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1.
Cad. Ibero Am. Direito Sanit. (Impr.) ; 11(4): 182-203, out.-dez.2022.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1402521

ABSTRACT

Objetivo: identificar os dez medicamentos mais demandados judicialmente no estado do Rio Grande do Sul (RS) e investigar a evolução dos gastos, de 2010 a 2019, com a judicialização de medicamentos, comparando os dados com a implementação das políticas públicas de medicamentos no Brasil nesse período. Metodologia: trata-se de um estudo descritivo, transversal, retrospectivo, utilizando dados de relatórios do sistema de Administração de Medicamentos da Secretaria Estadual de Saúde do RS e dados públicos do Portal da Transparência do RS. Resultados: destacam-se na lista dos medicamentos mais judicializados o brometo de tiotrópio 2,5 mcg, que apareceu em todos os anos na primeira posição, desde 2011; citalopram 20 mg, venlafaxina 75 mg e duloxetina 60 mg foram os antidepressivos mais demandados, além de sulfato de glicosamina 500 mg em associação com condroitina 400 mg e rivaroxabana 20 mg. Os antineoplásicos foram os responsáveis pelo maior impacto no orçamento do estado. Entre 2010 e 2019, o RS aumentou o gasto em 773,1% com a judicialização de medicamentos. Conclusão: o fenômeno da judicialização de medicamentos no RS demonstrou um crescimento considerável no período em estudo e a adoção de políticas públicas de assistência farmacêutica não demonstrou ter influenciado o acesso a medicamentos por meio da judicialização.


Objective: identify the ten most legally demanded medicines in the State of Rio Grande do Sul, Brazil, and study the evolution of expenditures related to the judicialization of medicines from 2010 to 2019, comparing the data with the implementation of public policies on medicines in Brazil during this period. Methods: this is a descriptive, retrospective, cross-sectional study using data from reports of the Medicines Management System of the Health Office and public data from the Transparency Portal, both from the State of Rio Grande do Sul. Results: tiotropium bromide 2.5 mcg topped the list of most frequently court-ordered medications and has topped this list every year since 2011. Citalopram 20 mg, venlafaxine 75 mg, and duloxetine 60 mg were the most frequently requested antidepressants, as were glucosamine sulfate 500 mg in association with chondroitin 400 mg, and rivaroxaban 20 mg. Antineoplastics were responsible for the largest state budget impact. Between 2010 and 2019, the State of Rio Grande do Sul's expenditures increased by 773.1% due to the judicialization of pharmaceuticals. Conclusion: the phenomenon of judicialization of medicines in the State of Rio Grande do Sul has experienced significant growth during the period studied, and the adoption of public policies of pharmaceutical support does not seem to have affected access to medicines through judicialization.


Objetivo: identificar las diez drogas más demandadas legalmente en el estado de Rio Grande do Sul, Brasil, e investigar la evolución de los gastos, de 2010 a 2019, con la judicialización de las drogas, comparando los datos con la implementación de políticas públicas de drogas en Brasil en este periodo. Metodología: se trata de un estudio descriptivo, transversal, retrospectivo, utilizando datos de informes del sistema de Administración de Medicamentos de la Secretaría de Estado de Salud de Rio Grande do Sul y datos públicos del Portal de Transparencia de Rio Grande do Sul. Resultados: el bromuro de tiotropio 2,5 mcg destaca en la lista de las drogas más judicializadas, que aparece en la primera posición todos los años desde 2011; citalopram 20 mg, venlafaxina 75 mg y duloxetina 60 mg fueron los antidepresivos más demandados, además de sulfato de glucosamina 500 mg en associación con condroitina 400 mg y rivaroxabán 20 mg. Los antineoplásicos fueron los responsables del mayor impacto en el presupuesto estatal. Entre 2010 y 2019, el estado de Rio Grande do Sul aumentó el gasto en un 773,1% con la judicialización de medicamentos. Conclusión: el fenómeno de la judicialización de medicamentos en Rio Grande do Sul mostró un crecimiento considerable en el período de estudio y la adopción de políticas públicas para la asistencia farmacéutica no pareció haber influido en el acceso a los medicamentos a través de la judicialización.

2.
Ciênc. Saúde Colet. (Impr.) ; 27(12): 4579-4588, Dec. 2022. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1404206

ABSTRACT

Resumo O acesso integral à saúde é um problema global. Estima-se, que um terço da população não tenha acesso regular aos medicamentos essenciais. A Pessoa Privada de Liberdade (PPL) é uma das que apresenta situações de iniquidades de acesso. Diante da singularidade do sistema penitenciário, esta pesquisa objetivou identificar os fatores determinantes no acesso aos medicamentos disponibilizados pelo Sistema Único de Saúde (SUS) para a PPL paraense. Trata-se de uma pesquisa aplicada, exploratória, qualitativa, realizada no período de agosto de 2019 a fevereiro de 2020, utilizando-se, também do framework APOTECA. Evidenciou-se na análise do framework APOTECA que fatores técnicos, políticos e administrativos são identificados como principais barreiras na garantia ao acesso equânime aos medicamentos disponibilizados pelo SUS para a PPL paraense. A privação de liberdade, vulnerabilidade social e outros fatores inerentes a realidade carcerária dificultam a efetivação do direito à saúde das PPL, sendo que diversos desafios devem ser superados quanto a garantia ao acesso equânime aos medicamentos.


