Trauma in the elderly caused by traffic accident: integrative review

OBJECTIVE To describe the scientific knowledge produced about trauma in the elderly caused by traffic accidents in healthcare area studies. METHODS Integrative review of studies from 2003 to 2013 searched in LILACS, SciELO, PubMed and CINHAL databases. We used combination of the descriptors injuries, wounds and accidents, in English, Portuguese and Spanish languages. RESULTS 32 studies were selected. In the thematic analysis, three categories emerged: epidemiological data from traffic accidents involving elderly; traffic accidents with elderly pedestrians; and trauma care in the elderly. We observed increased incidence of trauma in most countries and pedestrians represented a large part of the victims. Among these, the elderly are the most vulnerable group. CONCLUSION Studies showed that trauma care in the elderly need protocols and professionals with training in gerontology specialized in trauma care services

Consumo de medicamentos por trabalhadores de hospital

Medicamentos são um componente essencial da terapêutica, no entanto, informações sobre seu consumo em população trabalhadora são escassas. Para estimar a prevalência, caracterizar o perfil daqueles consumidos e avaliar os fatores associados ao seu uso em trabalhadores foi realizado estudo seccional de dados da linha de base da Coorte "PROSEC" (n=417). A prevalência de consumo de pelo menos um medicamento foi de 72,4%, destacando-se fármacos com ação no sistema nervoso (25,4%), especialmente analgésicos (17,8%). Fatores associados ao uso de qualquer número de medicamentos (pAlthough medication is acknowledged as a key element in treating health problems, there is little information available on the use of medication by hospital workers. To estimate the prevalence and describe the patterns of medication consumption by hospital workers and to identify the factors associated with such consumption in this population, data from the "PROSEC" baseline cohort were analyzed (n=417). The prevalence of overall medication consumption was 72.4%, most of which was for nervous complaints (25.4%), especially analgesics (17.8%). Use of any amount of medication was independently associated with gender, number of medically diagnosed conditions and health problem in the two weeks prior to the interview. Use of a drug was significantly associated with income whereas self-diagnosed health problems were independently related with the use of two or more pharmaceutical products. The high prevalence of medication usage in this population, with analgesics being the most consumed medication, should be seen as a cause for concern, since many consumers are unaware that these products are not exempt from risk. Women and individuals in poor health are the main candidates for intervention programs in order to promote adequate and proper use of these pharmaceutical products

Immunosuppressants in Brazil: underlying drivers of spending trends, 2010-2015

BACKGROUND: Immunosuppressants are recommended for treatment of autoimmune diseases, and in transplant therapy. The high cost of these drugs has been causing an important impact on global pharmaceutical spending. OBJECTIVE: Analyzing immunosuppressant expenditure in Brazil, using data from the Federal Procurement System database (SIASG), between 2010 and 2015. METHODS: The pharmaceutical products were classified in accordance with the Anatomical, Therapeutic and Chemical (ATC) classification system recommended by World Health Organization (WHO) and aggregated by volume and by expenditure. The expenditure variation was decomposed into three broad categories: price effects, quantity effects, and drug mix effects. RESULTS: During the period, annual expenditure increased by 49%, ranging from USD 494.5 million in 2010 to USD 738.7 million in 2015, while purchased quantities increased by 294%, ranging from 49.8 million in 2010 to 196.5 million in 2015. Two factors drove expenditures: the quantity effect and the drug-mix effect. CONCLUSION: These findings may contribute to understand immunosuppressant spending trends and the factors that influence them in order to formulate effective cost containment strategies and design optimum drug policy. Rigorous evaluations are recommended to reduce the drug-mix effect, including systems to monitor price, effectiveness, safety, therapeutic value and budget impact of pharmaceutical innovations

Comparative studies of health systems

Countries across the world have organized their health care systems in different ways in terms of funding, structure and mode of operation. Comparative studies on drug utilization are valuable tools to promote development of health systems. Drug utilization studies may compare health system factors related to legislation for drug approval, prescribing regulations, drug supply structures, financing models and strategies by which to promote access to essential medicines and the quality use of medicines. A variety of methodological approaches have been used to compare drug utilization between health care systems. Further research is needed to develop good indicators for comparison purposes. There are currently few comparative studies of self‐medication and drugs sold directly to the consumer without a prescription, but they have been gaining increasing attention recently due to quality and safety concerns. Countries across the world have organized their health care systems in different ways in terms of funding, structure and mode of operation. Comparative studies on drug utilization are valuable tools to promote development of health systems. Drug utilization studies may compare health system factors related to legislation for drug approval, prescribing regulations, drug supply structures, financing models and strategies by which to promote access to essential medicines and the quality use of medicines. A variety of methodological approaches have been used to compare drug utilization between health care systems. Further research is needed to develop good indicators for comparison purposes. There are currently few comparative studies of self‐medication and drugs sold directly to the consumer without a prescription, but they have been gaining increasing attention recently due to quality and safety concerns

Immunosuppressants in Brazil: underlying drivers of spending trends, 2010–2015

BACKGROUND: Immunosuppressants are recommended for treatment of autoimmune diseases, and in transplant therapy. The high cost of these drugs has been causing an important impact on global pharmaceutical spending. OBJECTIVE: Analyzing immunosuppressant expenditure in Brazil, using data from the Federal Procurement System database (SIASG), between 2010 and 2015. METHODS: The pharmaceutical products were classified in accordance with the Anatomical, Therapeutic and Chemical (ATC) classification system recommended by World Health Organization (WHO) and aggregated by volume and by expenditure. The expenditure variation was decomposed into three broad categories: price effects, quantity effects, and drug mix effects. RESULTS: During the period, annual expenditure increased by 49%, ranging from USD 494.5 million in 2010 to USD 738.7 million in 2015, while purchased quantities increased by 294%, ranging from 49.8 million in 2010 to 196.5 million in 2015. Two factors drove expenditures: the quantity effect and the drug-mix effect. CONCLUSION: These findings may contribute to understand immunosuppressant spending trends and the factors that influence them in order to formulate effective cost containment strategies and design optimum drug policy. Rigorous evaluations are recommended to reduce the drug-mix effect, including systems to monitor price, effectiveness, safety, therapeutic value and budget impact of pharmaceutical innovations.2025-01-0