To characterize storage and disposal practices associated with expired medicines in home pharmacies of Primary Care users. Cross-sectional study based on data collected from 423 users of 15 Primary Care units located in a Brazilian city, between August 2014 and July 2016. Data were collected via face-to-face interviews. Categorical (demographic and socioeconomic characteristics) and continuous variables were expressed as proportions and means and standard deviations, respectively . Storage behaviors and disposal practices associated with unused and expired medicines were described as frequencies. Most (83%) interviewees were female and approximately 70% had completed high school. The kitchen was the most common medicine storage place (58.6%). Approximately 75% of participants reported inappropriate medicine disposal practices. This study revealed high rates of inappropriate medicine disposal practices with direct impacts on pharmacological treatment and the environment. Continuing education of healthcare professionals and the general public is required to raise awareness about proper medicine use and disposal.

OBJECTIVE: To analyze the frequency, profile, and additional variables associated with the prescription of potentially inappropriate medications (PIM) to older adults in primary care, and evaluate physicians’ knowledge about these medications. METHODS: A cross-sectional study was conducted based on data from patient records for the period of January 2014 to December 2017 in a city located in the state of Minas Gerais. The frequency of PIM use was evaluated based on the 2019 Beers-Fick criteria. Physician knowledge was evaluated using a validated questionnaire as a primary data source. RESULTS: In a sample of 423 older adults, 75.89% (n = 321) used at least one PIM, the most common of which were medications used to treat central nervous system disorders (48.00%; n = 203). Most participants were female (62.41%; n = 264) and 70 years or older (69.50%; n = 294). When presented with clinical cases illustrating common situations in the management of older patients, 53.33% of physicians (n = 8) answered four or five questions correctly out of a possible seven; 13.33% (n = 2) answered six questions correctly; and 33.33% (n = 5) obtained three correct answers or fewer. CONCLUSIONS: These findings showed a high frequency of PIM use among older adults treated in Primary Health Care settings, with medications used in the treatment of central nervous system disorders. Our results highlight the importance of continuing education for health professionals and improved assessments of the medication available in the Unified Health System (Sistema Único de Saúde; SUS) for use in older adults, especially those taking multiple medications

OBJECTIVE: To elaborate and validate an instrument on barriers and enablers to deprescribing benzodiazepines in the patient’s perspective. METHODS: This study was conducted in 3 stages: (1) a methodological stage, (2) a semi-structured pilot interview with 25 older adults undergoing clonazepam deprescribing, and (3) content validation with the Delphi technique. Content validation was performed by 50 specialists with degrees and/or experience with primary health care and/or health care of older adults, such as physicians, pharmacists, and nurses. For evaluating the obtained results, we analyzed the concordance of evaluations with the coefficient of content validity (CCV). We considered values equal to or higher than 0.8 as acceptable levels of concordance. RESULTS: The instrument was considered validated in the first round of evaluation, where all items obtained a CCV of more than 0.8 in the specialists’ assessment. Nevertheless, they proposed improvements that were incorporated to the final version of the questionnaire. CONCLUSION: The instrument represents an important tool to be used by health care professionals for optimizing benzodiazepine deprescribing, with suitable levels of clarity and validity.

Introdução: O controle rígido da concentração sanguínea de glicose previne o surgimento e a progressão de complicações microvasculares relacionadas ao diabetes mellitus tipo 2 (DM2). Objetivos: O objetivo deste estudo foi avaliar a frequência de pacientes com DM2 atendidos na atenção primária à saúde (APS) do Sistema Único de Saúde (SUS) que apresentam controle glicêmico adequado. Materiais e métodos: Foi realizado um estudo transversal, com duração de cinco meses, na APS do SUS dos municípios de Bernardino de Campos e Salto Grande, SP. Os critérios de inclusão foram: diagnóstico médico de DM2, idade > 18 anos, ter realizado exames de glicemia de jejum e hemoglobina glicada (HbA1c) há menos de 12 meses da coleta de dados, ser atendido nas unidades de saúde do estudo. Resultados:1313 pacientes possuíam idade > 18 anos, e diagnóstico médico de DM2; entretanto, 547 destes pacientes tinha realizado exame de glicemia de jejum e HbA1c há mais de 12 meses da coleta de dados, e consequentemente, não atenderam a todos os critérios de inclusão. Seiscentos e três pacientes atenderam a todos os critérios de inclusão e aceitaram participar do estudo. Foi verificado que 190 pacientes (31,5%) apresentaram glicemia de jejum e HbA1c dentro da meta recomendada pelas diretrizes da Sociedade Brasileira de Diabetes (SBD). Conslusões: Os resultados mostraram que número elevado de pacientes com DM2 não alcança controle glicêmico adequado, e não realiza exames de glicemia de jejum e HbA1c na frequência recomendada pela SBD, sendo necessário a adoção de novas estratégias para mudar este cenário.

Objectives: To analyze potential pharmacological interactions and drugs potentially inappropriate for the elderly in users of primary care of the Unified Health System. Methods: This is a cross-sectional study with individuals aged 18 years or over, who were approached at the health facilities of the city of Divinópolis, MG, at which time a home visit was scheduled. A structured questionnaire on drug use was applied and drug interactions were analyzed in Drugs.com® sources, Micromedex®, bulletin of the Brazilian Health Regulatory Agency (ANVISA). Only the frequencies of serious interactions were analyzed. Potentially inappropriate drugs for elderly people (MPI) were identified by the Beers Criterion (2015) and the Brazilian Consensus on Potentially Inappropriate Medications for the Elderly (2016). The Mann-Whitney test was performed to compare the medians of the analyzed variables. Results: Among the study participants, 55% were elderly. Comparing them with the adult population, it was observed that the number of medications and potential drug interactions were significantly higher (p <0.05) among patients 60 years of age or older. Considering only the elderly, 77.3% used at least one MPI, according to the Beers Criterion. Conclusion: It was found that the vast majority of primary care users use at least one inappropriate drug and, when compared to adults, are more exposed to polypharmacy and potential drug interactions.