Abstract Comprehensive access to health is a global issue. One-third of the population does not have regular access to essential medicines. People Deprived of Liberty (PDL) are one of those people in a situation of unequal access. Given the uniqueness of the penitentiary system, this research aimed to identify the determining factors in the access to medicines made available by the Brazilian Unified Health System (SUS) for the PDLs in Pará, Brazil. The applied, exploratory, qualitative research was conducted from August 2019 to February 2020 using the APOTECA framework. The APOTECA framework analysis revealed that technical, political, and administrative factors are the main hurdles to guaranteeing equal access to medicines made available by the SUS for the PDLs in Pará. The deprivation of liberty, social vulnerability, and other factors inherent to the prison reality hinder the implementation of PDLs' right to health, and several challenges must be overcome to secure equal access to medicines.

3.
JBES ; Volume 14(2)Ago. 2022.
Article in Portuguese, English | LILACS-Express | LILACS | ID: biblio-1412810

ABSTRACT

Objetivo: Avaliar o custo com medicamentos básicos de uso contínuo de usuários da Atenção Primária em Saúde de Santa Rosa-RS. Métodos: Estudo transversal e analítico realizado em um município do noroeste do Rio Grande do Sul. Foram incluídos usuários cadastrados nas 17 unidades de estratégia de saúde da família, das áreas urbana e rural, em uso de no mínimo um medicamento de uso contínuo. A coleta de dados foi realizada pelo acesso ao sistema informatizado de prescrição eletrônica. Resultados: Foram incluídos 642 usuários, com idade média de 60,40 anos, sendo 64,3% mulheres. Identificou-se média de 4,68 ± 2,82 medicamentos/prescrição e 47,4% ± 14,48 dos usuários em uso de cinco ou mais medicamentos. Dos medicamentos em uso, 87,9% pertencem ao componente básico da assistência farmacêutica. O custo anual do município por usuário de medicamento foi em média de R$ 250,60. O sistema cardiovascular foi o grupo anatômico com maior custo total. Verificou-se maior frequência de uso de medicamentos entre os idosos, que consequentemente representam o grupo etário com maior custo de tratamento. Conclusão: Evidenciou-se que a maioria dos medicamentos prescritos atua sobre os sistemas cardiovascular e nervoso, e pertence ao componente básico da assistência farmacêutica. O custo com medicamentos demonstrou investimento do município de valores 25 vezes maiores do que o mínimo estabelecido pela legislação vigente, com vistas a garantia de acesso ao tratamento e manutenção da qualidade de vida da população assistida.


Objective: The objective of this study was to evaluate the cost of basic medicines for continuous use by users of Primary Health Care in Santa Rosa-RS. Methods: A cross-sectional and analytical study carried out in primary health care in a city in the Northwest of Rio Grande do Sul, comprising 17 unites of Strategies Family Health. Registered users in urban and rural units were included, using at least one continuous treatment. Data collection was performed by accessing the computerized electronic system. Results: 642 users were included in the study, with an average age of 60.40 ± 14.48 years, 64.3% were women. The average number of prescription drugs was 4.68 ± 2.82/prescription and 47.4% of users were using five or more medications. Of the drugs in use, 87.9% belonging to the basic component of pharmaceutical care. These drugs represent an annual cost per user of R$ 250.60. The cardiovascular system presents itself as the anatomical group with the highest total expenditure. Hydrochlorothiazide was the most prescribed drug and beclomethasone represented the highest individual expense. Conclusion: It became evident that most of the drugs prescribed belonged to the basic component of pharmaceutical care and belonged to the cardiovascular and nervous system. Cost of drug implies the investment of the city of 25 times higher than the established by the current legislation, with a view to guaranteeing access to treatment and maintaining the quality of life of the assisted population.

