Rational Use Of Medicines Research Articles

Фармакоэкономические подходы для оценки рационального использования офтальмологических лекарственных препаратов в условиях поликлиники

Purpose. To evaluate the results of the rational use of ophthalmic medicines with the use of pharmacoeconomical analysis. Material and methods. With the help of ABC-VEN analysis, a comparative study of the quality of pharmacotherapy and drug provision of patients who were monitored and treated by an ophthalmologist of the polyclinic in 2015 and 2019 was conducted. Results. As a result, it was found that the share of costs for vital drugs increased by 10.1% and amounted to 71.1% in 2019, which corresponds to the standardized criterion (70-80%). There was a reduction in the cost of purchasing secondary drugs by 7.6%, which indicates a rational drug supply of ophthalmic drugs. The most commonly used drugs for the treatment of glaucoma were 27.8% in 2015 and 35.1% in 2019. The share of their acquisition costs was 54.9% and 67.9%, respectively. There was a significant increase in the range and number of drugs for the treatment of patients with glaucoma: a 2.8-fold increase in the number of purchased eye drops for monotherapy and a 12% increase in the number of combined drugs. Conclusion. Pharmacoeconomical analysis showed an optimization of spending money on the purchase of drugs used in ophthalmology: an increase of 10.1% in the share of vital drugs and a decrease of 7.6% in the cost of purchasing secondary drugs. There was an increase in the range and quantity of drugs for the treatment of patients with glaucoma. Key words: ABC-VEN-analysis, drugs, ophthalmology, pharmacoeconomics.

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.

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.

Evaluation of Rational Use of Medicine Using WHO/INRUD Core Drug Use Indicators at Teda and Azezo Health Centers, Gondar Town, Northwest Ethiopia

BackgroundDespite medicines are a major contributor to the health and well-being of the community, irrational use of medicines is being a serious public health crisis with significant harmful implications for patients, healthcare systems, and communities as a whole.ObjectiveThis study was aimed at evaluating the rational use of medicine using the World Health Organization/Network of Rational Use of Drugs (WHO/INRUD) core drug use indicators at Teda and Azezo health centers of Gondar town, northwest Ethiopia.MethodsA cross-sectional study was conducted among 1200 prescription papers retrospectively, and 60 patients prospectively at two health centers of Gondar town, northwest Ethiopia from May 01/2019 to April 30/2020. The data were collected using a standard data collection checklist. Data were analyzed using SPSS® version 24. The data were analyzed descriptively by using mean, frequency, and proportion.ResultsPrescribing indicators: From a total of 2595 prescribed medicines, 94% of them were prescribed by generic name; percent encounters with injection was 9.5±0.28%, percent encounters with antibiotics was 73.85±0.35%, and 100% of medicines were prescribed from the essential medicine list of Ethiopia. Patient care indicators: Only 16.7% of the patients knew the correct dosage of their medications, and 17.5% of dispensed medicines were adequately labeled. From the prescribed medications, only 77.17% were actually dispensed. Average consultation and dispensing time were 5.35 minutes and 40.24 seconds, respectively. Facility-specific indicators: Only 83.5% of key medicines were available in the health centers.ConclusionAccording to the WHO/INRUD core drug use indicators, rational medicine use is not achieved in terms of most components of the prescribing, patient care, and facility-specific indicators. Therefore, both health centers should work towards promoting the rational use of medicines.

Antibiotic use amongst pregnant women in a public hospital in KwaZulu-Natal.

