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According to Article of the Peruvian penal code, possession of drugs is not punishable if possessed for personal and immediate consumption in quantities not exceeding:. Importantly, Article states that the possession of two or more types of drugs is a punishable offence. Carrying two different types of drugs — regardless of quantity — is definitely not a good idea. The quantities listed in Article may seem clear-cut and relatively lenient. The way in which Peruvian police officials interpret and carry out these laws, however, is a far more complicated and inconsistent concept. In reality, the possession of an illegal drug — regardless of quantity — can lead to serious problems. When combined with poorly trained and sometimes corrupt police officials, this can turn what should be a slap on the wrist into one big punch in the face metaphorically speaking. In practice, Peruvian police treat drug possession as a crime, even if you are in possession of amounts that, by law, are not punishable. View More The standard allowable period of police detention is a maximum of 24 hours — more than enough to seriously ruin your time in Peru. For drug-related offenses, however, the police detention period is extended to a maximum of 15 days. If the police suspect any involvement in trafficking, prepare yourself for a long stay. If you are suspected of trafficking, then get ready for a truly awful experience. Peruvian prisons are hellish, and a drug trafficking charge could see you locked up for six months before a judge even hears your case. If you are then found guilty, you can expect a minimum sentence of three years. You can have fun making your head numb with coca leaves. Or you can head to the jungle and knock back half a pint of ayahuasca. All good, clean fun… and totally legal. Drugs in Peru: The Laws of Possession. View More. Peruvian Borders Officially Open October 1st ! Book your flights today and travel on the safest travel company in Peru! Machu Picchu Tickets — All you need to know!

Purchase of medications without prescription in Peru: a cross-sectional population-based study

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Official websites use. Share sensitive information only on official, secure websites. This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This new version considered interesting comments of reviewers. In the abstract section, we give a simpler explication of the main outcome variable. Additionally, we highlight the possible non-response and memory bias as possible limitations of the present study. Finally, we considered the comments of one reviewer, about the paper redaction. In this case, they are row percentages. Background: Low availability of medicines in health services, self-medication, inadequate use of medicines, and inadequate dispensing practices in pharmacies are frequent problems in Peru. We aimed to evaluate how frequent the purchase of medications without medical prescription is in Peru, and which factors are associated with this practice. Purchase of one or more medicines that require a prescription was measured as a dichotomous variable. Results: There were participants in the dataset. The prevalence of purchasing medications without prescriptions was History of having previously consumed the same medication Regarding the recommendation of the medication purchased, the advice of the pharmacy, and remembering a previous old prescription, were the most frequent reasons On the multivariable analysis, users that buy medications without prescription were more likely to be of aged ; reside in the Jungle and Highlands regions; and self-consumption of the purchase. Individuals with Seguro Integral de Salud Comprehensive Health Insurance were less likely to buy medications without prescription. Conclusions: There is a high prevalence of prescription requiring medication being bought without one from pharmacies in Peru. It is necessary to include the evaluation of consumer patterns to develop strategies with the aim to regulate the consumption of prescription drugs in the Peruvian population. Self-medication is the use of medicines to treat symptoms or disorders identified by the users without prescription, or the intermittent or continued use of a medicine prescribed by a physician to treat recurring or chronic symptoms or illnesses of the user or their family members, especially children or elderly people 1. It is a common practice both in developed and developing countries that may cause potential risks due to an incorrect self-diagnosis, failures in treatment, risk of overdose, medical interactions, severe adverse effects, among others 2 , 3. Several studies show that patterns of self-medication widely vary among populations, and these patterns are influenced by multiple factors, such as age, sex, income, expenses, orientation to self-care, level of education, medical knowledge, satisfaction with health services, and perception of illness 1 , 4. A systematic review of publications from different countries show a prevalence of self-medication ranging between However, in , it was reported that Furthermore, These results could demonstrate a low availability of medicines in health facilities, which added to self-medication, an inadequate use of medicines, and inadequate dispensing practices in pharmacies, represent a critical problem in the Peruvian health system with prevalence of self-medication ranging from Such studies might assess a very frequent practice in the country such as the purchase of medicines without medical prescription. To that effect, the objective of this study was to assess the prevalence of purchasing medicines which required a medical prescription in Peru without prescription, to know their characteristics, and to identify factors related to this practice. All complete cases of people older than 15 years were included for the analysis. ENSUSALUD includes questionnaires available from the SUSALUD website addressed to health professionals, executives of health services, and users of pharmacies and health services, and their objective is to monitor and assess the functioning and performance of the Peruvian health system, by studying the main participants in health