4.
Rev. ciênc. farm. básica apl ; 43: 1-14, 20220101.
Article in English | LILACS-Express | LILACS | ID: biblio-1369955

ABSTRACT

Objectives: The present study aimed to assess the short- and long-term outcomes of a clinical service provided by a pharmacist structured in a primary healthcare center (PHC) in Fortaleza, Ceará, Brazil. Methods: A longitudinal-type study was conducted. Data were collected from pharmacotherapy follow-up (PTF) records from the Pharmaceutical Care Unit of the PHC Dr. Anastácio Magalhães. The PTF was provided to patients diagnosed with hypertension and/or diabetes mellitus. Two groups were formed: records of patients who intended to undergo six months or more of PTF (PTF group) and those who opted not to go through with it after the first session (control). In addition, new blood pressure and glucose measurements were obtained after invitation by phone call at least six months after the completion of the PTF to assess maintenance of the benefits gained. The control patients were invited for this new data collection as well for comparison purposes. Research Ethics Committee approval protocol no. 329.717. Results: A total of 224 patients were considered, 109 in the complete PTF group and 115 in the control group, where the following main results were obtained: systolic pressure (mean ± SD) went from 139.43±20.6 to 128.31±16.03 mmHg; diastolic pressure, from 82.45±11.44 to 77.68±9.21 mmHg; blood glucose, from151.78±75.8 to 121.39±47.56 mg/dL; and cardiovascular risk, from 21.59±9.42 to 18.95±9.06%. In comparison, the control group did not show significant changes on the above parameters. In the post-PTF analysis, the benefits gained tended to be maintained even at least six months after its conclusion. Conclusions: Thus, the findings of the present study suggest that the provision of the clinical pharmaceutical service assessed at the primary healthcare level offers benefits to patients who attended it for at least six months. Furthermore, the data also suggest that these benefits are maintained in the long term.

5.
China Pharmacy ; (12): 240-243, 2022.
Article in Chinese | WPRIM | ID: wpr-913118

ABSTRACT

OBJECTIVE To provi de reference for scholars to carry out the research on the competency of pharmacists in pharmaceutical care and the human resource management of hospital pharmaceutical personnel. METHODS The questionnaire was designed with Pharmacist Pharmaceutical Service Competency Evaluation Standard (Trial)as the competency evaluation indexes. The convenient sampling method was used to investigate the pharmaceutical technicians from two third-class grade A hospitals in Harbin. Exploratory factor analysis was used to judge whether each dimension and item of competency index system needed to be adjusted;the final weight of each evaluation index was calculated by analytic hierarchy process ;fuzzy comprehensive evaluation method was used to evaluate the competency of pharmacists in pharmaceutical care. RESULTS Totally 152 questionnaires were collected and 142 valid questionnaires were collected ,with an effective recovery rate of 93.42%. In this study ,women accounted for 76.8%,those aged 40 and below accounted for 60.6%,those with bachelor ’s degree and above accounted for 84.5%,those with intermediate professional title accounted for 45.1%,and those with 10 years of work or below accounted for 60.6%. Four common factors were extracted in exploratory factor analysis ,and the cumulative variance contribution rate was 78.841%,which were named knowledge and skills ,motivation,personal literacy and professional ethics. The average score of the pharmacist ’s pharmaceutical care competency was (5.884±0.810),and the development of various dimensions of competency was not balance ; honesty and trustworthiness ,conscientiousness and responsibility and dedication scored higher ,while the scores of statistical knowledge,foreign language knowledge and drug treatment evaluation ability were lower. According to the evaluation method of fuzzy comprehensive evaluation ,the final comprehensive evaluation result was “consistent”. CONCLUSIONS The evaluation indexes of pharmacist competency have good reliability and validity in the competency evaluation of pharmacists in medical institutions. At the same time ,the basic knowledge of 32 hospital pharmacists and their ability to participate in clinical rational drug use need to be further improved.

6.
China Pharmacy ; (12): 2277-2280, 2022.
Article in Chinese | WPRIM | ID: wpr-943072

ABSTRACT

OBJECTIVE To provide ideas for pharmaceutical care of Mycobacterium abscess infection. METHODS The diagnosis and treatment plan ,about a patient with M. abscess infection after resection of intervertebral neurilemmoma participated by clinical pharmacists ,was analyzed . According to the results of bacterial culture and drug sensitivity test of wound secretion ,the clinical pharmacist timely dealed with the adverse drug reactions during the treatment . For the tinnitus caused by the patient taking amikacin(0.4 g,intravenous drip ,q12 h),it was suggested to stop amikacin and replace it with linezolid ;however,the patient suffered from knee pain after taking linezolid . The clinical pharmacist once again suggested stopping linezolid ,continuing to use amikacin,and adjusting the dose to 0.8 g,intravenous drip ,q24 h;at the same time ,the patients were given medication guidance and ordered to have regular follow -up after discharge . RESULTS The physicians adopted the suggestions of clinical pharmacists , and the patient did not suffer from tinnitus ,knee pain and other discomfort ,and the liver and kidney functions were normal . CONCLUSIONS Clinical pharmacists timely assist clinicians to adjust the medication plan ,which improves the effectiveness and safety of patients ’medication.