BackgroundAntibiotics are amongst the more frequently prescribed medicines in pregnant women and the use of antibiotics is increasing. However, with limited studies available in this population, the safe use of antibiotics in pregnancy remains a concern.AimTo evaluate the use of antibiotics amongst pregnant women attending a public health care facility. The main objective of this study was to quantify the types of antibiotics used in pregnant women.SettingA public hospital classified as a referral hospital located in Durban, KwaZulu-Natal.MethodsDemographic and treatment information of women were collected retrospectively from January 2019 to July 2019. A total of 184 pregnant patients, who received antibiotic therapy, were included in this study. Descriptive and analytical measures were used to analyse both patient demographics and treatment variables.ResultsA total of 416 antibiotic prescriptions, issued to 184 patients, were reviewed. Penicillins (39.7%), macrolides (13.0%) and combination penicillin- and beta-lactam inhibitors (12.3%) were reported as the most commonly prescribed antibiotics. Rifamycin (2.9%), hydrazides (2.2%) and aminoglycosides (1.9%) were less frequently prescribed. Most antibiotics were prescribed for diseases of the circulatory system (36.1%).ConclusionSeveral classes of antibiotics were used in pregnancy despite the lack of available safety data and clinical evidence. Informing women of the potential side effects and keeping abreast with new information played an important role in the safe, rational and effective use of medicines that contributed to improving maternal health.

Rational Use of Medicine in the Treatment of Helminth Infection : A Mini Review

Indonesia still has health problem, especially soil transmitted helminth. These helminths can cause deteriorate health, nutrition, intelligence and productivity of patients so causes a lot of losses economically. The aim of this article is to review the rational treatment of helminth infection. Albendazole, mebendazole, and pyrantel pamoate are the drugs recommended by the WHO. However, the uses of the three are different, especially for mass treatment or selective medicine. This review conclude that the three drugs are used according to the target patient's age with dosages and preparations that must be adjusted.

Report on the use of medicinal plants among pregnant women treated at the Centro de Salud Viña Alta, La Molina. Lima, Peru

The objective was to explore the frequency and forms of use of medicinal plants in a group of pregnant women from the “Viña Alta” health center, La Molina. 21 pregnant women participated voluntarily, they were administered a survey validated by experts, which inquired about the use of medicinal plants. It was shown that 86% of pregnant women used medicinal plants, 67% did not consult their doctor about their use, the main form of use was by oral intake through infusion, and the most consumed plants were chamomile, parsley, eucalyptus, boldo, aloe, mint, and rue. Teratogenic effect, uterine stimulant, abortifacient, among others, of some medicinal plants used are reported. It is necessary to know the real load of plant use in Peruvian pregnant women, and to make a safety classification of medicinal plants, to promote the rational use of traditional medicine and contribute to public health. Keywords: Medicinal plants, pregnant women, consumption, risk, teratogenic, abortion

Pharmaceutical procurement among public sector procurers in CARICOM.

ABSTRACTObjective.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.Methods.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.

Atenção e intervenção farmacêutica à pacientes intubados em Unidade de Terapia Intensiva (UTI)

Entende-se por Unidade de Terapia intensiva (UTI), trata-se de uma ala hospitalar destinada à cuidados à pacientes críticos que se encontram em estado clínico moderado à grave e que necessitam de aparelhos tecnológicos e de uma equipe que o assiste durante todo o período de internação. O objetivo principal relatar a importância da atenção e intervenção farmacêutica à pacientes que se encontram intubados em UTI, assim como compreender a metodologia de ventilação mecânica, assim como, sinalizar fatores que justifiquem a relevância de subsumir o profissional farmacêutico à equipe que constitui a UTI. Como método de pesquisa, foi realizada pesquisa bibliográfica, foram selecionados artigo através de periódicos da saúde, como a Medical Literature Analysis and Retrieval System (Medline) e a SCIELO, utilizando os seguintes descritores: Assistência Farmacêutica, Respiração Artificial e Unidades de Terapia Intensiva. A pesquisa constatou que são diversos fatores que justifiquem o porquê da inserção do farmacêutico na UTI, dentre eles: garantir o uso racional de medicamentos, aderir o melhor meio de administração, verificar a possível existência de interação medicamentosa, dentre outras. Por fim, conclui-se com a presente pesquisa que cada profissional da saúde têm sua importância no tratamento dos pacientes, e, juntos podem realizar mais que um bom atendimento, mas oferecer melhor qualidade de vida à estes pacientes.

Assuring Access to Safe Medicines in Pregnancy and Breastfeeding.

