Eliane Ribeiro

Polifarmácia entre idosos do Município de São Paulo - Estudo SABE

Polypharmacy for the elderly and associated factors were assessed. A cross-sectional study was conducted using data from the SABE Study (Health, Well-being and Aging), 2006. 1,115 individuals representing 422,377 elderly aged 65 or more, living in Sao Paulo City, were interviewed. Polypharmacy was defined as the use of five or more medications. A multivariate regression logistics was used. Polypharmacy prevalence was 36%. Female (OR = 1.7; IC 95%: 1.0; 2.9), age over 75 years (OR = 1.9; CI 95%: 1.3; 2.7), higher income (OR = 1.8; CI 95%: 1.2; 2.8), working (OR = 1.8; CI 95%: 1.1; 2.9), regular self assessed health (OR = 1.6; CI 95%: 1.1; 2.3) or poor (OR = 2.6; CI 95%: 1.4; 4.9), hypertension (OR = 2.0; CI 95%: 1.4; 2.9), diabetes (OR = 4.1; CI 95%: 2.2; 7.5), rheumatic diseases (OR = 2.3; CI 95%: 1.5; 3.6) and cardiac problems (OR = 2.9; CI 95%: 1.9; 4.5) were associated positively with polypharmacy. Using only the public health system (OR = 0.5, 95% CI: 0.3; 0.7) was inversely associated with polypharmacy. Medicines for the cardiovascular system and for the alimentary tract and metabolism were the most used. The knowledge of factors associated with polypharmacy, such as those identified in this study, may be useful to alert health professionals about the importance of identifying and monitoring the elderly groups most vulnerable to polypharmacy.

A importância e a história dos estudos de utilização de medicamentos

No mundo atual, onde ha ampla necessidade de racionalizacao de recursos, sobretudo nos paises mais pobres, esses estudos apresentam-se como alternativa que permite reduzir custos sem perda de qualidade nos tratamentos medicos, alem de terem como funcao detectar possiveis abusos no uso dos medicamentos ou a ocorrencia de eventos adversos. Os medicamentos representam boa parcela dos gastos publicos com saude e nao sao substâncias inocuas. Essas sao as duas principais razoes pelas quais, cada vez mais, se reconhece a necessidade e a importância dos estudos que analisam os tratamentos medicamentosos, em especial nos hospitais, e os dados relativos ao consumo em si. Os ultimos possibilitam a aplicacao da farmacoeconomia e da farmacoepidemiologia como ferramentas no combate a utilizacao inadequada de medicamentos e a gastos desnecessarios. A pesquisa tornou possivel confirmar a importância da ocorrencia desses estudos, especialmente em hospitais, visando a reducao do gasto com medicamentos. A deteccao de desvios, ineficacia e eventos adversos com a utilizacao inadequada de medicamentos possibilita, em nivel macro, o desenvolvimento de politicas governamentais e, em nivel micro, a realizacao de intervencoes educativas - ambas as medidas tendo como objetivo a utilizacao dos medicamentos de forma racional.

Pityrosporum Folliculitis : Renal Transplantation Case Report

Pityrosporum folliculitis is caused by the fungus Pityrosporum ovale. It is characterized by the presence of pruriginous follicular papulae and papulae‐pustules in face, upper part of the trunk, and upper limb root. It is more prevailing in places with hot and humid climates. Its incidence can be associated with either immunosuppressive or chemotherapy states secondary to pathiologies. We report herewith a case of pityrosporum folliculitis in a patient who had previously underwent kidney transplantation and thes result of the itraconazol therapeutics given.

Custo-efetividade e impacto orçamentário da saxagliptina como terapia adicional à metformina para o tratamento do diabetes mellitus tipo 2 no sistema de saúde suplementar do Brasil

OBJECTIVES: To compare costs and clinical benefits of three additional therapies to metformin (MF) for patients with diabetes mellitus type 2 (DM2). METHODS: A discrete event simulation model was built to estimate the cost-utility ratio (cost per quality-adjusted life years [QALY]) of saxagliptine as an additional therapy to MF when compared to rosiglitazone or pioglitazone. A budget impact model (BIM) was built to simulate the economic impact of saxagliptine use in the context of the Brazilian private health system. RESULTS: The acquiring medication costs for the hypothetical patient group analyzed in a time frame of three years, were R

Compliance with treatment: related-issues and insights for pharmacist intervention

10,850,185, R

Cost-effectiveness and budget impact of saxagliptine as additional therapy to metformin for the treatment of diabetes mellitus type 2 in the Brazilian private health system.

14,836,265 and R

Reações adversas a medicamentos levando crianças a atendimento na emergência hospitalar

14,679,099 for saxagliptine, pioglitazone and rosiglitazone, respectively. Saxagliptine showed lower costs and greater effectiveness in both comparisons, with projected savings for the first three years of R

Vancomycin use in a brazilian teaching hospital: comparison with the Hospital Infection Controlpractices Advisory Committee Guidelines (HICPAC)

3,874 and R

Fish oil consumption prevents glucose intolerance and hypercorticosteronemy in footshock-stressed rats

3,996, respectively. The BIM estimated cumulative savings of R

Adverse drug reactions leading children to the emergency department

417,958 with the repayment of saxagliptine in three years from the perspective of a health plan with 1,000,000 covered individuals. CONCLUSION: From the perspective of private paying source, the projection is that adding saxagliptine with MF save costs when compared with the addition of rosiglitazone or pioglitazone in patients with DM2 that have not reached the HbA1c goal with metformin monotherapy. The BIM of including saxagliptine in the reimbursement lists of health plans indicated significant savings on the three-year horizon.