7.
China Pharmacy ; (12): 2162-2166, 2022.
Article in Chinese | WPRIM | ID: wpr-941462

ABSTRACT

OBJECTIV E To develop the infor mation-based pharmaceutical care pathway of anticoagulant therapy in patients with atrial fibrillation and improve the efficacy and safety of treatment for them. METHODS The“anticoagulant pharmaceutical care”module was developed on the basis of medical intelligent and decision system. Patients with atrial fibrillation were taken pharmaceutical care in the whole anticoagulant treatment by evaluating the thromboembolism and bleeding risks ,pre-reviewing antithrombotic prescriptions ,monitoring efficacy and drug interactions ,and warning adverse reactions. RESULTS A total of 1 228 patients receiving anticoagulant therapy were enrolled. It was found after analysis of their doctor ’s orders that 9.27% of the patients adjusted the improper antithrombotic therapies ,3.99% modulated treatments according to the effects of potential drug interactions or the risk of adverse reactions ,and 70.29% of the wrong prescriptions were intervened successfully. After the information-based pharmaceutical care ,the anticoagulation treatment rate increased from 88.73% to 97.40%,the rate of patients ’achievements to warfarin’s international normalized ratio in hospital increased from 38.64% to 66.67%,and the incidence of serious bleeding events decreased from 2.94% to 0.37% (P<0.05). CONCLUSIONS The information-based pharmaceutical care path of anticoagulant therapy achieved comprehensive ,efficient and accurate management of patients with atrial fibrillation ,and improved the rationality ,effectiveness and safety of anticoagulant therapy.

8.
China Pharmacy ; (12): 2152-2156, 2022.
Article in Chinese | WPRIM | ID: wpr-941460

ABSTRACT

OBJECTIVE To intr oduce multidisciplinary collaborative blood glucose management mode (hereinafter referred as to blood glucose management mode of the whole hospital )of the whole hospital with the participation of clinical pharmacists ,and to evaluation it effects on the blood glucose management of perioperative diabetes patients. METHODS The process of blood glucose management mode of the whole hospital in Drum Tower Hospital Affiliated to Medical School of Nanjing University and the work content of clinical pharmacists were introduced. Three hundred patients with type 2 diabetes mellitus who underwent elective surgery were included and randomly divided into general consultation group (control group )and hospital-wide glucose management group (intervention group ). The effect of glucose management and indicators such as preoperative waiting time and total length of stay were compared between 2 groups. RESULTS In the blood glucose management team of the whole hospital ,the physicians,clinical pharmacists and nurses of blood glucose management in endocrinology department were the core members ,and the management process was divided into initial management ,daily management ,discharge management and follow-up. As the team secretary ,the clinical pharmacists were mainly responsible for daily summarizing and managing the blood glucose level and special conditions of patients ,regularly evaluating the management effect ,carrying out pharmaceutical ward rounds ,medical order review, pharmaceutical care , timely assessing the blood glucose of patients and guiding the rational use of drugs. Compared with before intervention , after 3 days ofintervention,the levels of fasting plasma glucose (FPG)and postprandial blood glucose (PBG) were decreased significantly in 2 groups(P<0.05);intervention group was significantly lower than control group (P<0.05). Compared with control group , the fluctuation of blood glucose in intervention group was significantly reduced (P<0.05),standard deviation of blood glucose had reached the targeted control level , and the postprandial glucose excursion and the largest amplitude of glycemic excursion were close to the targeted control level ;the rate of bl ood glucose reaching the standard before operation and at discharge were significantly increased (P<0.05);the preoperative waiting time and hospitalization days were significantly shortened (P<0.05). CONCLUSIONS The multidisciplinary collaborative blood glucose management mode of the whole hospital with the participation of clinical pharmacists can control the blood glucose level of diabetic patients in the perioperative period more stably and effectively ,and has practical significance for the disease treatment and prognosis of patients.

9.
China Pharmacy ; (12): 1769-1775, 2022.
Article in Chinese | WPRIM | ID: wpr-934963

ABSTRACT

OBJECTIVE To evalu ate relat ed researches about the cost- benefit of pharmaceutical care in medical institutions with cost- benefit analysis,in order to provide evidence-based basis for related policy decisions and provide methodological reference for the cost- benefit evaluation of pharmaceutical care in the future. METHODS Retrieved from PubMed ,Embase,the Cochrane Library ,CBM,Wanfang database ,VIP and CNKI ,cost-benefit analysis was used to evaluate the researches about the cost-benefit of pharmaceutical care in medical institutions. Two researchers independently screened the research and extracted data according to the “Consolidated Health Economic Evaluation Reporting Standards Checklist ”. The quality of included studies was scored and evaluated systematically. RESULTS A total of 46 studies from 17 countries were included. Most of them came from the United States (21.74%),China(19.57%)and France (8.70%). Average score of 46 literature was 14.30,of which 1 literature was excellent ,5 literature were good ,25 literature were qualified and 14 literature were unqualified. There were 25 research protocols of prospective study type ;the type of pharmaceutical care involved mostly was pharmaceutical monitoring (60.87%), followed by prescription review (23.91%),medication reconciliation (8.70%)and outpatient pharmacy (6.52%)were less. The median cost-benefit ratio of pharmaceutical care was 5.05 (3.08,11.28). CONCLUSIONS Pharmaceutical care shows good economic value ,and pharmacists have played an important role in saving medical resources ,but the design level and report quality of the existing studies need to be improved.

