Access to medicines:

Abstract

OBJETIVE To analyze the relationship between access to medicines by the population and the institutionalization of pharmaceutical services in Brazilian primary health care.METHODS This study 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, exploratory, and evaluative study composed of an information survey in a representative sample of cities, stratified by Brazilian regions. Access was defined based on the acquisition of medicines reported by the patient, ranging between: total, partial, or null. The institutionalization of pharmaceutical services was analyzed based on information provided by pharmaceutical services providers and by those responsible for medicines delivery. Chi-square test and multinomial logistic regression were used in the statistical analysis.RESULTS Full access to medicines was greater when professionals affirmed there were the following aspects of the dimensions: “management tools,” “participation and social control,” “financing,” and “personnel structure,” with significant associations in the bivariate analysis. The “pharmaceutical care” dimension did not achieve such an association. After multinomial logistic regression, full access was more prevalent when those in charge of pharmaceutical services stated that: they always or repeatedly attend meetings of the Municipal Health Council, OR = 3.3 (95%CI 1.5-7.3); there are protocols for medicines delivery, OR = 2.7 (95%CI 1.2-6.1); there is computerized system for managing pharmaceutical services, OR = 3.9 (95%CI 1.9-8.0); those responsible for medicines delivery reported having participated in a course or training for professionals in the past two years, OR = 2.0 (95%CI 1.1-3.5); there is computerized system for pharmaceutical services management, OR = 4.3 (95%CI 2.4-7.5).CONCLUSIONS Aspects related to the institutionalization of pharmaceutical services have been strongly related to access to medicines. Our results indicate the need to prioritize its implementation, contributing to its consolidation in Brazil and to the effectiveness of health services regarding the purposes of pharmaceutical services policies.

Availability of Analgesic and Anti-Inflammatory Medicines in Primary Health Care

“…Some published studies indicate that more well-structured healthcare units have better conditions to stock the medicines properly. Moreover, temperature control by an air-conditioning system in the storage room, the presence of a refrigerator in which to lay thermolabile medications, and the presence of a computerized system were linked to higher availability rates [18][19][20]. According to current Brazilian legislation, a health clinic is a unit that provides health assistance to a specific population by a mid-level professional, with or without the intermittent physical presence of a physician [23].…”

“…Poor planning, lackluster management, and the lack of financial resources from funding sources are associated with low medicine availability rates [19]. Previous research proposes interventions to cope with this low availability, such as social control, the existence of a Permanent Bidding Committee to buy medicines, and the regular participation of the professionals responsible for the disposal of medicines in the Municipal health council meetings [20].…”

“…The WHO estimates that one-third of the world's population does not have regular access to these medicines [17]. Physical structure, the good management of the healthcare services, and the presence of the pharmacist in the PHC units seems to be associated with higher availability rates [18][19][20].…”

Avaliação Da Potencialização Do Efeito Da Azitromicina Pela Ação Antimicrobiana Do Alho (Allium Sativum)

“…A trajetória da AF no Brasil aponta avanços e desafios para sua consolidação como política de Estado, cujo principal objetivo é a atenção integral à saúde da população (SOUZA et al, 2017).…”

What we know about antibiotics prescribed by dentists in a Brazilian southeastern state

“…14 Literature points to some factors that may explain the association between drug dispensing and socioeconomic characteristics of municipalities and service organization. 15 Moreover, aggregated data on antibiotic consumption may serve as a proxy for their actual use. 5 Ecological studies have been more frequently developed in recent years because they present the potential to assess the occurrence of associations between context determinants and specific health outcomes in a population group.…”