Quality indicators of pharmacists' services in community pharmacies in Paraná State, Brazil

ABSTRACT Pharmacists and their pharmacies have been evolving in their roles as health promoters in Brazil. Some examples are the recent legislation reaffirming the role of Brazilian pharmacies as health institutions, rather than having only a commercial profile, giving greater clarity to pharmacists about their roles as health care providers. This evolution came with the recognition that is already seen in other developed countries, confirming the need for the pharmacist as a health promoter, and not simply a dispenser of drugs in society. This study has obtained the profile and activities of community pharmacists, as well as the quality indicators of private community pharmacies throughout the State of Paraná through the application of an online survey sent to pharmacists in the state. Out of all pharmacists surveyed, 533 were part of the final analysis, being the pharmacists to complete the survey in full. Participants were mostly female (69.4%) and were, on average, 35.2 ± 9.2 years old. Of these, 60% worked in pharmacy chains and just 37% of all pharmacist respondents were issuing the Declaration of Pharmaceutical Services. The current study showed that many pharmaceutical services are not adopted by pharmacies as these services bring no significant financial reward. Regarding the structure, the Paraná State showed that pharmacies present a good overall structure. The kind of pharmacy (chain or independent) influenced the pharmaceutical services provided and the available structure, where the independent pharmacies provide a wider range of services and have better structure. This study was able to identify the profile and behaviors of pharmacists and also the quality indicators of pharmacies in Paraná State.

The practice of OTC counseling by community pharmacists in Parana, Brazil / La práctica del asesoramiento en OTC por farmacéuticos comunitarios de Paraná, Brasil

Background: In order to provide appropriate advice to the patient at the time of dispensing and over-the-counter (OTC) medication counseling, community pharmacists need access to current and reliable information about medicines. Brazilian pharmacists have assumed new functions such as prescribing medication, in a dependent model, based in protocols. Objective: To examine the practice of community pharmacists in a Brazilian State, focusing on OTC recommendation. Method: A cross-sectional survey of community pharmacists in a state of Brazil was conducted from October 2013 to January 2014, with data collection through a pre-piloted self-administered anonymous survey via Survey Monkey® platform. Following ethical approval, the online instrument was sent to 8,885 pharmacists registered in Parana State, Brazil, focusing on professionals working in community pharmacies. The questionnaire assessed the community pharmacy setting, the search for information, the knowledge of the evidencebased practice, the important factors to consider when recommending an OTC medicine, and the pharmacist prescribing. Responses were imported into SPSS® (version 22.0) for analysis. Nonparametric tests were used to assess the association between responses and demographic information with a significance level less than 5% (p<0.05). Results: Of the pharmacists, 97.4% dispensed medications and counseled patients for a median of six hours per day. Product's efficacy (97%) and adverse effects (62.3%) were the most important factors taken into account when counseling a nonprescription medicine. Few pharmacists knew the meaning of terms related to evidence-based health. Most respondents agreed that pharmacists have the necessary training to prescribe. Conclusion: Over-the-counter medication counseling is a daily practice among Brazilian pharmacists. Learning needs exist for community pharmacists in relation to evidence-based practice. Thus, sources of information with good evidence could be used daily by community pharmacists, especially as regards nonprescription medication counseling (AU)

Antecedentes: Para proporcionar asesoramiento adecuado al paciente en la dispensación de medicamentos over-the-counter (OTC), los farmacéuticos comunitarios necesitan acceso a información actual y fiable sobre medicamentos. Los farmacéuticos brasileños han asumido nuevas funciones, tales como la prescripción de la medicación, en un modelo independiente basado en protocolos. Objetivo: Examinar la práctica de los farmacéuticos comunitarios en un estado de Brasil, centrándose en las recomendaciones de OTC. Métodos: Se realizó un estudio transversal de farmacéuticos comunitarios en un estado de Brasil entre octubre 2013 y enero 2014, con recogida de datos mediante un cuestionario auto-administrado, pre-pilotado y anónimo en una plataforma Survey Monkey®. Después de la aprobación ética, se envió el instrumento online a 8.885 farmacéuticos registrados en el estado de Paraná (Brasil), centrándose en los profesionales que trabajan en farmacia comunitaria. El cuestionario evaluaba el establecimiento de la farmacia comunitaria, la busca de información, el conocimiento de las prácticas basadas en la evidencia, los factores importantes a considerar cuando se recomienda un medicamento OTC, y la prescripción del farmacéutico. Las respuestas se importaron a SPSS® (versión 22.0) para su análisis. Se usaron pruebas no paramétricas para evaluar la asociación entre respuestas y la información demográfica con un nivel de significancia de menos del 5% (p<0,05). Resultados: El 97,4% de los farmacéuticos dispensaba medicamentos y aconsejaba a pacientes durante una mediana de seis horas por día. Los factores más importantes a tener en cuenta cuando se aconsejaba un medicamento sin receta eran la eficacia del producto (97%) y los efectos adversos (62,3%). Pocos farmacéuticos conocían el significado de los términos relacionados con la práctica basada en la evidencia. La mayoría de los respondentes estaban de acuerdo con que los farmacéuticos tienen la formación necesaria para prescribir medicamentos. Conclusión: El asesoramiento en medicamentos overthe- counter es una práctica diaria entre los farmacéuticos brasileños. Existen necesidades formativas de los farmacéuticos comunitarios en relación a la práctica basada en la evidencia. Así, los farmacéuticos comunitarios podrían usar a diario las fuentes de información con buena evidencia, especialmente relativas al asesoramiento de medicación sin receta (AU)

Análise das propagandas dos medicamentos isentos de prescrição veiculadas em revistas para prescritores na área médica / Analysis of advertisements for OTC drugs aimed at prescribers in the medical

O presente artigo apresenta uma análise da qualidade das propagandas de medicamentos isentos de prescrição destinadas à classe médica, baseado na nova RDC no 96, de 17 de dezembro de 2008. Para análise coletou-se 16 fascículos da Revista Brasileira de Medicina (RBM) a partir de agosto 2009 a dezembro de 2010. Para averiguação da qualidade, elaborou-se um questionário dividido em três partes. Ao todo 160 peças publicitárias foram encontradas, em que 27 delas eram referentes aos medicamentos isentos de prescrição, contemplando nove indústrias farmacêuticas. Observou-se que nenhuma das peças publicitárias cumpriu na íntegra as novas regras exigidas na legislação vigente (RDC 96/08), apresentando infrações desde identificação da mesma até as proibições de figuras humanas e mensagens subjetivas. Portanto, concluiu-se que: há necessidade de implantação de um instrumento mais efetivo de fiscalização, a fim de melhorar à qualidade das propagandas para poderem ser usadas como fonte fidedigna de informação e atualização aos prescritores.

This article presents an analysis of the quality of advertisements for over-the-counter (OTC) drugs addressed to the medical profession, based on the new Anvisa resolution RDC 96 (17/12/2008). For this analysis, 16 volumes of the Brazilian Journal of Medicine (RBM) were collected, from August 2009 to December 2010. To investigate the quality of the adverts, we prepared a questionnaire divided into three parts. In total, 160 advertisements were found, of which 27 were related to drugs exempt from prescription, from 9 laboratories. It was observed that none of the advertisements complied fully with the new rules, as required by legislation (RDC 96/08), with violations ranging from identification of the advert to prohibitions of human figures and subjective messages. Therefore, it was concluded that there is a need to implement more effective monitoring, so as to improve the quality of the adverts, so they can be used as a reliable source of information and update by prescribers.