Scientists and regulators in Europe and the United States continue to seek methods and strategies to improve knowledge on rational use of medicines for pregnant and breastfeeding populations, an important subset of women’s health. Regulatory agencies have made strides toward improvement, but much more is needed. Recognizing the importance of international collaboration, we have begun to consider how to address these important public health issues more globally. The health of the child begins with the health of the mother.

Efficient and qualitative medicinal treatment – consequence of rational selection and use of medicines

The contemporary doctor has an enormous number of drugs for the prophylaxis and treatment of various ailments. Qualitative drug treatment is due to the determination of key moments in the evolution of the disease in the specifi c patient (individual), followed by a correct prescription of the drug, eff ective selection or substitution and rational use of drugs compliance with the requirements and recommendations of protocols and clinical standards. adherence to treatment regimens, at the same time the exclusion of undue arguments (polypragmatism, polytherapy) and prevention of possible adverse adverse events (incompatibilities), timely detection with prevention of use of counterfeit drugs and fi nally revocation of all irrational challenges and consequences Treating Th e apparent economy of means of improper substitution of original preparations with generics can lead to an increase in the frequency of adverse eff ects and a reduction in the quality of life of patients, as well as lead to a considerable increase in costs. Th e reckless transition from the original to the generic preparation can have unpredictable consequences for the patient.

Development, translation, and validation of a bilingual questionnaire on unused medications in homes

BackgroundUnused medications in homes pose significant health, economic, and environmental risks. Patients are the medications end users and their knowledge, attitude, and practices (KAP) play an important role towards medication use, unuse and wastage. Thus, a valid instrument to reliably measure patients’ KAP towards unused medications in homes may help manage the associated risks. ObjectiveTo develop, translate, and validate a questionnaire for the assessment patients’ KAP towards unused medications in Qatar homes (i.e., QUM-Qatar). SettingThis cross-sectional validation study was conducted among randomly selected outpatients visiting various public and private pharmacies in Qatar between September 2019 and February 2020. MethodNine experts in the field of pharmacy practice with Qatar contextual background established the content validity of the instrument. The validity was quantified using content validity index (CVI). Furthermore, construct validity was performed using principal component analysis (PCA), whereas internal consistency reliability of items was determined using Cronbach’s alpha. Statistical analyses were performed using STATA 15 statistical software. Main outcome measureThe psychometric properties of the QUM-Qatar assessment instrument. ResultsAn English/Arabic questionnaire was developed and validated. Content validity in the form of scale-level-CVI (S-CVI)/Average and S-CVI/UA was 0.88 and 0.84, respectively, suggesting adequate relevant content of the questionnaire. Variation explained by the multivariate model was 85.0% for knowledge, 94.8% for attitude, and 89.8% for practice. Cronbach’s alpha coefficients were 0.68, 0.82, and 0.84, for knowledge, attitude, and practice domains, respectively. From the psychometric results obtained, the questionnaire's validity and reliability were attained. ConclusionThe QUM-Qatar instrument has acceptable psychometric properties and has the potential for future use in research and practice to assess KAP towards unused medications in Qatar and elsewhere. It may consequently help in improving medication use and mitigating the negative health, economic, and environmental impacts of unused medications.Impacts on practice.•There is now a valid and reliable English/Arabic language questionnaire to assess patients’ KAP towards unused medications.•Policymakers can utilize this questionnaire to develop evidence-based policies and strategies for managing unused medications and their disposal.•To improve medication use review, rational use of medicines, and adherence, it is necessary to consider patient-reported outcomes that may eventually reflect on saving health, economic resources, and environment.

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.

