A importância da atenção farmacêutica como ferramenta para a promoção do uso racional de medicamentos em idosos que fazem uso de polifarmácia: uma revisão integrativa

De acordo com projeções em todo o mundo, a população da faixa etária idosa tende a crescer nas próximas décadas. Com esse crescimento, o aparecimento de várias patologias paralelamente em um único paciente tende se tornar mais comum (perfil de multimorbidade) que é característico dessa faixa etária. Este processo, na maioria das vezes é acompanhado por um consumo de vários medicamentos de forma simultânea (polifarmácia), o que é alarmante, levando em consideração as alterações fisiológicas dos idosos, que levam a uma maior fragilidade e propensão a problemas relacionados a medicamentos. A Atenção Farmacêutica é uma saída assertiva para esse problema, através do acompanhamento clínico individualizado. Trata-se de um estudo de revisão integrativa de literatura, de caráter qualitativo, que reuniu dados que tratam da importância da Atenção Farmacêutica como ferramenta para o uso racional de medicamentos em idosos polifarmácia, utilizando os principais bancos de dados como fontes, sendo eles: Pubmed, Scielo e LILLACS, onde foram utilizados e combinados os seguintes descritores: Atenção Farmacêutica, Polifarmácia, Idosos e Uso Racional de Medicamentos, e para o PubMed: Pharmaceutical Care and Polypharmacy and Rational Use of Medicines and Elderly. Foram separados 79 artigos, dentre os quais, após leitura minuciosa, foram selecionados 17 para compor este trabalho. A literatura demonstrou que a presença de do farmacêutico realizando intervenções de Atenção Farmacêutica nesses idosos é de extrema importância na melhoria da qualidade de vida, farmacoterapia e na prevenção de eventos adversos, apontando o impacto e a multidimensionalidade dessas intervenções, trazendo também melhorias no que tange ao autocuidado.

Clinical pharmacology-real basis of effi cient and inoff ensive pharmacotherapy

Clinical pharmacology play an important role in ensuring effective and inofensive pharmacotherapy. The administration of a adjusted treatment according to the pharmacokinetic and pharmacodynamic peculiarities of the drug, as well as the patient’s condition is indispensable. The rational use of medicines would increase the patient’s quality of life, as well as has important financial and public health benefits. Excessive, unreasonable prescription of drugs, polypharmacy, misuse of drugs, including expensive and unnecessary are the most common problems of irrational drug use. Many efforts have been made to improve drug use, but few evaluations have been carried out in this area. Identifying the problems that lead to irrational drug use and awareness of the importance of clinical pharmacology could ensure safe and effective pharmacotherapy.

The Rational Use of Medicines (RUM) in Coronavirus Disease 2019 (COVID-19)

The article's abstract is not available.

A study of the population attitude towards rational use of antibiotics

The World Health Organization (WHO) has expressed concern about the threat posed by bacterial resistance to antibiotics. Irresponsible consumption affects the entire ecosystem. Nowadays this has become a problem as their overuse has reached a level where resistance is growing and spreading and new drugs are lacking to meet this challenge [1]. It is not only doctors who have to take responsibility for their unnecessary use, but also each of us – not to engage in self-medication. Alexander Fleming, a British scientist and professor of bacteriology who was the first to discover the antibiotic penicillin, is very important in the history of antibiotics. Until then, doctors did not have effective means to treat infections like gonorrhea, rheumatism, pneumonia. With the discovery of penicillin, the era of antibacterial drugs began. Concerns expressed a few years ago that society may remain unarmed against infections, as before the discovery of antibiotics, are becoming a real threat [2]. The word "rational" is derived from the Latin word rationalis and means reasonable, thoughtful, purposeful, intelligent, clearly understood, based on new scientific methods [3]. The issue of rational use of medicines was first raised at an international conference of the World Health Organization in 1985 in Nairobi. The principles of rational use of medicines say that the patient must receive high-quality, safe and effective medicines when he needs them, taking into account his clinical characteristics, by individual doses, for the appropriate period, at appropriate intervals, only for a certain time, at an affordable price, with the right information [4]. The majority of the participants of the study stated that antibiotics kill bacteria and less than half - that it kills viruses. The study showed that less than half of the population treats themselves without consulting a doctor. The aim of the study is to reveal the attitude of the population towards the rational use of antibiotics.

