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[巴西圣保罗州里贝朗普雷图初级医疗保健中精神药物的消费情况]

[Consumption of psychotropic medications in primary healthcare in Ribeirão Preto, São Paulo State, Brazil].

作者信息

Oliveira Júlia Raso Ferreira de, Varallo Fabiana Rossi, Jirón Marcela, Ferreira Iahel Manon de Lima, Siani-Morello Manuela Roque, Lopes Vinícius Detoni, Pereira Leonardo Régis Leira

机构信息

Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.

Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago, Chile.

出版信息

Cad Saude Publica. 2021 Jan 11;37(1):e00060520. doi: 10.1590/0102-311X00060520. eCollection 2021.

Abstract

The consumption of psychotropic drugs is considered a public health problem, due to the potential for addiction and the occurrence of adverse events. In this context, the current study aimed to characterize the consumption of psychotropic medications dispensed in primary healthcare units in Ribeirão Preto, São Paulo State, Brazil. This ecological study consulted the Hygia database from 2008 to 2012. The following variables were extracted: psychotropic drugs dispensed, amount dispensed per year, and patients' sex and age bracket. For each psychotropic drug, we calculated the defined daily dose per 1,000 inhabitants/day (DDD/1,000PD), defined daily dose per 1,000 inhabitants/day considering 75% of the population (DDD75%/1,000PD) who withdrew medicines through the Brazilian Unified National Health System (SUS), and the prescribed daily dose (PDD). The study compared the population growth rate to the growth in the medicines' consumption. A total of 1,577,241 patients were identified who withdrew medications during the study period, of whom 287,373 (18.2%) used at least one drug subject to special control. There was an increase in the total consumption of psychotropic drugs (DDD/1,000PD), but comparison to the population growth rate showed that only sertraline (p = 0.021), risperidone (p = 0.034), and clonazepam (p = 0.043) presented higher growth rates. The PDD for seven drugs were higher than the World Health Organization (WHO) DDD. Identifying discrepancies between DDD and PDD can be useful as a strategy for screening patients eligible for pharmaceutical care, since they can contribute to the prevention of morbidity and mortality related to medications.

摘要

由于存在成瘾可能性及不良事件的发生,精神药物的使用被视为一个公共卫生问题。在此背景下,本研究旨在描述巴西圣保罗州里贝朗普雷图市基层医疗单位所发放精神药物的使用情况。这项生态学研究查阅了2008年至2012年的Hygia数据库。提取了以下变量:发放的精神药物、每年发放量、患者性别和年龄组。对于每种精神药物,我们计算了每1000居民/天的限定日剂量(DDD/1000PD)、考虑通过巴西统一国家卫生系统(SUS)取药的75%人口时每1000居民/天的限定日剂量(DDD75%/1000PD)以及规定日剂量(PDD)。该研究比较了人口增长率与药物消费的增长情况。在研究期间共识别出1577241名取药患者,其中287373名(18.2%)使用了至少一种受特殊管制的药物。精神药物的总消费量(DDD/1000PD)有所增加,但与人口增长率相比,仅舍曲林(p = 0.021)、利培酮(p = 0.034)和氯硝西泮(p = 0.043)呈现出较高的增长率。七种药物的PDD高于世界卫生组织(WHO)的DDD。识别DDD和PDD之间的差异作为筛选符合药学服务条件患者的策略可能会很有用,因为它们有助于预防与药物相关的发病率和死亡率。

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