Pharmaceutical care has undergone several transformations in the health context over the years. Thus, the pharmacist has suffered a reconfiguration of his performance, mainly with the incorporation of clinical services and patient approach. The study analyzed the results of the implementation of pharmaceutical clinical services in Primary Health Care, through the use of indicators of supply, demand and productivity, clinical and process quality related to pharmaceutical care. We included all the clinical visits (n=1,833) performed to 1,080 users in 12 Basic Health Unit facilities from May to November 2016, of which 40.8% (n=748) were consultations in the establishments and 50.2% (n=1,085) home visits. Most patients (73.5%) were referred by team and 17.5% were captured through active search. Of the total workload, 12.5% were dedicated to pharmaceutical consultations and 20.0% to home visits. In total, we identified 3,078 pharmacotherapy-related issues, an average of 2.8 per patient, and 6,882 pharmaceutical interventions were performed, equivalent to 6.3 interventions per patient. The problem with adherence to pharmacotherapy and the intervention of medication counseling were the most found. Results reinforce the importance of pharmaceutical clinical services in identifying the control of the most prevalent health conditions and monitoring the therapeutic results associated with drug use.

The objective is to reveal the difficulties concerning the access and use of medicines by elderly individuals with dementia, reported by their caregivers. This qualitative study applied the participant observation method during pharmaceutical appointments performed in a specialized geriatrics service of the University Hospital of Brasília. Caregivers reported facing difficulties regarding the itinerary for medicines access in public pharmacies, as well as the high cost of these technologies in private establishments. Psychiatric symptoms, cognitive deficits, behavioral changes, apraxia, dysphagia, among other clinical manifestations of dementia syndromes, incapacitates the elderly for self-responsibility concerningthe use of drugs, which accentuates the complexity of medicines administration within the care process. In conclusion, it is fundamental to recognize caregivers' role in promoting the rational use of medicines, and so this theme should be highlighted within the pharmaceutical services context.

Background In early 2020, the COVID-19 pandemic paralyzed the world and exposed the fragility of health systems in the face of mass illness. Health professionals became protagonists, fulfilling their mission at the risk of physical and mental illness. The study aimed to evaluate absenteeism indirectly related to SARS-CoV-2 infection in a large population of health care professionals. Methods An observational longitudinal repeated measures study was performed, including workers linked to 40 public university hospitals in Brazil. All causes of absenteeism were analyzed, focusing on those not directly attributed to COVID-19. Results for the same population were compared over two equivalent time intervals: prepandemic and during the pandemic. Findings A total of 32,691 workers were included in the study, with health professionals comprising 82.5% of the sample. Comparison of the periods before and during the pandemic showed a 26.6% reduction in work absence for all causes, except for COVID-19 and mental health-related absence. Concerning work absence related to mental health, the odds ratio was 39.0% higher during the pandemic. At the onset of the pandemic, there was an increase in absenteeism (all causes), followed by a progressive reduction until the end of the observation period. Interpretation Work absence related to mental illness among health care professionals increased during the COVID-19 pandemic, highlighting the need for health care managers to prioritize and implement support strategies to minimize absenteeism.

Background Since the beginning of the COVID-19 pandemic, health professionals have been working under extreme conditions, increasing the risk of physical and mental illness. We evaluated the prevalence of burnout and its associated factors among postgraduate student residents in health professions during the global health crisis. Methods Healthcare residents were recruited from all across Brazil between July and September 2020 through digital forms containing instruments for assessing burnout (Oldenburg Burnout Inventory (OLBI)), resilience (brief resilient coping scale (BRCS)) and anxiety, stress and depression (depression, anxiety and stress scale (DASS-21) and Patient Health Questionnaire (PHQ-9)). Additionally, the relationships between burnout and chronic diseases, autonomy and educational adequacy in the residency programme, personal protective equipment (PPE), workload and care for patients with COVID-19 were evaluated. The chi-square test, Student’s t test, Pearson’s correlation test and logistic regression were performed. Results A total of 1,313 participants were included: mean (standard deviation) age, 27.8 (4.4) years; female gender, 78.1%; white race, 59.3%; and physicians, 51.3%. The overall prevalence of burnout was 33.4%. The odds (odds ratio [95% confidence interval]) of burnout were higher in the presence of pre-existing diseases (1.76 [1.26–2.47]) and weekly work > 60 h (1.36 [1.03–1.79]) and were lower in the presence of high resilience (0.84 [0.81–0.88]), autonomy (0.87 [0.81–0.93]), and educational structure (0.77 [0.73–0.82]), adequate availability of PPE (0.72 [0.63–0.83]) and non-white race (0.63 [0.47–0.83]). Burnout was correlated with anxiety (r = 0.47; p < 0.05), stress (r: 0.58; p < 0.05) and depression (r: 0.65; p < 0.05). Conclusions We observed a high prevalence of burnout among residents during the COVID-19 pandemic. Individual characteristics and conditions related to the work environment were associated with a higher or lower occurrence of the syndrome.

