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巴西儿童按年龄划分的药物非标签使用情况:一项人群研究。

Off-label use of drugs by age in Brazilian children: a population study.

作者信息

Diel Juliana do Amaral Carneiro, Heineck Isabela, Santos Djanilson Barbosa Dos, Pizzol Tatiane da Silva Dal

机构信息

Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Programa de Pós-Graduação em Assistência Farmacêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

出版信息

Rev Bras Epidemiol. 2020;23:e200030. doi: 10.1590/1980-549720200030. Epub 2020 May 11.

Abstract

OBJECTIVE

To estimate the prevalence of off-label drug use by age in children 12 years old and younger in Brazil.

METHOD

Population-based cross-sectional study (National Survey on Access, Use and Promotion of Rational Use of Medicines - PNAUM), including 7,528 children aged 12 years or younger. Face-to-face interviews were used to collect the data in the domiciles. The age-related off-label classification was carried out using the electronic medication compendium of National Agency of Sanitary Surveillance (ANVISA). Sociodemographic characteristics, presence of chronic disease, use of health services and characteristics of the informant were collected. Data were expressed by relative frequencies and 95% confidence intervals. Pearson's chi-square test was used to evaluate the statistical significance of the differences between the groups, with a significance level of 5%. Main outcome measure was the prevalence of off-label use.

RESULTS

The prevalence of off-label use by age was 18.7% (95%CI 16.4 - 21.3). Children younger than 2 years old presented the highest prevalence of off-label use. The most frequently used off-label drugs by age were amoxicillin, nimesulide and the combination of phenylephrine and brompheniramine.

CONCLUSION

The off-label use of drugs by age is common in the Brazilian pediatric population, especially among children under two years old.

摘要

目的

评估巴西12岁及以下儿童按年龄划分的药品未按说明书用药的流行情况。

方法

基于人群的横断面研究(全国药品合理使用获取、使用与推广调查 - PNAUM),纳入7528名12岁及以下儿童。通过在住所进行面对面访谈收集数据。使用国家卫生监督局(ANVISA)的电子药物手册进行与年龄相关的未按说明书用药分类。收集社会人口学特征、慢性病患病情况、卫生服务使用情况及信息提供者的特征。数据以相对频率和95%置信区间表示。采用Pearson卡方检验评估组间差异的统计学显著性,显著性水平为5%。主要结局指标为未按说明书用药的流行率。

结果

按年龄划分的未按说明书用药流行率为18.7%(95%CI 16.4 - 21.3)。2岁以下儿童的未按说明书用药流行率最高。按年龄划分,最常使用的未按说明书用药的药物为阿莫西林、尼美舒利以及去氧肾上腺素和溴苯那敏的组合。

结论

在巴西儿科人群中,按年龄划分的药品未按说明书用药情况普遍,尤其是在2岁以下儿童中。

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