Drug Purchases’s analysis for COVID-19 treatment in Rio Grande do Sul

Objective: To evaluate quantities and costs of drug purchases related to COVID-19 treatment by regional governments under the Tribunal de Contas do Estado do Rio Grande do Sul (TCE-RS). Methods: A cross sectional study whose data collection was carried out in accordance with the data registered in the LicitaCon system of TCE-RS until September 29, 2020. The purchase processes of the pharmaceutical products hydroxychloroquine, chloroquine, ivermectin, nitazoxanide, vitamin D, vitamin C and zinc were analyzed in more detail. Results: There were 5,299 purchase processes registered on LicitaCon. Two hundred and fifty cases contained medications, of which 232 were analyzed, for only these met the study’s inclusion criteria. At least one of the aforementioned pharmaceutical products was found in 142 (61.2%) of the analyzed cases. Resulting in a total amount of $ 661.913,52 for the analyzed processes. The most purchased drug was ivermectin, present in 80 of the acquisitions, adding up to $ 241.794,81. The municipality of Garruchos, with an estimated population of 2,886, spent $ 6,858 per inhabitant for the obtainment of ivermectin, consuming a total of $ 19.796,06. Conclusions: The use of such pharmaceutical products for COVID-19 goes against the current available scientific evidence, the recommendations of WHO, the Rational Use of Medicines and Evidence-Based Health.

Rational and Irrational Drug Use: Factors, Impacts and Strategies to Combat Irrational Drug Use: A Narrative Review

Misuse of drugs is a serious health problem all around the world. Rational drug use can be characterized as follows: patients receive drugs that meet their clinical needs, at doses that meet their requirements, promptly and at the lowest cost to themselves and their region. Drug abuse, polypharmacy, and misuse are the most prominent drug use problems today. Misuse of drugs can occur for a variety of reasons at different levels, including recommended mistakes and over-the- counter medications. Inappropriate use of income can lead to real negative benefits and financial results. There are many irrational drug mixtures available. Appropriate rational use of medicines will increase personal satisfaction and lead to better local health services. A list of essential medicines recommended by the World Health Organization (WHO) can assist the countries around the globe in rationalizing the distribution and purchasing of medicines, thus decreasing the costs to healthcare systems. Irrational drug use has been a subject of concern for years as it affects the health system and patients badly. Irrational use of drugs can result from several factors such as patient, prescriber, dispenser, health system, supply system, or regulations. Thus, diverse strategies have been used to promote rational drug use and also to tackle irrational use. Thereby the concept of rational and irrational drug use and factors that lead to either result should be identified and monitored.

A questionnaire based cross sectional study to assess the knowledge and perceptions regarding concept of rational use of medicines among second year medical students

Background: The main goal of teaching clinical pharmacology, concept of rational usage of medicines to medical students is to imbibe the knowledge, skills so that in future as a clinicians they will be able to weigh the potential benefits versus risks of a treatment along with its cost-effectiveness. Objective: To assess the knowledge, attitude and perceptions about rational use of medicines in second year medical students. Materials and Methods: This was a questionnaire -based, cross-sectional study. The study participants were second year medical students (152). The questionnaire was designed to assess the knowledge, perceptions about rational usage of medicines. Results: Were expressed as counts and percentages. Majority of respondents were aware about over the counter medicines (72%), importance of reading medicine label (86%). Majority of the students 84% purchased all medicines written in prescription. Conclusion: Majority of the students were aware about the concept of rational usage of medicines which seems to be a positive finding. Keywords: Rational use of medicines, Knowledge, Perceptions.

Prospects of creating a new medicine based on biologically active substances of bearberry leaves for correction of the metabolic syndrome

