Assessment of the level of health literacy of drug users in the Primary Health Care of the Brazilian Unified Health System
DOI:
https://doi.org/10.33448/rsd-v10i11.19444Keywords:
Health Literacy; SUS; Prescribed medication; Drug’s misuse; Patients ‘knowledge; Rational use of medicine.Abstract
Patients’ knowledge and awareness of their disease and medication (health literacy) are essential to ensure treatment effectiveness. This work analyzed the health literacy (HL) level of users of the Brazilian Unified Health System (SUS) in Diadema city (SP) and its consequences concerning the rational use of prescribed medication. A total of 1,121 SUS users were interviewed and descriptive and inferential analyses were performed. Bivariate analyses estimated the crude odds ratio. A logistic regression model was developed, and the results were presented as adjusted odds ratio. Almost half of the sample did not know the name of the drug, 20% did not know the reason for using it, 14% did not know how to use the drug, 71% declared that they were unaware of the drug’s adverse reactions, 21.3% believed that the drug did not cause any adverse reaction, and only 7.7% considered that the drug could cause some problem and 92% claimed not to have asked the doctor anything about this matter. The data show an inadequate level of HL of SUS users concerning basic information about the prescribed drug and a potential risk arising from the drug’s misuse, considering the patient’s lack of familiarity with the medication and their pathology and poor interaction with the health professional.
References
Alshammari, T. M. (2016). Patient's medicinal knowledge in Saudi Arabia: Are we doing well? Saudi Pharm J, 24(5):560-562. 10.1016/j.jsps.2015.03.014.
Andrade, S. M., Cunha, M. A., Holande, E. C., Verde R. M. C. L., & Oliveira, E. H. (2020). Characterization of the profile of drug intoxications by self-medication in Brazil, from 2010 to 2017. Research, Society and Development, 9:1-16. 10.33448/rsd-v9i7.3952.
Araújo, A. L, Pereira, L. R., Ueta, J. M., & Freitas, O. (2008). Pharmacist care in the Brazilian primary health care system. Cien Saude Colet., 13(6):11-7. 10.1590/s1413-81232008000700010.
Auchewsk, i L., Andreatini, R., Galduróz, J. C., Lacerda, R. B. (2004). Evaluation of the medical orientation for the benzodiazepine side effects. Braz J Psychiatry, 26(1):24-31. 10.1590/s1516-44462004000100008.
Bastos A. (2021). Desemprego mantém recorde de 14,7% no trimestre encerrado em abril. Disponível em: https://agenciadenoticias.ibge.gov.br/agencia-noticias/2012-agencia-de-noticias/noticias/31050-desemprego-mantem-recorde-de-14-7-no-trimestre-encerrado-em-abril. Acessado em: 04 de agosto de 2121.
Bosch-Lenders, D., Maessen, D. W., Stoffers, H. E., Knottnerus, J. A., Winkens, B., & van den Akker, M. (2016). Factors associated with appropriate knowledge of the indications for prescribed drugs among community-dwelling older patients with polypharmacy. Age Ageing, 45(3):402-8. 10.1093/ageing/afw045.
Cajita, M. I., Cajita, T. R., & Han, H. R (2016). Health Literacy and Heart Failure: A Systematic Review. J Cardiovasc Nurs, 31(2):121-30. 10.1097/JCN.0000000000000229.
Calikoglu, E. O., Köyceğiz, E., Kosan, Z., & Aras, A. (2019). Rational drug use and prescribing behavior of family physicians in Erzurum, Turkey. Niger J Clin Pract. 22:626-32. 10.4103/njcp.njcp_258_18.
Castro, M. C., Massuda, A., Almeida, G., Menezes-Filho, N. A., Andrade, M. V., Souza Noronha, K. V. M., Rocha, R., Macinko, J., Hone, T., Tasca, R., Giovanella, L., Malik, A. M., Werneck, H., & Fachini, L. A., Atun, R. (2019). Brazil's unified health system: the first 30 years and prospects for the future. Lancet, 394(10195):345-356. 10.1016/S0140-6736(19)31243-7.
