Resumo O objetivo deste artigo é avaliar a associação entre fatores socioeconômicos, organização dos serviços de saúde e a utilização de um sistema de gestão e monitoramento da dispensação de antibióticos prescritos por cirurgiões-dentistas em Minas Gerais, Brasil. Estudo epidemiológico ecológico que analisou dados secundários do Sistema Integrado de Gestão da Assistência Farmacêutica (SIGAF) da Secretaria de Estado de Saúde de MG, Brasil, em 2017. Treze variáveis independentes foram analisadas para testar a influência destas com a adesão dos municípios ao SIGAF das prescrições odontológicas de antibióticos. Foram realizadas análises estatísticas descritivas, e a técnica de Árvore de Classificação e Regressão foi utilizada. Foram examinadas 57.279 prescrições de antibióticos prescritos por dentistas e registradas no SIGAF. Fatores socioeconômicos não foram associados ao uso do SIGAF para registro dessas prescrições. A cobertura de saúde bucal esteve positivamente associada à utilização do SIGAF para as dispensações de antibióticos prescritos por cirurgiões-dentistas. A presença de Centro De Especialidade Odontológica, esteve negativamente associado ao desfecho. Municípios com maior cobertura de saúde bucal e sem Centro de Especialidade Odontológica foram mais propensos a utilizar o SIGAF.

Abstract This article aims to investigate the association between socioeconomic factors, health care organizations, and the use of a management and monitoring system for the dispensing of antibiotics prescribed by dentists in public health services in Minas Gerais, Brazil. This is an ecological-epidemiological study that analyzed secondary data from the Integrated Pharmaceutical Care Management System (SIGAF) of the Department of Health of the state of MG, Brazil, in 2017. Thirteen independent variables were analyzed to assess their influence on municipal adherence to SIGAF system considering dental prescriptions of antibiotics. Descriptive statistical analyses were performed, and the Classification and Regression Tree technique was used to identify the municipal variables associated with the outcome. A total of 57,279 antibiotic courses prescribed by dentists and recorded in SIGAF were examined. Socioeconomic factors were not associated with the use of SIGAF to record these prescriptions. Oral healthcare coverage was positively associated with the use of SIGAF for the dispensing of antibiotics prescribed by dentists. Dental Specialties Center were negatively associated with the outcome. Municipalities with high oral healthcare coverage and those without a Dental Specialties Center were more likely to use SIGAF.

Abstract This article aims to investigate the association between socioeconomic factors, health care organizations, and the use of a management and monitoring system for the dispensing of antibiotics prescribed by dentists in public health services in Minas Gerais, Brazil. This is an ecological-epidemiological study that analyzed secondary data from the Integrated Pharmaceutical Care Management System (SIGAF) of the Department of Health of the state of MG, Brazil, in 2017. Thirteen independent variables were analyzed to assess their influence on municipal adherence to SIGAF system considering dental prescriptions of antibiotics. Descriptive statistical analyses were performed, and the Classification and Regression Tree technique was used to identify the municipal variables associated with the outcome. A total of 57,279 antibiotic courses prescribed by dentists and recorded in SIGAF were examined. Socioeconomic factors were not associated with the use of SIGAF to record these prescriptions. Oral healthcare coverage was positively associated with the use of SIGAF for the dispensing of antibiotics prescribed by dentists. Dental Specialties Center were negatively associated with the outcome. Municipalities with high oral healthcare coverage and those without a Dental Specialties Center were more likely to use SIGAF.

