Analysis of the pharmaceutical assistance cycle in Romelândia, Santa Catarina, Brazil

Abstract

The Pharmaceutical Assistance Cycle (PA) is the basis for healthcare services through which pharmaceutical assistance and expertise can be implemented in a functional and structured way to meet public health demands, adhere to the Brazilian Ministry of Health vision, and strike a balance in the contemporary struggle for health equity. The aim of this research is to analyze the effectiveness of the PA cycle in the city of Romelândia (SC), through a study conducted at a Primary Healthcare Unit in the municipality. For the study, 120 patients (service users) and seven healthcare professionals were interviewed. The majority of patients confirmed that they were given advice and instruction on dosage during the dispensing process, as well as advice on the recommended use of medicines and course duration. A small number of service users, 4.1%, said that they received instructions on adverse drug interactions; 36.6% commented on a lack of access to medicines available in the municipal pharmacy, and 71.4% of the health professionals interviewed, identified non-availability of medicines in the pharmacy as the most pressing and telling problem facing the service. There is also no local Pharmacy and Therapeutics Committee, and the only selection criteria is the Ministry of Health essential medicines list. Our study has therefore identified several weaknesses facing the city healthcare service, namely: the shortage of medicines; a lack of resolute professional communication between pharmacist and service user; a lack of patient counseling during the dispensing process, and a lack of communication regarding patient follow-up treatment and wellbeing. O ciclo da Assistência Farmacêutica (AF) é o norte para a implementação das ações da AF nos serviços de saúde de maneira estruturada e funcional como preconiza o Ministério da Saúde. O objetivo deste estudo foi diagnosticar as ações do ciclo da AF em Romelândia (SC). O estudo foi realizado na Unidade Básica de Saúde do município onde foram entrevistados 120 usuários e sete profissionais de saúde envolvidos diretamente nas ações de AF. Dos 120 usuários entrevistados, a maioria recebe orientações no momento da dispensação sobre a posologia, modo de usar e duração do tratamento. Poucos (4,1%) recebem informações sobre interações e reações adversas 36,6% não encontram o medicamento na farmácia municipal quando necessitam e para 71,4% dos profissionais, a falta do medicamento na farmácia é o principal problema da Secretaria de Saúde (SS), pois não atende a quantidade programada. O município não tem Comissão de Farmácia e Terapêutica e o critério para a seleção dos medicamentos na SS é a lista da farmácia básica e a demanda. O estudo indica como fragilidade, a falta constante do medicamento e de orientação farmacêutica no momento da dispensação bem como o acompanhamento dos usuários.

Indicators related to the rational use of medicines and its associated factors

“…The transmission of medicine guidelines is fundamental for the adherence to treatment and success of pharmacological therapy 21 . In our study, 74.8% of users reported having received information at the pharmacy on how to use the medicines, a proportion lower than that of a study conducted in a Brazilian city (92.5%) 18 . The professionals who reported the presence of a full-time pharmacist in the UBS had a greater chance of transmitting information to users.…”

Pharmaceutical services in primary health care: dissatisfaction among users, managers and pharmacists

“…The scenario identified in the studied municipality -demonstrated by PS results and the perception of users, managers and pharmacists-converges with data from previous studies, which showed that the absence of fulltime pharmacists in pharmacies hinders communication with users and impedes their adherence to treatment (Prevedello, Busato, 2014), revealing how essential their constant presence is (Mendes et al 2015).…”

“…The managers suggested that medicine shortage also influenced dispensing, which has also been found in other studies (Helena, Andersen, Menoncin, 2015;Bonadiman et al, 2018;Rover et al, 2017). Shortages can be triggered on account of misdirected prioritizing and purchasing by municipal managers and responsible professionals (Prevedello, Busato, 2014).…”