Delavar, F., Pashaeypoor, S., & Negarandeh, R. (2020). The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial. Patient Educ Couns, 103(2):336-342. 10.1016/j.pec.2019.08.028.
Dunn, P., & Conard S. (2018). Improving health literacy in patients with chronic conditions: A call to action. Int J Cardiol, 15;273:249-251. 10.1016/j.ijcard.2018.08.090.
Falgas-Bague, I., Wang, Y., Banerjee, S., Ali, N., DiMarzio, K., Palao, Vidal, D., & Alegría, M. (2019). Predictors of Adherence to Treatment in Behavioral Health Therapy for Latino Immigrants: The Importance of Trust. Front Psychiatry, 10:817. 10.3389/fpsyt.2019.00817.
Guénette, L., & Moisan, J. (2011). Elderly people's knowledge of the purpose of their medicines. Am J Geriatr Pharmacother. 9(1):49-57. 10.1016/j.amjopharm.2011.02.007.
Hersh, L., Salzman, B., & Snyderman, D. (2015). Health Literacy in Primary Care Practice. Am Fam Physician, 92(2):118-24. PMID: 26176370.
Hibbard, J. H.. & Pope, C. R. (1987). Women's roles, interest in health and health behavior. Women Health, 12(2):67-84. 10.1300/J013v12n02_05.
IBGE (2010) Instituto Brasileiro de Gogrfia e Estatística. Indice de Desenvolvimento Humano. https://www.ibge.gov.br/busca.html?searchword=diadema+IDH.
Johnson, J. L., Moser, L., & Garwood, C. L. (2013). Health literacy: a primer for pharmacists. Am J Health Syst Pharm 70(11):949-55. 10.2146/ajhp120306.
Kesmodel, U. S. (2018). Cross-sectional studies - what are they good for? Acta Obstet Gynecol Scand, 97(4):388-393. 10.1111/aogs.13331
Lee, S. Y., Tsai, T. I., Tsa,i Y. W., & Kuo, K. N. (2012). Health literacy and women's health-related behaviors in Taiwan. Health Educ Behav, 39(2):210-8. 10.1177/1090198111413126.
Marciano, L., Camerini, A. L., & Schulz, P. J (2019). The Role of Health Literacy in Diabetes Knowledge, Self-Care, and Glycemic Control: a Meta-analysis. J Gen Intern Med, 34(6):1007-1017. 10.1007/s11606-019-04832-y
Massuda, A. (2020). Primary health care financing changes in the Brazilian Health System: advance ou setback? Cien Saude Colet, 25(4):1181-1188. 10.1590/1413-81232020254.01022020.
Massuda, A., Hone, T., Leles, F. A. G., Castro, M. C., & Atun, R. (2018). The Brazilian health system at crossroads: progress, crisis and resilience. BMJ Glob Health, 3(4):e000829. 10.1136/bmjgh-2018-000829.
Matsuyam, a R. K, Wilson-Genderson, M., Kuhn, L., Moghanaki, D., Vachhani, H., & Paasche-Orlow, M. (2011). Education level, not health literacy, associated with information needs for patients with cancer. Patient Educ Couns, 85(3):e229-36. A cross-sectional study was carried out (Kesmodel, 2018)10.1016/j.pec.2011.03.022
Mendez, L. C., Moraes, F. Y., Fernandes, G. D. S., & Weltman, E. (2018). Cancer Deaths due to Lack of Universal Access to Radiotherapy in the Brazilian Public Health System. Clin Oncol (R Coll Radiol), 30(1):e29-e36. 10.1016/j.clon.2017.09.003.