10.
Article in Chinese | WPRIM | ID: wpr-924064

ABSTRACT

Objective To explore the clinical pharmacist’s role in drug therapy and monitoring for the patient with postoperative MRSA infection. Methods Clinical pharmacists participated in planning anti-infective treatment, antimicrobial medication selection, identification of high-risk factors for MRSA infection, evaluation of vancomycin efficacy, dosage adjustment using TDM technology, monitoring and management of vancomycin adverse reactions. Results With the pharmaceutical care provided by clinical pharmacists, the patient received effective treatment with minimal vancomycin-related adverse reactions. Conclusion Clinical pharmacists played an important role in accelerating patient recovery by rational and safe medication use.

11.
China Pharmacy ; (12): 1037-1043, 2022.
Article in Chinese | WPRIM | ID: wpr-923749

ABSTRACT

OBJECTIVE To pro vide so lutions for the appli cation of legal liability caused by the confusion of the concept of pharmaceutical care. METHODS Literature research and comparative method were adopted to clarify the legal concept of pharmaceutical care ,analyze the civil and administrative liabilities arising from different forms of pharmaceutical care ,and standardize the new responsibilities of pharmacists in pharmaceutical care. RESULTS & CONCLUSIONS The legal concept of pharmaceutical care has the function of judgement standard. Only such behaviors can belong to pharmacists ’liability under legal regulation,which are based on mutual agreements ,ensure the public medication safety and optimize patient treatment effect through the application of pharmaceutical expertise related to drug treatment. Under this definition ,the civil liability of pharmaceutical care needs to distinguish the professional degree of pharmaceutical care in different situations ,so as to establish a typed civil liability system and provide different levels of protection for patients ;regarding administrative liability ,it is necessary to improve the pharmaceutical regulatory system with the dual core of the Drug Administration Law and the Pharmacist Law from the perspective of liability integration.

12.
China Pharmacy ; (12): 981-986, 2022.
Article in Chinese | WPRIM | ID: wpr-923602

ABSTRACT

OBJECTIVE To ex plore the economic value of medication therapeutical management (MTM)service for patients with stable coronary disease. METHODS Totally 140 patients with stable coronary disease were divided into a control group and a intervention group ,70 cases in each group. Patients in control group were received routine medical services ,and patients in intervention group additionally received standardized MTM services on this basis. Medication complication ,satisfaction degree , safety indexes and efficacy indexes were compared between 2 groups. From the perspective of the whole society ,the economic value of MTM service for patients with stable coronary disease were evaluated by pharmacists using cost minimization analysis. RESULTS A total of 15 patients did not complete the study ,including 5 cases in intervention group and 10 cases in control group ; there was no death endpoint during the follow-up period. MMAS- 8 score,satisfaction score of drug communication dimension and score of overall satisfactionin of intervention group were obviously higher than control group (P<0.01). There was no significant difference in blood pressure standard rate ,blood lipid standard rate ,the incidence of adverse drug reaction ,and the incidence of acute coronary events between 2 groups(P>0.05). The total cost of intervention group was lower than that of control group (P< 0.01);the results of sensitivity analysis were consistent with those of cost minimization analysis. CONCLUSIONS Pharmacists implement MTM service for patients with stable coronary disease can reduce total cost ,save medical resources and has economic advantages.

