Nível de satisfação dos usuários e verificação do conhecimento dos farmacêuticos em farmácias públicas do Espírito Santo, Brasil / Satisfaction levels of users and verification of the knowledge of pharmacists in public pharmacies in the State of Espírito Santo, Brazil

Resumo O objetivo do presente estudo foi determinar o nível de satisfação dos usuários de farmácias públicas e verificar o conhecimento dos farmacêuticos com relação à dispensação de medicamentos. Trata-se de um estudo descritivo, realizado em municípios de uma mesma região, no interior do Estado do Espírito Santo, no período de maio a agosto de 2013. Os dados foram coletados por meio de questionário estruturado. Para a análise estatística, foi utilizado o Software SPSS20. Para os dados que apresentaram distribuição normal foram aplicados o teste t student ou ANOVA, enquanto que para os demais foram aplicados os testes Mann-Whitney ou Kruskal -Wallis. A correlação de Spearman foi utilizada para avaliar a satisfação do paciente em relação ao tempo de atendimento e ao tempo de espera. O nível de significância adotado para os testes foi de 5%. Os principais resultados obtidos foram o alto nível de insatisfação por parte dos usuários e a correlação com o tempo de espera até o atendimento. Além disso, o conhecimento dos farmacêuticos em relação à dispensação foi classificado como satisfatório/regular. Conclui-se que são necessárias medidas na gestão de serviços farmacêuticos para atender as expectativas dos usuários na dispensação de medicamentos.

Abstract The scope of this study was to determine the satisfaction levels of users of public pharmacies and verify the knowledge of pharmacists in relation to dispensing of medicines. This is a descriptive study, conducted in municipalities in the State of Espírito Santo, in the period from May to August 2013. Data were collected using a structured questionnaire and SPSS20 software was used for statistical analysis. The Student t or ANOVA test was used for data with normal distribution, while the Mann-Whitney or Kruskal-Wallis test was applied for data without normal distribution. The Spearman correlation was used to evaluate patient satisfaction with the service time and the waiting time. The significance level for the tests was 5%. The main results obtained were the high level of dissatisfaction among users and the correlation with the waiting time to be attended. Apart from this, the knowledge of pharmacists in relation to the medication dispensed was classified as satisfactory/regular. The conclusion drawn is that actions are necessary in the management of pharmaceutical service to address the expectations of users in the dispensation of drugs.

Coordinación entre servicios farmacéuticos para una farmacoterapia integrada: el caso de Cataluña / Coordination between pharmaceutical services for integrated pharmacotherapy: the case of Catalonia

Resumen Las políticas farmacéuticas han sido consideradas como estratégicas para contribuir con la garantía de la coordinación asistencial y la integración clínica. El presente estudio tiene como objetivo describir los servicios farmacéuticos desarrollados en diferentes niveles asistenciales en la red de salud de Cataluña, así como identificar y analizar los mecanismos e instrumentos que actúan como facilitadores y/o barreras para la coordinación de la farmacoterapia. Se trata de un estudio descriptivo de 12 casos de los servicios farmacéuticos hospitalarios, atención primaria y oficinas de farmacia comunitarias. Se identifica avances que relacionan la percepción, formalización y la coordinación asistencial y clínica de los servicios farmacéuticos. Sin embargo, se identifican también fragilidades y situaciones mejorables en cuanto a la coordinación. Se concluyó que las diferentes herramientas e instrumentos implantados, parece facilitar una mayor posibilidad de integración entre servicios farmacéuticos y de éstos con la red de salud para contribuir con una farmacoterapia integrada.

Abstract Pharmaceutical policies have been considered strategies to contribute to the guarantee of care coordination and clinical integration. This study sought to describe the pharmaceutical services developed at different levels of care in the health network in Catalonia, as well as to identify and analyze the mechanisms and instruments that act as facilitators and/or barriers to the coordination of pharmacotherapy. This is a descriptive study of 12 cases of hospital pharmacy services, primary care and community pharmacies. Advances related to the perception, formalization and clinical and assistance coordination of the pharmaceutical services were identified. However, weaknesses and potential improvements in coordination were observed. The conclusion drawn was that the different tools and instruments implemented appear to facilitate a greater possibility of integration between pharmaceutical services and the latter with the health services network to contribute to integrated pharmacotherapy.

Evaluation of community pharmacists' knowledge, attitude and practice towards good pharmacy practice in Iran

The principles of pharmaceutical care are embedded in the concept of Good Pharmacy Practice [GPP]. GPP is poorly applied in community pharmacies not only in Asian countries, but even in United States and Europe. The present study was undertaken to evaluate the knowledge, attitude and practice of the community pharmacists in Iran, regarding GPP. A total of 794 pharmacists were evaluated with a reliable and validated KAP [Knowledge, Attitude, and Practice] questionnaire regarding GPP in September 2008. The most important finding in the present study was the pharmacists' low knowledge [Mean= 13.42] and practice [Mean= 29.85] level about GPP, while their attitude towards this subject was at a high level [Mean= 74.83]. Increase in their knowledge of good pharmacy practice aligned with an increase in their attitudes towards this issue. Also increase in our pharmacists' knowledge and attitude aligned with an increase in quality of their practice. The current practice of Iranian community pharmacists needs further improvement. National pharmaceutical organizations should organize educational programs for the community pharmacists to equip them for their main role in community practice: promoting rational drug use.

Overview reflection of primary health care in Thailand supported from 1976 to 1996 by Japan-Thailand partnership.

The international health cooperation of Japan for developing countries has been mostly concentrated on matters such as improvement of hygienic environment, prevention of tropical infectious diseases, establishment of hospitals with modern medical instruments and devices, and dispatch of medical experts. PHC (Primary Health Care) activities based on voluntary participation of local inhabitants in developing countries have been largely neglected. In the field of health and medical care, sufficient effect may not be achieved unless the local health activity is based on voluntary participation of the inhabitants. The introduction of advanced modern medical technics may be beneficial to some of the inhabitants, while most of the local inhabitants may not have the chance to receive such benefits, and additionally it is difficult to propagate modern medical care and technics widely to rural areas. In Thailand, PHC activity based on community participation was started in 1985, with the following three main themes: (1) Training of Village Health Volunteers (VHV) and Village Health Communicators (VHC), and development of their activities. (2) Establishment and operation of Health Centers. (3) Establishment and operation of a Drug Cooperative System (DC). Earlier, one of PHC activities developed by Japan, "Thailand Local Health Activity Improvement Project" based on the program of Thailand-Japan Partnership, was initiated in 1976 in rural areas of Chanthaburi Prefecture. From 1982, third country training programs have been carried out by the Japan International Cooperation Agency (JICA). As 10 years have elapsed since the initiation of PHC activity in rural areas in Thailand under the cooperation of the Governments of Thailand and Japan, it seems to be time to reconsider how PHC activity should be developed in future based on a candid evaluation of achievements and results.

Remédios: saúde ou indústria? A produçäo de medicamentos no Brasil / Drugs: health or industry? The drugs production in Brazil

A questäo dos medicamentos e das vacinas é tratada evitando o recurso fácil à defesa da soberania nacional em um panorama mundial cada vez mais internacionalizado. Procura mostrar a importância de que os insumos essenciais sejam assegurados ao conjunto da populaçäo e a necessidade da intervençäo estatal no sentido de apoiar os laboratórios oficiais e as empresas nacionais voltados a estes insumos. Analisa, também, a evoluçäo da indústria farmacêutica no mundo contemporâneo, a questäo das patentes e os desafios para a inserçäo de uma política de medicamentos em uma política de saúde voltada aos interesses da populaçäo (AMSB)