Health belief model and the understanding of rational use of medicines

Community perception is an experience that causes a different understanding of treatment. Differences in people's perceptions of drug safety will affect their attitudes towards rational use of medicines (RUM). Therefore, it is necessary to do an in-depth measurement of public perceptions. The purpose of this study was to determine the relationship between community perceptions through the health belief model (HBM) with the understanding of (RUM). This study used a cross-sectional design with 97 samples in Denpasar City, Bali, Indonesia. Data collection was conducted from November 2019 to January 2020 using a questionnaire and analyzed using binary logistic tests. The results showed that perceptions based on perceived susceptibility perceived severity, health motivation, perceived benefits, and self-efficacy did not provide a significant relationship with the understanding of RUM (p>0.05). Perceived barriers provide significant results on the understanding of RUM (p<0.05). Health perceptions in allergy reporting and awareness of drug use based on clinical conditions and selection of alternatives increase understanding of rational drug use. The drug-taking procedure needs to be done quickly and according to the provisions to appropriately use the medication. Therefore, health workers' role is essential in providing complete services and information about drugs in health care, especially in symptomatic drugs.

Knowledge, attitude and practices of rational use of medicines among interns in a tertiary care teaching hospital in Telangana

Background: Rational use of drugs significantly impacts the treatment outcomes and the cost of health care. Most of the medical students are exposed to rational use of medicines and prescription writing during their second year but it is only during internship that they actually start prescribing under expert guidance. Aims and Objective: This study was planned to assess the rational prescribing practices of Interns in a tertiary care teaching hospital. Materials and Methods: With prior approval from Institutional Ethics Committee, a cross sectional study was conducted among 2014 batch of Interns from Malla Reddy Medical College for Women, Suraram, Hyderabad. Hard copies of prevalidated questionnaire consisting of 23 questions including a question on writing a prescription for a patient suffering from cold and fever was administered to the students after taking oral informed consent. Data from completed questionnaires was entered into excel sheet and analysed using descriptive statistics. Results: Of 64 interns, only 20% were aware of the term rational use of medicines, 75% of the term essential medicines and 22% of p drugs. Most of them were unaware of the step criteria for p drugs and advantages of using p drugs (87%). 95% of them reiterated that they could label the parts of prescription but mean score of the interns for writing a prescription was 3. 62% of them had positive attitude towards prescription writing. Conclusion: There is a need to improve the knowledge, attitude and practices of Rational use of Medicinesamong the Interns. Educational interventional strategies in the form of seminars, workshops, orientation programs can be adopted to promote rational use of medicines.

Pharmaceutical procurement among public sector procurers in CARICOM

Objective. To examine multiple aspects of the medicines in CARICOM procurement markets, including manufacturer headquarters location, regulatory history, and type (innovator versus generic); the proportion of World Health Organization (WHO) essential medicines; and the most expensive medicines procured. Method. An analysis of procurement information from selected CARICOM procurers. Four public sector procurement lists were obtained based on public availability or sharing of data from public sector procurers. Analyses were based on parameters available or deduced from these data. Results. The majority of products come from manufacturers headquartered in North America and Europe (63%–67%). The percentage of medicines procured from generic companies is 60%–87%; and 25%–50% of medicines procured are on the WHO Essential Medicines List. Wide price variations exist in the most expensive medicines purchased. Conclusions. The analysis identifies vulnerabilities and opportunities in the procurement situation of CARICOM states, particularly related to quality and rational use of medicines. This analysis represents a baseline that governments and other stakeholders can use in the future.

Study of knowledge, attitude, practice of rational use of medicines among interns at Mc Gann teaching district hospital, Shivamogga- a descriptive cross-sectional study

Background: Rational use of medicines requires that the patients receive medication appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of lime, and at the lowest cost to them and to their community. Objective of the study were like descriptive cross- sectional study was conducted to determine and identify the level of knowledge, attitude and practice regarding rational use of medicines among the interns.Methods: A validated structured questionnaire containing 19 questions regarding rational use of medicines in knowledge, attitude and practice (KAP) format was distributed in hand among 109 interns affiliated to this institution. Descriptive statistics were used to illustrate the results in the form of number and percentage.Results: Out of 109 interns, 102 completed the questionnaire and were included in the final analysis. Majority of interns who participated in study were aware of the concept of rational use of medicine but the knowledge related to EML (essential medicines list), P drugs, schedule H drugs and number of FDCs (fixed dose combination) in EML was limited.Conclusions: As interns are future prescribers, they need to be aware of all the aspects of rational use of medicine and there is need to emphasise on learning module and training programs to ensure the interns have knowledge of rational use of medicines.