13.
China Pharmacy ; (12): 789-794, 2022.
Article in Chinese | WPRIM | ID: wpr-923182

ABSTRACT

OBJECTIVE To in vestigate the existing problems about store construction and market operation and management of DTP (direct-to-patient)pharmacies in Guizhou province ,and to provide countermeasures and suggestions for the improvement and development of professional operation of DTP pharmacies in Guizhou province. METHODS According to the literature review , the questionnaire was designed. Then the field survey of 11 DTP pharmacies and questionnaire survey for the person in charge (or store managers ) in Guizhou province were conducted from April to May 2021. The questionnaire mainly included the basic information,online sales channel construction ,pharmaceutical logistics distribution ,pharmaceutical care ,vocational training , construction of pharmacy management system and application of drug management information system etc. ,in order to analyze the inadequacies of market operation and management of DTP pharmacies in Guizhou province and put forward suggestions. RESULTS Totally 11 questionnaires were delivered and 9 valid questionnaires were retrieved ,the effective response rate of questionnaires was 81.82% . The sample pharmacies were all from Guiyang ,most of them (77.78%)were established by local pharmaceutical enterprises in Guizhou province ,and only 22.22% of the sample pharmacies had opened online drug purchase channels. In terms of pharmaceutical care ,55.56% of the sample pharmacies provided basic testing and life style interventions respectively ,44.44% of the sample pharmacies provided adverse drug reaction monitoring ,and 33.33% of the sample pharmacies implemented health education presentations and chronic disease rehabilitation program respectively. In term of personnel training ,only 11.11% of the sample pharmacies implemented weekly business training ,and 66.67% of the sample pharmacies received innovative and academic pharmacy information training. The construction of DTP pharmacy management systems in Guizhou province was completed basically , but in terms of application of drug management information system , 22.22% of the sample pharmacies conducted drug application analysis and monitoring. CONCLUSIONS The development of DTP pharmacies in Guizhou province is still in initial stage currently. The convenience and accessibility of medicines for patients and the construction of online sales channel need to be improved ;the internet channel construction is slow ;an effective selection and evaluation mechanisms for pharmaceutical logistics enterprises need to be created ;pharmaceutical care ability and pharmacy service personnel training system need to be strengthened ;informatization management and industrial recognition of DTP pharmacies in Guizhou province need to be promoted. Therefore ,the enterprises , government, universities and associations should work together and strengthen the professionalization , informatization, institutionalization and standardization of DTP pharmacies in Guizhou province ,in order to provide patients with a convenient drug sales channels and high-quality personalized pharmaceutical care platforms eventually.

14.
Physis (Rio J.) ; 32(3): e320311, 2022. tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1406245

ABSTRACT

Resumo O mapeamento dos comportamentos frente ao uso de medicamentos informa as condições pelas quais um tratamento farmacológico é implementado. A localização da adesão à medicação como um problema clínico, evoca, no entanto, lugares bem demarcados quanto aos procedimentos para sua explicação e resolução. Nesse sentido, este trabalho busca problematizar os elementos fundantes do estudo da adesão à medicação, considerando que tal prática é hegemonicamente assimilada apenas por parâmetros científicos e biológicos, sem a inclusão de uma abordagem direcionada às especificidades históricas e culturais dos pacientes. Transferem-se, assim, a primazia da delimitação e a explicação da realidade ao próprio analista. Porém, o trabalho de campo demonstrou uma diversidade de posturas e agenciamentos quanto ao uso dos medicamentos, capaz de indicar que a geografia do cuidado não se orienta apenas a partir de um percurso linear, mas se apoia em espaços ambulantes e itinerantes, instalando-se em um campo paradoxal que mescla reprodução e criação.


Abstract The mapping of behaviors towards the use of medicines informs the conditions under which a pharmacological treatment is implemented. However, the location of medication adherence as a clinical problem evokes well-demarcated place as to the procedures for its explanation and resolution. In this sense, this work aims to problematize the founding elements of the study of medication adherence, considering that such practice is hegemonically assimilated only by scientific and biological parameters, without the inclusion of an approach directed to the patients' historical and cultural specificities. In this way, the primacy of delimitation and explanation of reality is transferred to the analyst. However, the field work showed a diversity of attitudes and management of medicines, capable of indicating that the geography of care is not oriented only from a linear path, but is supported by wandering and itinerant spaces, installing in a paradoxical field that mixes reproduction and creation.

15.
Physis (Rio J.) ; 32(2): e320212, 2022. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1386835

ABSTRACT

Resumo O artigo descreve a percepção de 10 farmacêuticos da Atenção Básica (AB) de uma região do município de São Paulo que participaram do processo de implantação do Cuidado Farmacêutico. A partir de uma pesquisa qualitativa com grupos focais e abordagem descritiva, os conteúdos foram analisados utilizando-se a Análise de Conteúdo. Das 52 unidades de registro organizadas em 10 categorias, resultaram três sínteses sobre o processo de implantação do CF. Nesse contexto, foi possível descrever o papel do farmacêutico na AB após a implantação dos serviços clínicos, de modo a identificar suas percepções, dificuldades e avanços. Os resultados demonstraram aspectos positivos, além da necessidade de uma mudança gradual no perfil e nas competências dos farmacêuticos para o desenvolvimento de serviços clínicos, ultrapassando os limites da categoria e dependendo do trabalho em equipe realizado na AB. Logo, os resultados promovem os diferentes papéis dos atores envolvidos nesta prática (usuários, equipe de saúde, gestores e farmacêuticos) e valorizam novas formas de cuidado no SUS.


