Pharmaceutical care in Brazil’s primary health care

Abstract

OBJECTIVE To characterize the activities of clinical nature developed by pharmacists in basic health units and their participation in educational activities aiming at health promotion.METHODS This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015), a cross-sectional and exploratory study, of evaluative nature, consisting of a survey of information in a representative sample of cities, stratified by the Brazilian regions that constitute domains of study, and a subsample of primary health care services. The interviewed pharmacists (n=285) were responsible for the delivery of medicines and were interviewed in person with the use of a script. The characterization of the activities of clinical nature was based on information from pharmacists who declared to perform them, and on participation in educational activities aiming at health promotion, according to information from all pharmacists. The results are presented in frequency and their 95% confidence intervals.RESULTS From the interviewed subjects, 21.3% said they perform activities of clinical nature. Of these, more than 80% considered them very important; the majority does not dispose of specific places to perform them, which hinders privacy and confidentiality in these activities. The main denominations were “pharmaceutical guidance” and “pharmaceutical care.” The registration of activities is mainly made in the users’ medical records, computerized system, and in a specific document filed at the pharmacy, impairing the circulation of information among professionals. Most pharmacists performed these activities mainly along with physicians and nurses; 24.7% rarely participated in meetings with the health team, and 19.7% have never participated.CONCLUSIONS Activities of clinical nature performed by pharmacists in Brazil are still incipient. The difficulties found point out to the professionals’ improvisation and effort. The small participation in educational activities of health promotion indicates little integration of pharmacists with the health team and of pharmaceutical services with other health actions.

Cost-consequence analysis of Pharmaceutical Care program for systemic arterial hypertension in the public health system in Brazil

“…As in the case of chronic nontransmittable diseases such as SAH, the preventive care is essential to avoid future comorbidity costs caused by SAH, being feasible that this strategy occurs at the level of primary care (Araújo, Ueta, Freitas, 2005;Borges, 2008;Borges et al, 2011;Malachias et al, 2016).…”

“…The PHS has sought alternatives to work around this panorama of SAH in Brazil, outlining strategies and care proposals that promote improved clinical results and preventive patient care (Araújo, Ueta, Freitas, 2005;Malachias et al, 2016). A health technology capable of providing better prospects in the control of chronic diseases, especially SAH, is Pharmaceutical Care (PC) (Araújo, Ueta, Freitas, 2005;De-Castro, Correr, 2007;Lyra-Jr, Marcellini, Pelá, 2008;Pereira, Freitas, 2008;Zubioli et al, 2013).…”

“…A health technology capable of providing better prospects in the control of chronic diseases, especially SAH, is Pharmaceutical Care (PC) (Araújo, Ueta, Freitas, 2005;De-Castro, Correr, 2007;Lyra-Jr, Marcellini, Pelá, 2008;Pereira, Freitas, 2008;Zubioli et al, 2013). It is a model of professional practice in which the pharmacist uses clinical and humanistic skills to promote patient care through pharmacotherapeutic follow up (Ivama et al, 2002).…”

Serviços Farmacêuticos Clínicos Na Atenção Primária À Saúde Do Brasil

“…Na atenção primária, o farmacêutico desempenha serviços categorizados como gerenciais e clínicos (Carvalho et al, 2016;Araújo, S. et al, 2017). Os serviços gerenciais (também conhecidos como 'serviços de logística') se caracterizam como um conjunto de atividades interdependentes, focadas na qualidade e na disponibilidade de medicamentos e produtos para saúde, com suficiência e regularidade (Pinheiro, 2010; Correr, Otuki e Soler, 2011; Organización Panamericana de la Salud, 2013; Brasil, 2014).…”

“…Os serviços gerenciais (também conhecidos como 'serviços de logística') se caracterizam como um conjunto de atividades interdependentes, focadas na qualidade e na disponibilidade de medicamentos e produtos para saúde, com suficiência e regularidade (Pinheiro, 2010; Correr, Otuki e Soler, 2011; Organización Panamericana de la Salud, 2013; Brasil, 2014). Estão inseridos nesse contexto as atividades de seleção, programação, aquisição, armazenamento e distribuição (Brasil 2014;Araújo, S. et al, 2017;Gerlack et al, 2017).…”