A proposal for an evaluation model of pharmaceutical services for malaria

Osório-de-Castro, Claudia Garcia Serpa; Chaves, Gabriela Costa; Ruiz, Adriana Mendoza; Miranda, Elaine Silva; Campos, Mônica Rodrigues; Suárez-Mútis, Martha Cecília; Freitas, Letícia Figueira

doi:10.1590/s0102-311x2009000900021

Cited by 7 publications

(9 citation statements)

References 6 publications

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“…For analysis purposes, the following quality indicators of the prescription of antimalarials were constructed, based on the prescription indicators proposed by the Mafalda Project 14 and according to the provisions of the pertinent sanitary legislation 15 and to the guidelines of the National Malaria Control Program [5][6][7] : -proportion of prescriptions whose treatment regimens do not comply with the official protocol: estimated by the number of inadequate prescriptions concerning the medication(s) prescribed and the gestational trimester/total of prescriptions. To construct this indicator, each prescribed treatment regimen was evaluated according to the guidelines established in the official protocol for the treatment of pregnant women [5][6][7] .…”

Section: Study Variablesmentioning

confidence: 99%

Prescrições para tratamento de malária não complicada em gestantes na Amazônia Legal: evidências do Projeto Mafalda*

Luz

Miranda

Freitas

et al. 2013

Rev. bras. epidemiol.

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Section: Study Variablesmentioning

confidence: 99%

Prescrições para tratamento de malária não complicada em gestantes na Amazônia Legal: evidências do Projeto Mafalda*

Luz

Miranda

Freitas

et al. 2013

Rev. bras. epidemiol.

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“…Initially, in order to subsidize the project, a comprehensive review of pharmaceutical services for malaria was carried out and published [ 12 ]. The framework comprising a logic model and 25 indicators was developed and subsequently published [ 13 ]. The indicators included in the framework encompassed the following dimensions: context and organization of pharmaceutical services, prescribing, dispensing and (implementation) adherence to treatment.…”

Section: Methodsmentioning

confidence: 99%

Dispensing and determinants of non-adherence to treatment for non complicated malaria caused by Plasmodium vivax and Plasmodium falciparum in high-risk municipalities in the Brazilian Amazon

Osorio-de-Castro

Suárez-Mútis

Miranda

et al. 2015

Malar J

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BackgroundIn Brazil, 99.7 % of malaria cases occur in the Amazon region. Although the number of cases is decreasing, the country accounted for almost 60 % of cases in the Americas Region, in 2013. Novel approaches for malaria treatment open the possibility of eliminating the disease, but suboptimal dispensing and lack of adherence influence treatment outcomes. The aim of this paper is to show the results on dispensing practices, non-adherence and determinants of non-adherence to treatment of non-complicated malaria.MethodsThe study was conducted in six high-risk municipalities with Plasmodium vivax and Plasmodium falciparum transmission in the Brazilian Amazon and based on the theoretical framework of the Mafalda Project, which included investigation of dispensing and adherence. The World Health Organization Rapid Evaluation Method has been used to estimate sample size. Individuals over 15 years of age with malaria were approached at health facilities and invited to participate through informed consent. Data was collected in chart review forms focusing on diagnosis, Plasmodium type, prescribing, and dispensing (kind, quantity, labelling and procedures). Follow-up household interviews complemented data collection at health facility. Non-adherence was measured during the implementation phase, by self-reports and pill-counts. Analysis was descriptive and statistical tests were carried out. Determinants of non-adherence and quality of dispensing were assessed according to the literature.ResultsThe study involved 165 patients. Dispensing was done according to the national guidelines. Labelling was adequate for P. vivax but inadequate for P. falciparum medicines. Non-adherent patients were 12.1 % according to self-reports and 21.8 % according to pill-counts. Results point to greater non-adherence among all P. falciparum patients and among malaria non-naîve patients. More patients informed understanding adverse effects than ‘how to use’ anti-malarials.ConclusionsNon-adherent patients were mostly those with a P. falciparum diagnosis and those in their second or more malaria episode. New taxonomies and concepts on adherence stress the importance of focusing on the individual patient. Interventions targeted to and tailored for malaria patients must be addressed by health policy and implemented by managers and clinicians.