Topicality. The metabolic syndrome is pathogenetically interrelated metabolic disorders in the condition of a sick person. A large set of factors is involved in its occurrence. Risk factors include genetic predisposition, overeating, insulin resistance, obesity, bad habits, hypodynamics, stress and unfavorable environmental conditions. First of all, defects of the lipid and carbohydrate metabolism provoke a cascade of genetic, metabolic, hormonal, nervous, inflammatory and other reactions and disorders in cells, tissues and organs, causing the metabolic syndrome and associated diseases, such as diabetes, kidney and gallstone disease, hypertension, platelet hyperaggregation, etc. Therefore, the rational use of synthetic and herbal medicines in the complex correction of these disorders can slow down the development of the metabolic syndrome. Aim. To develop the method for obtaining a dry modified extract from bearberry, study its chemical composition, hypoglycemic and hypolipidemic activity in order to determine the prospects of its use for the correction of the metabolic syndrome. Materials and methods. The study object was a dry extract of bearberry leaves modified with cysteine. HPLC and spectrophotometry were used to analyze the extract obtained. The hypoglycemic and hypolipidemic activity of dry extracts of bearberry was studied in rats with insulin resistance. Results and discussion. The method for obtaining a dry modified extract from bearberry leaves was developed by adding cysteine. Phenologlycoside (arbutin), 2 phenolic acids (gallic and ellagic), 6 flavonoids, 8 saponins were identified in the extract, and their quantitative content was determined. Hyperoside and catechin were dominant among flavonoids, and ursolic acid, uvaol, and lupeol prevailed among saponins. The content of the main groups of phenolic compounds was determined in the extract by spectrophotometry. The introduction of the dry extract from bearberry leaves modified with cysteine has a normalizing effect on metabolic disorders on the background of a high-fructose diet; therefore, it can be a promising agent for the correction of the metabolic syndrome. Conclusions. As a result of the research conducted, a new dry extract from bearberry leaves modified with cysteine has been created. The phytochemical composition, hypoglycemic and hypolipidemic activities of the extract have been studied, indicating the prospects for its use to correct the metabolic syndrome.

Management of clinical relevant drug-drug interactions with antipsychotics in nursing homes

Introduction Antipsychotics (APs) have been linked to several clinically relevant drug-drug interactions (leading, e.g. to QT-prolongation, torsades de pointes) but little is known about their management in nursing homes residents. Our aim was to characterise clinically relevant drug-drug interactions involving APs and to assess their prevalence in nursing homes residents. Materials and methods We conducted a cross-sectional study in two nursing homes in Portugal. Patients were included if they were older ≥65 and prescribed at least one AP (registered in medical charts). Interactions were identified using Drug Interaction Chequer (Medscape [1]) and supplemented with the summary of product characteristics (SmPC) when deemed necessary. Clinical relevant interactions were defined as serious or contraindicated interactions according to Medscape tool. Data were analysed using univariate statistics (Microsoft Excel 2016). Results A total of 59 patients (83.7 ± 7.1 years) were analysed, 79.7% (n = 47) females. A mean of 1.6 ± 0.7 antipsychotics were prescribed/patient, mostly on a regular basis (61.0%; n = 36). The majority were exclusively prescribed atypical APs (59.3%; n = 35), 28.8% (n = 17) simultaneously atypical and typical APs and 11.9% (n = 7) prescribed only typical APs. Nearly 90% (n = 52; 88.1%) of patients reported interactions with APs, (mean = 2.9 ± 2.3/patient). A total of 169 interactions with APs were found, mainly with antidepressants (27.2%; n = 46), benzodiazepines (22.4%; n = 38), and other antipsychotics (10.6%; n = 18). The majority of AP-drug interactions (83.4%; n = 141) were classified as “to be closely monitored”, mostly due to the sedation effect (56.7%; n = 80). Quetiapine was the AP most often involved in interactions (45.6%; n = 77), where 9.1% (n = 7) were considered “serious”. Haloperidol also registered 37 interactions (21.9%), four of which resulted in increased QTc interval (10.8%). Discussion and conclusions Data showed that one third of patients had clinically relevant AP-drug interactions. Future work will include the development of a user-friendly booklet on clinical relevant drug-drug interactions in elderly patients using APs, expected to contribute to enhanced patient safety and a more rational use of medicines.