Abstract The article describes the perception of 10 pharmacists from the Primary Health Care (PHC) of a region in the municipality of São Paulo that participated in the process of implementing the Pharmaceutical Care (PC). Based on qualitative research with focus groups and descriptive approach, contents were reviewed using the Content Analysis. The 52 registration units organized in 10 categories resulted in three summaries about the PC implementation process. In this context, we could describe the role of pharmacists in PHC after the implementation of clinical services, in order to identify their perceptions, difficulties and advances. Results unveiled positive aspects, besides the need for gradual change in the profile and competences of pharmacists to develop clinical services, extrapolating the category boundaries, and depending on the teamwork performed at PHC. Therefore, results promote the different roles of the players involved in this practice (users, health team, managers, and pharmacists), and value new forms of care in the Brazilian Health System (SUS).

16.
Braz. J. Pharm. Sci. (Online) ; 58: e18426, 2022. graf
Article in English | LILACS | ID: biblio-1394046

ABSTRACT

Abstract Transgender is a broad-spectrum term referring to people who do not match their assigned sex at birth. Several issues, including social detachment, poor access to healthcare services, and the lack of social/economic opportunities, have historically affected this population. In this scenario, pharmacists - not mentioned in national and international clinical guidelines/protocols regarding transgender care - might be key professionals to serve and care for this population. The main goal of this literature review was to identify the pharmacists' role in the care of transgender people. The articles were retrieved from scientific databases. After applying filters (e.g., language, full-text availability, and coverage of the research question), seven articles were included in this review. The articles did not present pharmaceutical experiences or practices regarding transgender healthcare. Instead, some articles stressed the inadequate or inappropriate use of hormones and their side effects, also covering the role of this issue in professional development, gaps, and potential opportunities for research and pharmaceutical services. Pharmacists, included in a multi-professional team, could be a key element to promote access to healthcare and the well-being of the transgender population.


Subject(s)
Pharmacists/classification , Review , Delivery of Health Care , Transgender Persons/classification , Pharmaceutical Services/ethics
17.
Article in English | LILACS | ID: biblio-1403762

ABSTRACT

Abstract COVID-19 (SARS-CoV-2) pandemic is raising many questions about the future of face-to-face interactions. The possible changes on healthcare delivery may provoke a long term disruption on pharmaceutical assistance requiring new approaches to provide pharmaceutical services. The proposal of pharmaceutical care is patient oriented, and its activities include different forms of interaction. The emergence of COVID-19 puts to the test all the efforts to reposition pharmaceutical care in the set of clinical activities. Now, the pharmaceutical consultations and group activities, which played a fundamental role in the reformulation of pharmacy practices, must be revised in order to reduce the risk of patient agglomeration and contamination. Several researchers suggest technology use to intermediate health care assistance. However, few studies had rigorously analyzed the effectiveness of virtual health care on the pharmaceutical field. Innovating the pharmacy workflow, during the course of a crisis like COVID-19, is the current challenge addressed to all pharmacists. This unforeseen situation requires us to reconsider our plans and actions. It will be necessary resilience, courage and creativity to achieve a consistent attitude, which provides a quick response to the health care needs in this time of crisis.


Subject(s)
Pharmacists/standards , Pharmaceutical Services/ethics , Delivery of Health Care/standards , Pandemics/prevention & control , COVID-19/complications , Patients/classification , Pharmaceutical Preparations/administration & dosage , Health Services Needs and Demand/standards
18.
Rio de Janeiro; s.n; 2022. 99 f p. tab, graf.
Thesis in Portuguese | LILACS | ID: biblio-1396961

ABSTRACT

O Brasil é signatário do documento da Organização Mundial da Saúde (OMS) para eliminação das hepatites virais até 2030. Uma das estratégias para eliminação das hepatites virais é aumentar o número de diagnósticos e tratamentos. A migração dos medicamentos de hepatites virais crônicas B e C do componente especializado para o componente estratégico da assistência farmacêutica foi regulamentado pela portaria 1537 do Ministério da Saúde de Junho de 2020 e normatizada pela Nota Técnica 319 de 2020. Para essa transição foi organizado um cronograma com as etapas do processo e implantação do Sistema de Controle Logístico de Medicamentos (SICLOM) nos estados. O SICLOM é um sistema de cadastro de usuário, dispensação dos medicamentos, controle de estoque, avaliação dos critérios para prescrição dos medicamentos, além de emitir relatórios sobre quantidade de medicamentos dispensados. Uma etapa fundamental do processo foi a pactuação das Unidade Dispensadoras Municipais (UDM) no âmbito das Comissões Intergestores Regionais (CIR) e, posteriormente, na Comissão Intergestores Bipartite (CIB) para deliberar que essas unidades iniciassem o processo como farmácias dispensadoras de medicamentos de hepatites B e C no componente estratégico, utilizando o sistema SICLOM, no Estado do Rio de Janeiro. O objetivo deste trabalho é descrever o processo e avaliar os resultados relacionados ao número de pontos de atendimento e o quantitativo de tratamentos dispensados no período de julho de 2021 a fevereiro de 2022 no Estado do Rio de Janeiro. A metodologia compreendeu uma revisão da literatura sobre o papel do tratamento como estratégia de eliminação das hepatites virais e a descrição das atividades previstas e realizadas na linha do tempo desde o início do processo após o embasamento legal e da publicação das normativas e a extração dos dados e informações sobre o número de tratamentos do SICLOM. A migração resultou em 1084 tratamentos de julho a dezembro de 2021, correspondendo a 56,4% do total dos 1922 tratamentos dispensados pelo Componente Especializado da Assistência Farmacêutica (CEAF) durante todo o ano de 2020. A migração transcorreu com sucesso, aumentou de 29 polos de dispensação especializados para 61 UDM que são as farmácias do componente estratégico, tornando a dispensação mais ágil do que a espera anterior. Apesar dos efeitos negativos provocados pela pandemia pode-se considerar que houve um grande avanço na política pública de assistência às hepatites virais.


