A significant prevalence of ADRs was found among hospitalised elderly people. The risk factors associated with ADRs in this population included use of drugs considered to be inappropriate for that population, number of previous diagnoses and number of administered drugs. More appropriate drug prescription could avoid part of this burden of disease by minimising preventable ADRs.

Approximately one-quarter of the elderly population living in Sao Paulo could be taking two or more potentially interacting medicines. Polypharmacy predisposes elderly individuals to PDDIs. More than half of these drug combinations (57.6%, n = 72) were part of commonly employed treatment regimens and may be responsible for adverse reactions that compromise the safety of elderly individuals, especially at home. Educational initiatives are needed to avoid unnecessary risks.

Self-medication in older adults is a problem that should be carefully addressed in public health policies. Surveys such as the present one are easy to carry out (and could conveniently be conducted in primary care settings), rapidly yield information about the true nature of self-medication in local populations, and provide a basis on which to design future interventions. Factors associated with self-medication in this study, including both socioeconomic characteristics (e.g. most self-medicators were poorly educated or lived alone) and therapeutic considerations (e.g. substantial proportions of patients self-medicated for hypertension, used previous prescriptions as the basis for self-medication, or reported adverse effects of self-medication), are vital clues to the design of effective and appropriately targeted interventions in the future.

The prevalence of potential DDIs during the conditioning period of BMT was high as a consequence of the therapeutic complexity of the procedure. Most potential DDIs identified in the study may result in clinically relevant consequences as they could lead to nephrotoxicity, cardiotoxicity, and other undesirable adverse effects. Careful monitoring of clinical and laboratory parameters is essential to ensure a successful BMT and to avoid adverse drug events related to DDI.

No abstract

An education intervention and discussion of actual clinical practice problems with health professionals and their involvement in drafting clinical guidelines helped improve health care quality and practitioners' adherence to these guidelines.

The use of antibiotics is the most important modifiable risk factor for the development of microorganism resistance. A cross-sectional study of outpatients receiving antibiotic prescriptions registered in a population database in Colombia was conducted. The characteristics of the consumption in capital cities and small municipalities was studied and the AWaRe classification was used. AWaRe classifies antibiotics into three stewardship groups: Access, Watch and Reserve, to emphasize the importance of their optimal use and potential harms of antimicrobial resistance. A total of 182,397 patients were prescribed an antibiotic; the most common were penicillins (38.6%), cephalosporins (30.2%) and fluoroquinolones (10.9%). ‘Access’ antibiotics (86.4%) were the most frequently prescribed, followed by ‘Watch’ antibiotics (17.0%). Being 18 or older, being male, living in a municipality, having one or more comorbidities and urinary, respiratory or gastrointestinal disorders increased the probability of receiving ‘Watch’ or ‘Reserve’ antibiotics. Penicillin and urinary antiseptic prescriptions predominated in cities, while cephalosporin and fluoroquinolone prescriptions predominated in municipalities. This analysis showed that the goal set by the WHO Access of mainly using Access antibiotics is being met, although the high use of Watch antibiotics in municipalities should be carefully studied to determine if it is necessary to design specific campaigns to improve antibiotics use.

The knowledge level on the voluntary reporting system among physicians and pharmacists in Venezuela is poor. These results strengthen the hypothesis that being unaware of the adverse effects of medicines and not knowing the existence of a PhV system is a major cause of underreporting. A careful study of the actual knowledge of PhV could be the basis to set up interventions specifically designed to overcome misleading concepts and to improve the reporting rate at a national level.