versão On-line ISSN 1683-9803
Introduction: A number of medications are offered in the worldwide pharmacological market whose therapeutic values are relative, questionable-to-null, or unacceptable as defined in the qualitative classification of medications of LaPorte. It is therefore necessary to assess the potential risk and benefits in relation to their costs. Objectives: To determine the prevalence of prescription of the medication, the amount used, the mean cost, and the way that symptomatic medication (SM) is acquired in primary pediatric care. Methods: A prospective, analytical, observational study. Using a questionnaire with open-ended and closed questions, parents were asked upon exiting the consultation about the medication indicated (drug name, quantity, commercial name, and means of acquisition). Sampling was by convenience. Data were loaded into the EPI INFO program for analysis. Results: In the months from November 200 to May 2008, 35,706 patients were seen, of whom 202 were chosen randomly, with 19% (39) being under age 1 year, 81% (163) between ages 1 and 16 years (mean 5±4 years), while 52% were male and all were from the urban zones of the country's Central Department. The five most common presenting complaints were cough (31%), fever (12%), cough and fever (10%), skin lesions (6%), and odynophagia (5%). The 4 most common diagnoses were upper respiratory infection (31%), bronchial obstruction syndrome (14%), status asthmaticus (6%), and acute gastroenteritis (5%). Most common comorbidities include pyodermia (33%), scabies (17%), and malnutrition (17%). Symptomatic medications were prescribed for 91% of patients, with 48% being given more than one. The symptomatic medications most frequently prescribed were ibuprofen (22%), paracetamol (acetaminophen) (8%), salbutamol (albuterol) (16%), and prednisone (10%). Infants received symptomatic medications less frequently than other age groups (82% vs. 93%, p=0.05). No difference between age groups was found in the number of symptomatic medications prescribed. Some 67% of patients acquired the SM by purchasing alone, 18% purchased some and were given some, including sometimes medical samples or from free pharmaceutical programs, while only 15% received all the medication prescribed at no cost (through medical samples or free pharmaceutical programs). The mean cost of the SM was 21236 ±19300 Guaranies per patient [approximately USD $4.51 ±$4.10]. The mean cost of the SM prescribed was 16989 ±20569 Guaranies [USD $3.61 ±$4.38] when only one medication was prescribed; 25355 ±17385 [USD $5.39 ±$3.70] when two medications were prescribed; and 27680 ±15240 [USD $5.89 ±$3.24] when three medications were prescribed. Conclusions: The prevalence of SM prescription was 91%, with almost half of patients being prescribed more than one. The mean cost of prescriptions was 21236 ±19300 Guaranies [USD $4.52 ±$4.11). Only 15% of patients received SM at the hospital at no cost.
Palavras-chave : Pharmaceutical preparations; palliative treatment; prescriptions; primary health care; pediatrics.