Zilda Mendes

Prevalence of Self-medication in Rural Areas of Portugal

AbstractObjectives: To study the prevalence of self-medication among pharmacy customers in rural areas of Portugal, to assess possible predictors of self-medication and to find out whether there was a seasonal dependence in the purchase of drugs for self-medication. Method: A cross-sectional study during four different periods of a year was conducted. Community pharmacies of rural areas of Portugal were invited to participate and pharmacists were asked to recruit one person every hour during the opening hours and administer a questionnaire. Drugs dispensed were classified according to the Anatomical Therapeutic Chemical Classification system up to the second level. Main outcome measure: Prevalence of self-medication is defined as the percentage of patients acquiring a medicine that was not prescribed (written) or recommended (orally) by a physician. Results: The prevalence of self-medication was 21.5%. Main therapeutic groups acquired for self-medication were “other alimentary tract and metabolism products” (A16; proportion acquired for self-medication= 75.0%), “throat preparations” (R02; 74.7%), “antiemetics and antinauseants” (A04; 70.0%), “cough and cold preparations” (R05; 56.5%), and “nasal preparations” (R01; 50.0%). Variables found to be predictors of self-medication were age, type of health professional or person consulted when a mild health problem occurred, time elapsed since last visit to the physician and time waited between setting an appointment and the actual visit. Seasonality seemed to occur for only “cough and cold preparations”, for “dermatologicals” and for “anti-inflammatory and anti-rheumatic products”. Conclusion: In rural Portugal about one fifth of the pharmacy customers engaged in self-medication. However, further research should be made to address appropriateness of self-medication.

Prevalência da automedicação na população urbana portuguesa

To determine the prevalence of self-medication in a Portuguese urban population, a cross-sectional study was carried out in Lisbon (11 pharmacies) and Oporto (15 pharmacies). Data collection took place between November 1995 and September 1996, during 6 periods of 10 days each. The overall prevalence of self-medication found was 26,2%. Statistical significant differences were found between self-medication prevalence according to sex, age, educational level and professional status. Fifty percent of the individuals who have used drugs in self-medication did so with the pharmacist advice. The most frequent therapeutic groups used in self-medication were cough and cold preparations (23%) and analgesics (13,6%). Analysing each group separately, statistical significant differences for sex and age were found according to the variable self-medication.

Asthma Mortality in Portugal

AbstractObjective: To determine whether the use of inhaled corticosteroids or leukotriene receptor antagonists (LTRAs) has had an impact on asthma mortality in Portugal during the period 1991–2001. Methods: A population-based ecological study was conducted for the period 1991–2001. Yearly asthma death rates were computed for all ages. Data on sales of inhaled corticosteroids and LTRAs were obtained and expressed in defined daily doses (DDDs)/year. The association between the yearly rate of asthma deaths and consumption of these medications was estimated using Poisson regression. Results: The rate of asthma death decreased steadily from 39.4 per million inhabitants in 1991 to 14.2 in 2001. At the same time, the use of inhaled corticosteroids in the population increased from 5.8 to 22.2 million DDDs per year. The adjusted rate ratio of asthma death was 0.85 (95% CI 0.78, 0.92) for every additional 5 million DDDs of inhaled corticosteroids per year and 0.84 (95% CI 0.70, 1.02) for every additional 5 million DDDs of LTRAs per year. Conclusion: The increasing use of inhaled corticosteroids and leukotriene receptor antagonists during the 1990s in Portugal appears to have contributed to the reduction in asthma mortality in that country.