A doença causada pelo novo coronavírus 2019 (COVID-19) é uma condição respiratória infecciosa que emergiu em dezembro de 2019 na China e assumiu proporções pandêmicas em março de 2020, com potencial de sobrecarga dos sistemas de saúde de todo o mundo. Nesse sentido, estratégias de enfrentamento à COVID-19 são de grande relevância em saúde pública, dentre as quais as da Escola de Pacientes DF (EP-DF), que, sendo baseadas em gestão clínica e educação permanente e Educação em Saúde, promovem padrão de cuidado e autocuidado ao paciente. Nesse contexto, materiais educativos individuais impressos e audiovisuais online comunitários são utilizados como recursos assistenciais complementares ao atendimento, como por exemplo materiais técnicos para profissionais de saúde, organizados em Capítulos compartilhados no Google Drive. As orientações contendo informações essenciais para o autocuidado são entregues ao paciente usando mecanismos preventivos de contágio e mantidas com o usuário em sua Pasta da Saúde. Há também ênfase em boas práticas de proteção individual e coletiva, higiene respiratória, distanciamento social, isolamento e sinais de alarme. Fontes bibliográficas preferenciais para atualização dos Capítulos são planos, diretrizes e protocolos do Ministério da Saúde,

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.

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BACKGROUND A growing body of evidence suggests that infection by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) during pregnancy may affect maternal-fetal outcomes, with possible implications for the long-term development of exposed children OBJECTIVE The PRegnancy OUtcomes and child Development Effects of SARS-CoV-2 infection STudy (PROUDEST) is a multicenter prospective study designed to understand the repercussions of COVID-19 to mother-child global health. METHODS The PROUDEST trial comprises two prospective sequential substudies. The PREGNANT substudy will assess the effects of SARS-CoV-2 infection on pregnancy, childbirth and puerperium clinically and from a mechanistic standpoint to understand the inflammatory and immunological phenomena underlying COVID-19 in relation to pregnancy. Pregnant women aged 18 to 40 years with laboratory-proven exposure to SARS-CoV-2 (group A, n = 300) will be compared to control subjects with no laboratory evidence of in-pregnancy exposure to the virus (group B, n = 300). Subjects exposed to other infections during pregnancy will be excluded. The BORN substudy is a long-term follow-up study assessing the offspring of women who entered the prior substudy. It will describe the effects of SARS-CoV-2 exposure during pregnancy on children’s growth, neurodevelopment and metabolism from birth up to five years of age. It includes two comparison groups: group A (exposed, n = 300) comprises children born from SARS-CoV-2-exposed pregnancies, and group B (controls, n = 300) comprises children from nonexposed mothers. RESULTS The recruitment has begun in July, 2020 and until September, 2020, 115 pregnant women infected with SARS-CoV-2 during pregnancy and 80 newborns were included. Data analysis is scheduled to start after all inclusion data have been collected. CONCLUSIONS Upon completion of the study, we expect to have obtained comprehensive data to provide a better understanding of the effects of SARS-CoV-2 and its inflammatory and immunological processes on pregnancy, puerperium and infancy. Our findings will inform clinical decisions regarding the care of exposed mothers and children and support the development of evidence-based public health policies. CLINICALTRIAL The PROUDEST study was registered on the Brazilian Register of Clinical Trials website (https://www. http://www.ensaiosclinicos.gov.br), ID RBR-65qxs2, on June 13th, 2020, where Brazilian clinical trials are exclusively registered.