if they use them properly. There was no information about characteristics of people who use drugs rationally or irrationally. So, the purpose of this research was to identify possible risk factors, which determine irrational drug treatment at home. There were chosen 36 patients who had got antimicrobial therapy at home after treatment or for prophylaxis in Clinics of Kaunas University of Medicine. Those patients had been questioned at home. Data were analyzed statistically (descriptive and comparative statistic analysis by parameter of Pearson’s chi square (statistically significant result was when chi square > 4, p < 0, 05)). At home people had more prescribed drugs than over the counter ones (mostly drugs acting on cardiovascular system). For self-medication the most popular are over the counter drugs acting on alimentary tract and metabolism and analgesics. It was determined that 31 percent of patients fail to adhere to prescribed antimicrobial therapy. Patients’ adherence was higher for treatment than for prophylaxis. 48 percent of the patients who used medicine for... [to full text]

Submitted by Ana Lúcia Torres (bfmhuap@gmail.com) on 2018-01-10T14:29:11Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Verano Costa Dutra.pdf: 542166 bytes, checksum: 1c6806c7536a60bb4697dca11753ab6a (MD5) / Approved for entry into archive by Ana Lúcia Torres (bfmhuap@gmail.com) on 2018-01-10T14:29:20Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Verano Costa Dutra.pdf: 542166 bytes, checksum: 1c6806c7536a60bb4697dca11753ab6a (MD5) / Made available in DSpace on 2018-01-10T14:29:20Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Verano Costa Dutra.pdf: 542166 bytes, checksum: 1c6806c7536a60bb4697dca11753ab6a (MD5) Previous issue date: 2010 / Faculdade Pitágoras de Guarapari / Introdução: O uso irracional de medicamentos faz parte do processo de medicalização da sociedade, que traz mais danos que benefícios. Nesse contexto, o comércio eletrônico de medicamentos apresenta os riscos adicionais da ausência de orientação de um profissional da saúde e a oferta de medicamentos ilegais. Medicamentos com alto apelo publicitário, como os inibidores da fosfodiesterase 5 (IPDE5), podem representar casos extremos deste problema de saúde contemporâneo. Objetivo: Analisar os sites de venda de IPDE5 em língua portuguesa. Método: Estudo transversal descritivo sobre os anúncios dos medicamentos Viagra® (citrato de sildenafil), Cialis® (tadalafila), Levitra® (vardernafila) (medicamentos legais); e Pramil (citrato de sildenafil) e Eroxil (tadalafila) (medicamentos ilegais). A seleção dos sites foi feita através da ferramenta de busca Google®. Foram coletadas informações gerais sobre os sites e também sua adequação à RDC 44/2009. Resultados: Foram encontrados 497 anúncios, sendo 310 para medicamentos legais e 187 para medicamentos ilegais. Para ambos os tipos, a maioria dos anúncios foi hospedado em sites estrangeiros, e não foi possível identificar a localização do vendedor. Uma minoria dos sites, tanto legais quanto ilegais, apresentava informações sobre indicação, contra-indicação e posologia. As diferenças encontradas na distribuição de todas as variáveis de caracterização dos sites legais ou ilegais não apresentaram significância estatística. Em relação aos apelos publicitários, exceto pela palavra “Segurança”, todas as demais palavras analisadas foram mais frequentes nos anúncios de medicamentos ilegais. Ambos os tipos de sites apresentavam baixa adesão às recomendações da RDC 44/2009. Conclusão: Este estudo demonstra que a adesão à regulação da venda de medicamentos pela Internet no Brasil encontra-se em fase incipiente, sendo que esta investigação, anterior à RDC 44/2009, identificou poucas diferenças entre sites de medicamentos legais e ilegais. Assim, para além do estabelecimento do marco regulatório, intervenções mais gerais no âmbito da Saúde Pública são importantes e necessárias / Introduction: The irrational drug use is part of the process of medicalization of the society, which brings more harm than benefits. In this context, the e-commerce of medications has the additional risks of the absence of orientation from a healthcare professional and the offer of illegal medications. Drugs with high marketing appeal, such as the phosphodiesterasis 5 inhibitors (PD5I), may represent extreme cases of this contemporary healthcare problem. Objective: To analyze sites of e-commerce of PD5I in Portuguese language. Method: Descriptive cross-sectional study on the advertisements of the drugs Viagra® (sildenafil citrate), Cialis® (tadalafil), Levitra® (vardernafil) (legal drugs); and Pramil (sildenafil citrate) and Eroxil (tadalafil) (illegal drugs). The site selection was performed by the use of the search engine Google®. General information about the sites as well as its compliance to the RDC 44/2009 was collected. Results: A number of 497 advertisements were found, being 310 for legal and 187 for illegal drugs. For both types, the majority of advertisements were hosted on foreign sites, and it was not possible to identify the vendor location. A minority of sites, both legal and illegal, showed information on indication, counter-indication and way of use. The differences found in the distribution of all legal or illegal site features variables had no statistical significance. Regarding the marketing appeal, except for the word “Security”, all other analyzed words were more frequent on illegal drug sites. Both types of sites showed low compliance to the RDC 44/2009 recommendations. Conclusion: This study shows that the compliance to the ecommerce regulation of medications in Brazil is at its early stages, since this investigation, prior to the RDC 44/2009, showed few differences between legal and illegal drug sites. So, beyond the establishment of the regulation benchmark, more general interventions in the Public Health field are important and needed.