care processes provided by health facilities The survey is conducted yearly using face-to-face questionnaires and in its edition, this survey took place from May 13 to July 9. The classification of each one of the medicines dependent on if they required a medical prescription or not for their sale was conducted by two investigators independently, based on Health Registration of Pharmaceutical Products of the General Bureau for Medicines, Drugs, and Inputs of Peru , in which official information of the national regulatory agency is included for all authorized medicines sold in Peru. The independent variables included are: sex, age group, level of education, type of health insurance, geographical area of residency, language, consumption of purchased products, and request of prescription by a pharmacist. With regards to independent variables, it is important to point out that in Peru health insurance can correspond to one of the four subsystems: public system, which subsidizes health services to low-income population; social security system EsSalud , which provides formal workers and their dependants with services; health system of armed forces and police FF. The country is divided into 24 political-administrative departments which are distributed in three natural regions: Coast region, adjacent to the Pacific Ocean included Metropolitan Lima, capital city of the country ; Highlands region, where the Andes are located; and Jungle region, which is part of the Amazon rainforest. The second stage was composed by a bivariate and multivariate statistical analysis, for that reason generalized linear models GLM of Poisson family and the log linking function were used to determine the association between the purchase of medicine without prescription and the independent variables. Variables included in multivariate analysis were sex, age group, level of education, type of health insurance, geographical area of residency, language, consumption of purchased products, and request of prescription by a pharmacist. The characteristics of sampling of the survey were specified, they include weightings according to strata, expansion factor, and design; for this purpose, the svy command was used. This study did not require any approval of an ethics committee, because it is a secondary analysis of a database of free access and public domain which does not identify survey respondents or pharmacies where purchases were made. The average age of the survey respondents who purchased without medical prescription was Additionally, the pharmacist in The precedent of previously using the medicine The multivariate analysis showed that being in an age between PRa: 1. In this study, a high prevalence of purchasing prescription medicines without medical prescription was found according to the National Authority data. This practice was associated to the age group ranging from 25 to 44 years, inhabitants of the Highlands and Jungle regions, and when the purchase was for self-consumption. Having Comprehensive Health Insurance SIS and the pharmacist requesting a prescription would be factors that decrease the prevalence of purchase without prescription. The Peruvian natural regions of Highlands and Jungle showed the highest incidences of these practices. Inadequate and non-effective access to medicines has been a common problem in Peru over recent years 19 , existing in the previously mentioned regions 7 , which would explain the results found in these regions of the country. Among the reasons for the purchase of medicines without prescription, the delay to make an appointment or delay in receiving health care at the health center, and previous knowledge of the medicine to be purchased stand out as the most important in our results; this situation was previously reported in national 20 and international 21 , 22 studies. That would reflect the discontent of the users regarding the health service in the Peruvian health centers, where an average of 18 days is expected to make an appointment and minutes to be treated in an outpatient visit after their arrival to the health center for The practice of purchasing medicines in the surveyed users is mainly focused on self-consumption. A study carried out in eight Latin American countries about responsible self-medication showed that users have a positive attitude towards health care, they recognize that over-the-counter medicines are less dangerous than prescription medicine, they are also interested in reading the labels of the products to be informed about the possible adverse effects Thus, with a proper previous education for participants regarding the rational use of medicines, self-medication could produce potential benefits, like the improvement to the access to over-the-counter medicines, greater patient empowerment, and avoidance of unnecessary medical appointments amongst others 25 , The control of the pharmacies over the sale of prescription products is important, including antimicrobial medication due to the reported increase in the resistance to these products related to self-medication. This situation occurs both in developed and developing countries 11 , 26 , Regarding a recommendation for the purchase of medicines, the pharmacist or salesperson of the pharmacy was the person that mainly provided this information. This situation has been previously reported in other regions around the world 3. Previous conducted studies in the country report the recommendation of medicines other than those in the prescription or a change of prescription, including antibiotics, by the pharmacist or personnel of pharmacies, despite they are not entitled for these practices 28 , The advice of a relative and the previous consumption of a medicine are other important sources of recommendation for the purchase without prescription. Studies performed in a district of Metropolitan Lima, capital city of Peru, and in Cajamarca, had the same findings 8 , One of the main problems of this practice is the consumption of medicines that require prescription, such as antibiotics. Antimicrobial resistance has been shown to be associated with inappropriate antibiotic prescription, either for the wrong indication or incorrect duration of treatment 16 , 30 , Allergies to drugs or use of antibiotics