Atividades da farmácia hospitalar brasileira para com pacientes hospitalizados: uma revisão da literatura

Abstract

This paper discusses the literature on hospital pharmacy services for in-patients in Brazil, seeking a broader view of its characteristics and priorities. Seventeen papers were located in the Medline and Lilacs databases that complied with the pre-defined inclusion/exclusion criteria. Most of them were related to teaching and research, logistics and compounding, based on observations in public hospitals in Southeast Brazil. Few studies focused on core activities such as management and selection. The academic syllabus through which pharmacy students are trained may underlie the perception that compounding is the preponderant aspect of hospital pharmacy services, although this is required in only a few institutions. Added to this is poor compliance by pharmacy activities with established norms and standards and the lack of an indexed Brazilian publication in this field. As there were far more studies of the public sector than its private counterpart, it seems as though there is either greater freedom of action in the former or less scientific output in the latter, quantified by published studies.

Hospital pharmacy workforce in Brazil

“…While in developed countries such as the USA, pharmacy technicians are taking on administrative and clinical responsibilities to support pharmacists, this is not yet the case in Brazil [ 12 , 15 , 16 ]. Brazilian studies conducted by Magarinos-Torres et al and Freitas et al described factors negatively influencing pharmacists’ clinical responsibilities: the hospital manager is not interested in clinical activities or does not recognize the pharmacist as a clinical professional; insufficient clinical training in undergraduate studies; difficulty interacting with other professional categories; pharmacists do not recognize themselves as healthcare professionals and do not understand they can perform clinical functions; no structural contribution to develop clinical activities; administrative, logistic and bureaucratic time-consuming tasks, not leaving time for clinical activities [ 17 , 41 ].…”

“…In addition, the Minimum Standards for Hospital Pharmacy and Healthcare Services recommend at least one pharmacist for every 50 hospital beds for basic dispensing services [ 14 ]. Despite these recommendations and growing evidence that hospital pharmacy services improve patients’ clinical outcomes [ 15 , 16 ], low compliance with these legal requirements and standards have been observed [ 17 ]. Brazil currently has a higher density of pharmacists (9.1 per 10,000 population) than the global average (6 per 10,000 population) with growing capacity over the past years [ 4 , 18 ].…”

Avaliação do Serviço de Armazenamento nas Farmácias dos Hospitais Estaduais de Florianópolis, 2015.

“…Contudo, dentro da atividade da farmácia hospitalar brasileira, cabe ao serviço de armazenamento a responsabilidade por manter as propriedades originais dos medicamentos que estão armazenados; além da responsabilidade de fornecer informações fidedignas e atualizadas sobre o estoque, sempre que necessário. Ainda assim, problemas existem neste componente (Magarinos-Torres et al, 2007a). Mesmo na Atenção Básica, muitos resultados deficitários são apresentados neste contexto (Vieira et al, 2012).…”

“…O armazenamento está diretamente ligado a possíveis adulterações na estabilidade dos medicamentos e deve acontecer de maneira eficaz para que a assistência farmacêutica não fique comprometida e ocorra adequadamente. Diversos estudos apontam falhas no armazenamento de medicamentos e controle de estoque de medicamentos no sistema público de saúde (Rabuñal-Alvarez et al, 2013;Yu & Chan, 2011;Oliveira, Assis, & Barboni, 2010;Magarinos-Torres, Osorio-de-Castro, & Pepe, 2007a).…”

Brazilian scientific production on pharmaceutical care from 1990 to 2009

“…Regarding the hospital pharmacy, Margarinos-Torres, Osório-de- Castro and Pepe (2007) highlighted that there is still a scarcity of literature related to Brazilian studies on pharmacotherapeutic follow-up of hospitalized patients. This lack of studies may be explained by the fact that hospital pharmacies have, in general, major structural problems related to management, screening and logistics, such as: a) planning regarding the purchase of products; b) standardization of drugs; c) qualification process of suppliers; d) recording of stock movement; e) storage conditions; f) disposal of expired products; g) definition of weaknesses in the process of distribution and dispensing, among others, that need to be dealt with before pharmacotherapeutic follow-up studies are accomplished on a larger scale.…”