UTILIZATION OF ANTIHYPERTENSIVE DRUGS AS MONOTHERAPY AND COMBINED THERAPY IN BRAZIL: A POPULATION BASED STUDY

Objective: Our objective was to describe the use of antihypertensive drugs in Brazil with a focus on the combination of two drugs. Design and method: Secondary data analysis from the National Survey on Access Use and Promotion of Rational Use of Medicines (PNAUM 2014), a nationwide cross-sectional population-based study, focused on the use of medicines in Brazil with a total of 41,433 interviews. The sample consists of all antihypertensive drugs cited as used to treat hypertension. The I Brazilian Positioning about Combination of Antihypertensive Drugs 2013 was used as a criteria to identify the combinations as Preferential: ACEI (Angiotensin-converting enzyme inhibitors) + CCB (Calcium channel blockers), ACEI + Diuretic, ARB (Angiotensin II receptor blockers) + CCB (dihydropyridine derivates), ARB + Diuretic; Acceptable: Diuretic + BB (beta-Blockers), CCB (dihydropyridine derivates) + BB, CCB + Diuretic, RI (Renin inhibitor)+ Diuretic, RI + CCB, Diuretic Thiazide + Potassium-sparing Agent; Less usual: ACEI + BB, ARB + BB and Unusual combinations: CCB (non-dihydropyridine derivates) + BB, ACEI + ARB, ACEI + RI, ARB + RI, Antiadrenergic agents, centrally acting + BB. The Statistical Analysis System (SAS) version 9.4 was used. Results: A total of 45 antihypertensive drugs was related. Diuretics (47.2% 95%CI 45.5–48.8), ACEI (38.1% 95%CI 36.4–39.8) and ARB (37.1% 95%CI 35.5–38.7) were the most used drugs, regardless the treatment as monotherapy or combined therapy. As monotherapy the three classes cited was the most used, however in a different percentage: ACEI (37.1% 95%CI 35.0–39.4), ARB (28.1% 95%CI 26.1–30.2) and Diuretics (14.5% 95%CI 12.9–16.1). Considering people under therapy with two drugs and the I Brazilian Positioning about Combination of Antihypertensive Drugs criteria, the preferential combinations represented 66.3% (95%CI 63.8–68.8), acceptable 19.2% (95%CI 17.1–21.2), less usual 10.1% (95%CI 8.5–11.8), unusual combinations 1.4% (95% CI 0.9–1.9) and other combinations 3.0% (95%CI 1.9–4.1). The most preferential combinations were ARB + Diuretic 30.3% (95%CI 27.8–32.8) and ACEI + Diuretic 28.0% (95%CI 25.5–30.5). In general, Brazil is using antihypertensives according to the guidelines of hypertension. Conclusions: In general, Brazil is using antihypertensives according to the guidelines of hypertension.

Effects of different forms of communication on knowledge, attitudes and practices related to antibiotics smart use by undergraduate students in different faculties

Objectives To investigate correlations among different forms of communications and the knowledge, attitudes and practices of undergraduate students related to antibiotics smart use. Methods Correlations of knowledges, attitudes, and practices regarding antibiotics and different forms of communications among third year students of three faculties, Associated Medical Sciences (AMS), Engineering (ENG) and Economics (ECON), were computed using a questionnaire and Spearman’s rank correlation coefficient analysis. Results The highest correct knowledge and practices scores were exhibited by AMS students: 3.17 ± 1.12 (p < 0.001) and 4.08 ± 0.67 (p = 0.001), respectively. Gender, the only personal factor, was significantly correlated with negative attitudes and practices among Engineering and Economics students. Correct knowledge scores were significantly correlated with the method of communication. Only weak relationships were found with communication from medical practitioners among AMS and Engineering students, r = 0.278 (p = 0.004); and r = 0.295 (p < 0.001). Correlations were also weak for radio, television, and print media among the Engineering students, r = 0.287, (p = 0.003). A moderate relationship was found with communication from the internet in Engineering students, r=0.311 (p < 0.001), health posters or brochures, and family or close friends of the AMS students, r =0.329, (p = 0.001), and r = 0.305, (p = 0.001), respectively. Other correlations were not statistically significant. Conclusion Antibiotics Smart Use (ASU) is an innovative model to promote the rational use of medicines, fight against the irrational use of antibiotics, and counteract antimicrobial resistance. The present study revealed that the information regarding antibiotics smart use provided via various forms of communications should be provided to improve the knowledge, attitude, and practice regarding antibiotics smart use among undergraduate students