to treat viral diseases are other frequent problems 28 , From these finding it can be seen that it is crucial to apply measures that guarantee effective access to medicines in health facilities, and to establish procedures that allow verification of proper practices in the purchase of prescription medicines in private pharmacies. The proposals should be an initiative of the national health authority Ministry of Health in order to end this phenomenon, taking into consideration the characteristics of people who purchase medicines without prescription. Among the measures to be included in such a policy are: rationalization of the medicines provision and improvements in the main four stages of the medicines management cycle selection, purchase, distribution, and use through actions like: the development of information and control systems; the implementation of proper storage mechanisms and development of clinical practice guidebooks procedures to promote rational prescription ; optimization of the efficiency of investments in supply systems for public provision of medicines; implementation of centralized medication purchases; national and joint international bidding to reduce drug prices; rational prescription, distribution and consumption; among others The national representation of the results and the characterization of each one of the medicines to establish if they require a medical prescription for their purchase are the main strengthens of the study. Also, this is one of the first studies in the country to analyze the relation between socioeconomic factors and the purchase of prescription medicines without medical prescription at national level. However, given that it is a data analysis from secondary sources, there is a possibility that the collected data are not accurate. Because the self-medication item was self-reported causing memory bias, and for drugs for special control, like opioids, causing non-response bias. Another limitation is that it does not allow to establish a causal connection due to the cross-sectional design of the study. Despite that, we consider that our analysis is a good approach to the study of this problem, which represents a greater negative impact in countries with segmented health systems or in developing countries, as in the Peruvian case. In conclusion, the purchase of prescription medicines without medical prescription is a common practice within the Peruvian health system and is more frequent in regions with a lower supply of medical facilities or access to health services. This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. The revised version looks much better and I have no further comments. This manuscript can now be accepted for indexing. Interesting article, finely written. Introduction reports adequately about antecedents and justification of research. Methods reports designs, variables, and statistical analysis. Results and analysis are performed adequately in my opinion and discussion is enriched with comparison with recent publications about the research question, that's why I consider this paper as suitable for publication. The authors may detail the criteria used to include variables in the regression model. The authors showed that poor access to health services increases self-medication. I would like to add three suggestions. First, investigate colinearity between independent variables to avoid type I errors. Second, discuss the measurement bias: the self-medication was self-reported and may be influenced by memory bias last 12 months or non-response bias for drugs for special control, like opioids, etc. Third, add reference from Latin America 1. The study titled 'Purchase of medications without prescription in Peru: a cross-sectional population-based study' is an interesting and relevant study from the perspective of Peru. The authors have done a good job. However, some of the following issues should be addressed prior to indexing. In the abstract, the author mention age range of , but in the study they have used years. This should be addressed. I would suggest suing the Jungle region term consistently in the abstract as well instead of Amazon. In the second paragraph of the Introduction, the authors mention 'several studies' but only provide two studies as reference 1, 4. If it is only two studies, then it should be called a few or handful studies. Also, where were these studies conducted and how are they relevant in the context of Peru? In the third paragraph of the Introduction section, some important statistics are provided. But it might be more appropriate to mention when these changes happened etc. The weighted percentage column of Table 1 is confusing. Are they column percentages? The authors need to clarify this issue. In Table 2, there is a mention of 'Other' reason to purchase medicines without medical prescription. I am wondering if the respondents were allowed to provide comments on them? If yes, then some interesting comments should be provided either in this Table or in the text somewhere in the Results section. And finally, although this manuscript is rather well written, but in some places English editing is required for clarification e. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Other versions. Find articles by Christoper A Alarcon-Ruiz. Find articles by Luisa Magallanes-Quevedo. Find articles by Diego Rosselli. Accepted Feb 20; Collection date Version Changes Revised. Amendments from Version 1 This new version considered interesting comments of reviewers. Open in a new tab. SD: Standard deviation. Nobody, I took them by a personal decision 9. PR: prevalence ratio. Find articles by Marcus Tolentino Silva. Competing interests: No competing interests were disclosed. Marcus Tolentino Silva : Referee. Find articles by Sandipan Bhattacharjee. Sandipan Bhattacharjee : Referee. Find articles by Fernando M Runzer-Colmenares. Fernando M Runzer-Colmenares : Referee. Associated Data. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Consumption of purchased products. Request of prescription by a pharmacist. Why did you purchase medicines without medical prescription? They delay too much to make an appointment to health care in a health center.

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