Brazil is a signatory country to the World Health Organization (WHO) document for the elimination of viral hepatitis by 2030. One of the strategies to eliminate viral hepatitis is to increase the number of diagnoses and treatments. The migration of drugs for chronic viral hepatitis B and C from the specialized component to the strategic component of pharmaceutical care was regulated by ordinance 1537 of the Ministry of Health of June 2020 and standardized by Technical Note 319 of 2020. A schedule was organized for this transition with the steps of the process and implementation of the logistics and dispensing system (SICLOM) in the states. SICLOM is a user registration system, drug dispensing, inventory control, evaluation of drug prescription criteria, in addition to issuing reports on the quantity of drugs dispensed. A fundamental step in the process was the agreement between the Municipal Dispensing Units (UDM) within the scope of the Regional Inter-management Commissions (CIR) and, later, in the Bipartite Inter-management Commission (CIB) to decide that these units would start the process as pharmacies that dispense hepatitis drugs. B and C in the strategic component, using the SICLOM system, in the State of Rio de Janeiro. The objective of this work is to describe the process and evaluate the results related to the number of service points and quantitative of treatments dispensed from July/2021 to February/2022 in the State of Rio de Janeiro. The methodology included a literature review on the role of treatment as a strategy to eliminate viral hepatitis, and the description of the activities planned and carried out in the timeline since the beginning of the process after the legal basis and the publication of norms, and the extraction of data and information on the number of treatments from SICLOM. The migration resulted in 1084 treatments from July to December 2021, corresponding to 56.4% of the total 1922 treatments dispensed by the Specialized Pharmaceutical Assistance Component (CEAF) throughout 2020. The migration was successful, increasing from 29 specialized dispensing centers to 61 DMUs, which are the pharmacies of the strategic component, making dispensing more agile than the previous wait. Despite the negative effects caused by the pandemic, it can be considered that there was a great advance in the public policy of assistance to viral hepatitis.


Subject(s)
Pharmaceutical Services , Health Evaluation , Health Policy , Hepatitis, Viral, Human/drug therapy , Unified Health System , Brazil
19.
Braz. J. Pharm. Sci. (Online) ; 58: e18593, 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1403731

ABSTRACT

Abstract In the epistemic field, several studies demonstrate the importance of pharmaceutical services in health care networks. Nonetheless, literature still addresses the strengths and barriers present in the provision of these services in an incipient way. Thus, this study aimed to understand these contexts in the development of clinical services for primary health care in the Federal District, Brazil. A qualitative study adopted the technique of open-script interview, structured based on the logic of the SWOT matrix. Pharmacists reported weaknesses such as precariousness and scarcity of physical infrastructure, material, and human resources. As threats, they discussed the lack of social recognition, discontinuities of government actions, and lack of preparation of the pharmacist for the provision of clinical services. Regarding themes pertaining to the service's strengths and opportunities, the advances in propositions and executions of public policies, actions, and governmental programs that have expanded the pharmaceutical workforce in primary care and that are impelling the accomplishment of clinical services were listed. This study contributes to understanding the scenario of the development of clinical pharmaceutical services, and consequently provides subsidies for the actions of planning, evaluation and qualification of health services.

20.
Braz. J. Pharm. Sci. (Online) ; 58: e20029, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1403734

ABSTRACT

Abstract Pharmaceutical services correspond to a set of actions that aim to guarantee the integral access and rational use of drugs by the population. In this sense, this study aimed to identify the frequency and conditioning factors for clinical services of primary care in the Federal District, Brazil. A quantitative cross-sectional study was conducted, in which 34 pharmacists were interviewed. The most frequently developed clinical pharmaceutical services were dispensing, pharmaceutical guidance for users, and technical-pedagogical activities for the health team. There is a greater frequency of operation of clinical services by pharmacists working in pharmacies with physical infrastructure, with better levels of adequacy, greater support from management and health staff, and the inclusion in Family Health Support Nucleus activities. Although the clinical pharmaceutical services in primary care are incipient, the study raises important data for the reorientation and qualification of these actions.

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