Oliveira, L. H., de Mattos, R. A., & Souza, A. I. (2009). Travelling citizens: the 'users' of the Brazilian Unified Health System and the meanings of its demand to the health care emergency services in the context of a process of assistential model reorientation. Cien Saude Colet, 14(5):1929-38. 10.1590/s1413-81232009000500035.
Olsson, E., Wallach-Kildemoes, H., Ahmed, B., Ingman, P., Kaae, S., & Kälvemark Sporrong, S. (2017). The influence of generic substitution on the content of patient-pharmacist communication in Swedish community pharmacies. Int J Pharm Pract, 25(4):274-281. 10.1111/ijpp.12299.
Pasternak, J. (2018). What is the future of the Brazilian Public Health System? Einstein (Sao Paulo), 16(4):eED4811. 10.31744/einstein_journal/2018ED4811.
Parnell, T. A., Stichler, J. F., Barton, A. J., Loan, L. A., Boyle, D. K., & Allen, P. E. (2019). A concept analysis of health literacy. Nurs Forum, 4(3):315-327. 10.1111/nuf.12331.
PNAD (2018). Parâmetros de Diadema disponível em: https://cidades.ibge.gov.br/brasil/sp/diadema/panorama. Acessado em 13 de maio de 2021.
Portela, A. S., Simões, M. O., Fook, S. M., Montenegro Neto, A. N., & Silva, P. C. (2010). Medical prescriptions: adequate orientation to medicine use? Cien Saude Colet, 15(3):3523-8. 10.1590/s1413-81232010000900027.
Sørensen, K., Pelikan, J. M., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., Fullam, J., Kondilis, B., Agrafiotis, D., Uiters, E., Falcon, M., Mensing, M., Tchamov, K., van den Broucke, S., Brand, H., & HLS-EU Consortium (2015). Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). Eur J Public Health, 25(6):1053-8. 10.1093/eurpub/ckv043.
Tae, C. H., Jung, S. A., Moon, H. S., Seo, J. A., Song, H. K., Moon, C. M., Kim, S. E., Shim, K. N., & Jung, H. K. (2016). Importance of Patients' Knowledge of Their Prescribed Medication in Improving Treatment Adherence in Inflammatory Bowel Disease. J Clin Gastroenterol, 50(2):157-62. 10.1097/MCG.0000000000000431.
Visscher, B. B., Steunenberg, B., Zwikker, H., Heerdink, E. R., & Rademakers, J. (2021). The impact of health literacy on beliefs about medication in a Dutch medication-using population. Eur J Clin Pharmacol, 77(8):1219-1224. 10.1007/s00228-021-03105-0.
Wiginton, J. M., Fleming P. J., Barrington C., Donastorg Y., Lerebours L., Brito M. O. (2020). Masculine gender norms, male circumcision, and men's engagement with health care in the Dominican Republic. Glob Public Health, 15(5):654-665. 10.1080/17441692.2019.1704817.
Wittink H., & Oosterhaven J. (2018). Patient education and health literacy. Musculoskelet Sci Pract, 38:120-127. 10.1016/j.msksp.2018.06.004.
Wali, H., Hudani, Z., Wali, S., Mercer, K., & Grindrod, K. (2016). A systematic review of interventions to improve medication information for low health literate populations. Res Social Adm Pharm, 12(6):830-864. 10.1016/j.sapharm.2015.12.001.
WHO Promoting Rational use of Medicines: Core Components. WHO Policy Perspectives on Medicines. Report WHO/EDM/2002.3.2002. WHO. https://apps.who.int/iris/bitstream/handle/10665/67438/WHO_EDM_2002.3.pdf; 2002
Yevstigneev, V., Titarenko, A. F., Abakumova, T. R., Alexandrova, V. N. Khaziakhmetova, V. N., & Ziganshina, L. E. (2015). Towards the rational use of medicines. International Journal of Risk & Safety in Medicine, 27:S59-S60. 10.3233/JRS150690S.
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