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Os indicadores de qualidade da prescrição de medicamentos da Organização Mundial da Saúde ainda são válidos? Translated title: Are the drug prescription quality indicators of the World Health Organization still valid?

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      Abstract

      Este artigo tem como objetivo analisar os indicadores de qualidade da prescrição de medicamentos propostos em 1993 pela Organização Mundial da Saúde e sugerir novos indicadores, em razão do novo perfil de morbidade da população. Para tanto, se realizou um estudo transversal, através de entrevista pessoal e análise de prescrições de 320 usuários de Unidades de Estratégia Saúde da Família em um município brasileiro no estado do Rio Grande do Sul. Esses usuários foram recrutados por meio do método de amostragem não probabilístico consecutivo. Considerando os resultados obtidos com os indicadores de qualidade da prescrição propostos pela Organização Mundial da Saúde, as prescrições podem ser consideradas adequadas. Contudo, a análise desses indicadores mostrou que, atualmente, eles podem ser inapropriados. Portanto, novos indicadores foram desenvolvidos. Pela nova proposta de indicadores, simples e de fácil quantificação, pôde-se perceber os problemas em uma prescrição de medicamentos com o intuito de guiar para uma ação subsequente.

      Translated abstract

      The scope of this article is to analyze the drug prescription quality indicators proposed by the World Health Organization in 1993 and suggest new indicators attuned to the new profile of illness of the population. For this purpose, a cross-sectional study was conducted by means of personal interviews and prescription analysis among 320 patients who were attended at Strategic Family Health Units located in a Brazilian municipality in the state of Rio Grande do Sul. The users were recruited by the consecutive nonprobabilistic sampling method. In accordance with the drug prescription quality indicators of the World Health Organization, the prescriptions can be considered adequate. However, analysis of those indicators shows that they may currently be inappropriate. Therefore, new indicators were created. Using the new, easily quantifiable and straightforward indicators proposed, it was possible to detect the problems in a drug prescription with a view to taking corrective action.

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      Most cited references 37

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      Symptoms of depression and anxiety during adult life: evidence for a decline in prevalence with age.

      To test the hypothesis that the prevalence, in the general population, of symptoms of depression and anxiety declines with age. A general population sample of 2725 persons aged 18 to 79 years was administered two inventories for current symptoms of depression and anxiety, together with measures of neuroticism and of exposures that may confer increased risk of such symptoms. Symptoms of depression showed a decline with age in both men and women. For anxiety, the decline was statistically significant for women but not consistently so for men. For the risk factors examined, there was a decline with age in the neuroticism score, the frequency of adverse life events, being seriously short of money and having had parents who separated or divorced. Further analysis showed that the association between age and a declining symptom score cannot be entirely attributed to these risk factors, with the single exception of neuroticism. The latter is itself likely to be contaminated by current symptoms. Unless these findings are due to bias in the sample of those who agreed to participate, they add to the evidence that symptoms of depression and to a lesser extent of anxiety decline in prevalence with age. Some risk factors also decline with age. It now has to be determined if these cross-sectional observations are also to be found in longitudinal data; and what process may underlie this striking change in mental health during adulthood.
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        Twenty years of research on the quality of medical care: 1964-1984.

         A Donabedian (1985)
        Since 1964 we have built on earlier work, with some refinements, particularly in the formulation of explicit criteria of process and outcome; the detailed standardization of case mix when outcomes signify quality; the prespecification of outcomes for follow-up, when adverse outcomes are only the occasion for later assessment of process; a greater emphasis on more subtle organizational characteristics in the study of structure; and the identification of the separate effects of structural attributes by multivariate analysis. We have also paid more systematic attention to questions of measurement, including the veracity and completeness of the record; the procedures of criteria formulation; and the reliability, validity, and screening efficiency of the criteria. A notable advance is the use of decision analysis to identify optimal strategies of care, including the introduction of patient preferences and monetary cost in the specification of such strategies, and the use of decisional algorithms to portray the criteria of quality.
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          Lei 9787 de 10 de fevereiro de 1999. Altera a lei n° 6360 de 23 de setembro de 1976, que dispõe sobre a vigilância sanitária, estabelece o medicamento genérico, dispõe sobre a utilização de nomes genéricos em produtos farmacêuticos e dá outras providências

          (1999)
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            Author and article information

            Affiliations
            [1 ] Universidade Federal do Rio Grande do Sul Brazil
            Contributors
            Role: ND
            Role: ND
            Journal
            csc
            Ciência & Saúde Coletiva
            Ciênc. saúde coletiva
            ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro )
            1413-8123
            April 2011
            : 16
            : 4
            : 2289-2296
            S1413-81232011000400028
            10.1590/S1413-81232011000400028

            http://creativecommons.org/licenses/by/4.0/

            Product
            Product Information: SciELO Brazil
            Categories
            Health Policy & Services

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