Objective: To estimate the prevalence of polypharmacy, describe the pharmacotherapeutic classes used, and investigate whether polypharmacy is associated with demographic and socioeconomic indicators, regardless of the number of diseases, among participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010). Method: In this analysis, 14,523 adults and elderly (35-74 years) participated. Polypharmacy was characterized as regular use of five or more medicines. The demographic and socioeconomic indicators analyzed were: gender, age, education level, per capita family income, and access to private health insurance. The independent association between demographic and economic indicators and polypharmacy was estimated by binary logistic regression. Results: The prevalence of polypharmacy was 11.7%. The most used drugs were those with action on the cardiovascular system. After adjustments, including by number of diseases, the chances of being on polypharmacy treatment were significantly higher among women, older participants and those with greatest number of diseases. Individuals without health insurance had lower chance to be under polypharmacy, as well as those with lower income. Conclusion: The occurrence of polypharmacy among ELSA-Brasil baseline participants was mainly due to drugs for the treatment of chronic diseases. The relation between polypharmacy and the female gender, as well as its association with old age, are in consonance with the results obtained in other studies. Despite the absence of an association between polypharmacy and education level, the income and health insurance results reinforce the existence of social inequalities regarding drug use.

Rationale: The implementation of Clinical Pharmacy Services in healthcare systems is multifactorial and complex. Some studies summarize the implementation research of these services in both outpatient and inpatient contexts. However, the literature lacks a comprehensive synthesis to understand how the implementation process occurs in Primary Health Care. Aim: To map, at an international level, the studies on the implementation of Clinical Pharmacy Services in Primary Health Care. Method: This scoping review followed the recommendations of the JBI Manual for Evidence Synthesis for Scoping Reviews. A systematic search was conducted in May 2023 across six electronic databases, grey literature, and the references of the selected studies. Original studies that described the implementation process of Clinical Pharmacy Services in Primary Health Care were eligible for inclusion. Two researchers independently assessed the studies based on eligibility criteria and extracted data from the selected articles. Data were presented descriptively. Results: A total of 97 studies were included, with 85.6% ( n = 83) conducted in developed countries. A significant emphasis was observed on qualitative and mixed‐methods research, accounting for 46.4% ( n = 45) of the studies. Only 22.7% ( n = 22) of the studies utilized theoretical models as research guides, while 96.9% ( n = 94), did not report on the implementation phase. Comprehensive Medication Management (36.8%, n = 35) was the most cited type of service. The most assessed implementation outcome was feasibility, at 73.2% ( n = 71). A total of 47.4% ( n = 46) assessed outcomes related to the implemented service, which included clinical, economic, and/or humanistic aspects. Conclusion: This study revealed numerous publications on the implementation of clinical services provided by pharmacists in primary care. These findings can guide future research on the implementation of these services and highlight the need for developing and underdeveloped countries to explore this topic further.

Brazil is the world's largest consumer of pesticides. To monitor the quality of food sold in the country, the Program for Analysis of Pesticide Residues in Food (Programa de Análise de Resíduos de Agrotóxicos em Alimentos - PARA) was created, responsible for carrying out analyzes of these foods and providing annual reports. The objective of this study was to carry out a survey of the information contained in these reports on the residues of pesticides found on unsatisfactory samples (unauthorized pesticides and/or above the permitted limit). This is a descriptive documentary study, based on the reports available (2001 to 2018). Information was collected on the pesticides that most appeared among the samples considered unsatisfactory and their possible damage to human health. Strawberries, bell peppers, and cucumbers presented the largest numbers of samples unsatisfactory, mostly because of the presence of pesticides unauthorized. The pesticides that have been repeated the most irregularly were chlorpyrifos, carbendazim, acefate and metamidophos, the latter has been banned since 2011 in Brazil. Evidence show that such pesticides are toxic to the human organism. Measures are needed to better control and inspect food and pesticides sold in Brazil, also raise awareness among the population and rural producers.

Background: There is a lack of studies that assess the effectiveness of pharmacotherapeutic follow-up in the context of the judicialization of insulin analogues. Aims: To evaluate the clinical and humanistic impact of pharmacotherapeutic follow-up in patients with type 1 diabetes mellitus who receive insulin analogues by judicial decision in a Brazilian municipality. Methods: A quasi-experimental study of the before-and-after type was carried out through pharmacotherapeutic follow-up. Patients who accepted to participate in the study underwent laboratory tests of glycemic and lipid profile before and after the intervention, and underwent five pharmaceutical consultations. In addition, quality of life and health, knowledge, and skills related to insulin application techniques were analyzed. Results: 28 patients participated in all stages. Of these, most were female (53.6%), with a mean age of 32.8 ± 11.6 years. After the intervention, there was a reduction in blood glucose levels, blood pressure, and increased body mass index. In addition, there was greater knowledge and skills regarding insulin application techniques, improved quality of life, health, greater number of medications used, reduction of pharmacotherapeutic problems, and improvement in eating habits. Conclusion: The pharmacotherapeutic follow-up promoted clinical and humanistic benefits, with improvement in quality of life and health.

The objective of this integrative review was to identify studies conducted in Brazil that address the occurrence of medication errors in a hospital environment. A integrative review was conducted with national observational studies which analyzed the occurrence of errors related to medication in the hospital environment. 1028 articles were found, of which only 23 (20.4%) studies met the eligibility criteria and were included in the review. Among the professional classes most investigated in medication errors are nurses (44.8%), followed by physicians (24.1%), nursing technicians (17.2%) and pharmacists (13.9%). The most prevalent medication errors are those related to dose (18.0%), omission (15.7%), time of administration (11.2%) and prescription (11.2%). The strategies of investigation of errors used in the Brazilian hospital systems do not always cover all professionals involved in the medication process. It is necessary that professionals work in an interdisciplinary way, aiming at the safety and well-being of the patient.