RESUMO
Background: Research on medicines access and use is heterogeneous and can be challenging for decision-makers to interpret. Pharmaceutical policy is an additional component for study and is the foundation for the promotion of access and use of medicines. This systematic review summarizes findings from the literature on medicines policy, access and use over the past two decades in Mexico and identifies research gaps that should be addressed. Methods: A systematic review of the literature published between 2000 and 2022 was conducted to identify publications on medicines policy, access and use in Mexico. The study followed PRISMA Statement guidelines 2020. A narrative review including content analysis was conducted. Results: A total of 5057 articles were reviewed, of which 77 fit the inclusion criteria. Studies described the lack of an explicit national policy, a misalignment between the legal framework and reinforcement incentives, deficient policy documentation at the national level, and the absence of necessary medicines regulation and transparency. In terms of access to medicines, challenges related to supply, selection, acquisition, distribution and expenditure were noted. Regarding medicine use, key study findings included a lack of adherence to standard treatment guidelines, dispensing, lack of reliable information on medicines, lack of treatment adherence and harmful self-medication. Conclusion: The appropriate use of medicines and adequate access to them are priority topics for the formulation of Mexican pharmaceutical policy. It is critical that further research includes longitudinal studies of medicine access and use, and the consideration of studying the private sector as well as new methodological approaches. Many reported challenges related to access to and use of medicines have persisted across decades, suggesting a lack of effective research-to-practice knowledge transfer and policy implementation.This article is part of the Hospital pharmacy, rational use of medicines and patient safety in Latin America Special Issue: https://www.drugsincontext.com/special_issues/hospital-pharmacy-rational-use-of-medicines-and-patient-safety-in-latin-america/.
RESUMO
Background: Pharmacy practice (PP) research is a new discipline that studies the scope of interventions and health services performed by pharmacists. Information on PP in Latin America is available; however, to date, it has not been methodically analysed. It is critical to understand the current level of evolution of pharmaceutical activities to support evidence-based decision-making. Methods: We performed a review of PP literature published in five databases, of which two were international and three were focused on Latin America. The data obtained were qualitative, such that the strategies used for data search and collection were structured by PRISMA guidelines, and data synthesis and analysis were conducted through a narrative review. Results: Of the 1863 articles found in the initial search, 108 were included in the final analysis. The majority of these were conducted in Brazil (n=73, 74%) and Colombia (n=14, 13%). The interventions and services most frequently reported were dispensing (n=24, 22%), clinical pharmacy services (n=21, 19%) and pharmaceutical care (n=21, 19%). Most studies focused on only one key strategic area (n=94, 87%), specifically on health services provision. Conclusion: PP in Latin America follows worldwide trends to some extent with regard to the inclusion of clinical pharmacy and pharmaceutical care. However, the region also demonstrates particularities, including the heterogenous level of development amongst its countries. It is vital for Latin American pharmacists to publish their activities, interventions and services in order to generate a solid evidence base to evaluate practice and support informed decision-making.
