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RESUMO - As reacções adversas associadas à utilização de medicamentos
podem ter como consequência a hospitalização,
incapacidade permanente e até mesmo a morte. A morbilidade
e mortalidade associada aos medicamentos é
comum, consome recursos e é frequentemente passível de
ser prevenida.
A consciencialização de que os ensaios clínicos pré-comercialização
não permitem, por razões metodológicas, um
conhecimento adequado da segurança dos medicamentos
levou à criação de estruturas que efectuassem a monitorização
da segurança dos fármacos após a sua comercialização.
A instituição de sistemas de farmacovigilância assume
especial relevância em termos de protecção da saúde
pública e requer a adequada participação de todos os
intervenientes — doentes, profissionais de saúde, investigadores,
universidades, indústria farmacêutica, governos,
organizações internacionais e comunicação social.
As falhas de comunicação sobre segurança de fármacos a
todos os níveis da sociedade podem levar à desconfiança,
à desinformação e a acções mal conduzidas que resultarão
em prejuízos e na criação de um clima em que os dados
sobre a segurança dos fármacos poderão ser ocultados,
omitidos ou ignorados. A comunicação sobre a segurança
de fármacos deve decorrer num clima geral de fiabilidade
e confiança.
São várias as fontes de dados em farmacovigilância; no
entanto, os sistemas de notificação espontânea são de um
valor inestimável enquanto sistemas de alerta, através dos
quais efeitos adversos inesperados podem ser rapidamente
identificados. A sua principal limitação é a potencial subnotificação.
Um dos mais graves problemas do Sistema Nacional de
Farmacovigilância é o da elevada taxa de subnotificação e,
a nível da União Europeia, Portugal é um dos países com
mais baixa taxa de notificação.
Apesar de os profissionais de saúde compreenderem que
nenhum medicamento é completamente seguro, poucos
estarão conscientes do impacto global das reacções adversas
medicamentosas nos serviços de saúde, sendo necessário
encontrar formas de incentivo para aumentar o
número de notificações espontâneas.
No campo da farmacovigilância é necessário assegurar que
os problemas emergentes são prontamente reconhecidos,
eficientemente abordados e que a informação e as soluções
sejam comunicadas de forma efectiva.
ABSTRACT - Adverse reactions associated with drugs use can lead to hospitalization, permanent disability and even death. The morbidity and mortality associated with medicines are common, costly and frequently preventable. The awareness that clinical trials, conducted before drugs marketing, do not allow, for methodological reasons, an adequate knowledge concerning drugs safety, led to the creation of structures which could monitor drugs safety after its marketing. The institution of pharmacovigilance systems assumes special relevance in terms of public health protection and requires the adequate involvement of all intervenients — patients, health professionals, researchers, universities, pharmaceutical industry, governments, international organizations and the media. Gaps in communication about drug safety, at all society levels, can lead to mistrusting, lack of information and to bad conducted actions, which will result in damages, and the creation of a climate where the data on drug safety can be occulted, omitted or ignored. The communication about drug safety must occur in a climate of reliability and confidence. There are several sources of pharmacovigilance data. The systems of spontaneous notification are, however, an inestimable value while alert systems through which unexpected adverse effects can be quickly identified. Its main limitation is the potential subnotification. One of the most serious problems of the Pharmacovigilance National System is the high subnotification rate and, at European Union level, Portugal is one of the countries with lower notification rate. Despite the fact that health professionals understand that no pharmaceutical is completely safe, few may be aware of the overall impact of adverse drug reactions on health units. It is still necessary to find new approaches to encourage spontaneous reporting of suspected adverse drug reactions. To ensure that emergent problems are promptly recognised, efficiently approached and that information and solutions are effectively communicated, is of the utmost importance in the pharmacovigilance field.
ABSTRACT - Adverse reactions associated with drugs use can lead to hospitalization, permanent disability and even death. The morbidity and mortality associated with medicines are common, costly and frequently preventable. The awareness that clinical trials, conducted before drugs marketing, do not allow, for methodological reasons, an adequate knowledge concerning drugs safety, led to the creation of structures which could monitor drugs safety after its marketing. The institution of pharmacovigilance systems assumes special relevance in terms of public health protection and requires the adequate involvement of all intervenients — patients, health professionals, researchers, universities, pharmaceutical industry, governments, international organizations and the media. Gaps in communication about drug safety, at all society levels, can lead to mistrusting, lack of information and to bad conducted actions, which will result in damages, and the creation of a climate where the data on drug safety can be occulted, omitted or ignored. The communication about drug safety must occur in a climate of reliability and confidence. There are several sources of pharmacovigilance data. The systems of spontaneous notification are, however, an inestimable value while alert systems through which unexpected adverse effects can be quickly identified. Its main limitation is the potential subnotification. One of the most serious problems of the Pharmacovigilance National System is the high subnotification rate and, at European Union level, Portugal is one of the countries with lower notification rate. Despite the fact that health professionals understand that no pharmaceutical is completely safe, few may be aware of the overall impact of adverse drug reactions on health units. It is still necessary to find new approaches to encourage spontaneous reporting of suspected adverse drug reactions. To ensure that emergent problems are promptly recognised, efficiently approached and that information and solutions are effectively communicated, is of the utmost importance in the pharmacovigilance field.
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Citação
Gomes, Sílvia Maria e Mota - Notificação de reacções adversas medicamentosas : sua relevância para a saúde pública = Adverse drug reactions reportings : its relevance to public health. Revista Portuguesa de Saúde Pública. ISSN 0870-9025. Vol. 19, Nº 2 (Julho/Dezembro 2001), p. 5-14
Editora
Universidade Nova de Lisboa, Escola Nacional de Saúde Pública