Resumo O objetivo deste artigo é avaliar a associação entre fatores socioeconômicos, organização dos serviços de saúde e a utilização de um sistema de gestão e monitoramento da dispensação de antibióticos prescritos por cirurgiões-dentistas em Minas Gerais, Brasil. Estudo epidemiológico ecológico que analisou dados secundários do Sistema Integrado de Gestão da Assistência Farmacêutica (SIGAF) da Secretaria de Estado de Saúde de MG, Brasil, em 2017. Treze variáveis independentes foram analisadas para testar a influência destas com a adesão dos municípios ao SIGAF das prescrições odontológicas de antibióticos. Foram realizadas análises estatísticas descritivas, e a técnica de Árvore de Classificação e Regressão foi utilizada. Foram examinadas 57.279 prescrições de antibióticos prescritos por dentistas e registradas no SIGAF. Fatores socioeconômicos não foram associados ao uso do SIGAF para registro dessas prescrições. A cobertura de saúde bucal esteve positivamente associada à utilização do SIGAF para as dispensações de antibióticos prescritos por cirurgiões-dentistas. A presença de Centro De Especialidade Odontológica, esteve negativamente associado ao desfecho. Municípios com maior cobertura de saúde bucal e sem Centro de Especialidade Odontológica foram mais propensos a utilizar o SIGAF.

Abstract The objective of this study was to analyze possible associations between antibiotic dental prescriptions in the public health service, health service characteristics, and social characteristics of the municipalities. Using the register of dispensing in the public health service of a state in the Southeast region of Brazil, in 2017 we analyzed patterns of antibiotic prescriptions by dentists. Data were obtained from the Integrated Pharmaceutical Services Management System (SIGAF, in Portuguese). The outcome variable was the number of Daily Defined Doses (DDD) per 1,000 residents/year in each municipality. CART (Classification and Regression Tree) technique was used to determine the influence of the following variables: populational social characteristics (Human Development Index, Gini Index, the proportion of rural population and proportion of families benefiting from the Bolsa Família Program) and oral health services characteristics (access to individual dental care, number of dentists and oral health teams per 1,000 residents, and percentage of preventive and restorative individual dental procedures. Data analysis was performed using IBM SPSS Statistics 21.0. Antibiotics were the medications most prescribed by dentists in the public health service, with penicillin being the most frequently prescribed class. The average DDD/1,000 residents/year for the 421 municipalities surveyed was 96.54 (range 0.008 and 619.660). Select factors were associated with antibiotic prescriptions including access to individual dental care (Adjusted p-value ≤0.001), a number of oral health teams/1,000 inhabitants (Adjusted p-value=0.001), and Gini Index (Adjusted p-value = 0.046). Access to oral health services and inequality were associated with the use of antibiotics.

Abstract The objective of this study was to describe dental prescriptions of non-steroidal anti-inflammatory drugs (NSAID), opioids, and analgesics dispensed by the Brazilian National Health System (BNHS, SUS in Portuguese) of a Southeastern state from January to December 2017, and to analyze their association with socioeconomic and oral health care services’ characteristics at municipal level. Data were collected from the Brazilian Integrated Pharmaceutical Care Management System. Medicines were grouped according to the Anatomical Therapeutic Chemical Classification System. The total number of Defined Daily Doses (DDD) and DDD per 1,000 inhabitants (inhab.) per year were presented and compared between groups of municipalities. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25.0. The total number of NSAID, opioids, and analgesics prescriptions was 70,747 and accounted for 354,221.13 DDD. The most frequently prescribed medicine was ibuprofen (n = 24,676; 34.88%). The number of dental practitioners in the BNHS per 1,000 inhab. (p < 0.001), first dental appointment coverage (p = 0.010), oral health teams per 1,000 inhab. (p=0.022), and the proportion of rural population (p = 0.014) were variables positively associated with the number of DDD of NSAID per 1,000 inhab. per year. Bolsa Família program coverage per 1,000 inhab. (p = 0.022) was negatively associated with NSAID prescription. Regarding analgesics, first dental appointment coverage (p=0.002) and Bolsa Família program coverage per 1,000 inhab. (p = 0.012) were positively associated with DDD per 1,000 inhab. per year. In conclusion, dental prescriptions of analgesics and NSAID in the BNHS were associated with socioeconomic and oral health care services’ characteristics.