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“…19 and Luiza (2003) 23 represented similarly pharmacist's activities focused on quality and access to medicines, including the components selection, programming and acquisition and logistics in the LF. The use of medicines was also considered a key component of PS by Oliveira et al (2002) 19 , Osorio-de-Castro et al (2009) 21 and Luiza (2003) 23 , entitled "use control", "prescription, dispensing and adherence", and "dispensation and promotion of Rational Use of Medicines (RUM)", respectively. Consendey, Hartz and Bermudez (2003) 18 and Luiza (2003) 23 were the only authors to consider, respectively, management or education as a component of PS.…”

Section: Impactmentioning

confidence: 99%

“…Consendey, Hartz and Bermudez (2003) 18 and Luiza (2003) 23 were the only authors to consider, respectively, management or education as a component of PS. Financing and research we never mentioned in literature, although they are essential to structure PS in SUS 15,[17][18][19][20][21][22][23][24][25] .…”

Section: Impactmentioning

confidence: 99%

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Pharmaceutical services as shared responsibility in SUS: a logical framework proposal

Simone¹,

Romano-Lieber²,

Tanaka³

2022

JAFF

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Objectives: To present a Logical Framework (LF) of Pharmaceutical Services (PS) in Unified Health System (SUS, Brazil). Methods: The LF results from the legislation synthesis and experts' consultation. Delphi methodology was used to create and quantify consensus between specialists. Results: Legislation selected (n= 183) were published mostly by Federal Level (88%), between 2010 and 2015 (91%). The legislation contained 304 sections that addressed inter-federal responsibilities, contemplating eight components of PS (selection, financing, programming and acquisition, logistics, use, management, education and research), and an array of 54 responsibilities and 73 products in charge of Federal, State and Municipal Governments, which support PS three main pillars: access to essential drugs, rational use of medicines and structuring of PS. Conclusions: PS is under shared responsibility by the three levels of government, thus, the successful implementation of this public policy depends on the joint effort. The LF allows a broader understanding of the role of SUS managers, can be useful to define strategies to implement PS in Health Care Networks, and above all provides a reference for the construction of theoretical evaluation models addressing PS as a shared responsibility in SUS. Resumo:Objetivos: Apresentar um modelo lógico (ML) da assistência farmacêutica (AF) no Sistema Único de Saúde (SUS, Brasil). Métodos: O ML foi resultante da síntese de legislações e da consulta a especialistas. A metodologia Delphi foi empregada para criação e quantificação do consenso entre especialistas. Resultados: As legislações selecionadas (n= 183) foram publicadas principalmente pelo nível federal (88%), entre 2010 e 2015 (91%). As legislações continham 304 trechos relacionados a responsabilidades interfederativas, contemplando oito componentes da AF (seleção, financiamento, programação e aquisição, logística, utilização, gestão, educação e pesquisa), e uma matriz de 54 responsabilidades e 73 produtos a cargo dos Governos Federal, Estadual e Municipais, os quais suportam os três principais pilares da AF: acesso a medicamentos essenciais, uso racional de medicamentos e estruturação da AF. Conclusões: AF é uma responsabilidade compartilhada pelos três entes federativos, assim, o sucesso na implementação desta política pública depende do esforço conjunto. O ML contribui para o entendimento do papel dos gestores do sistema de saúde de forma abrangente, podendo ser útil para definição de estratégias para implementação da AF nas Redes de Atenção à Saúde, e sobretudo fornece uma referência para a construção de modelos teóricos de avaliação da AF como responsabilidade compartilhada no SUS Palavras-chave:

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A proposal for an evaluation model of pharmaceutical services for malaria

Abstract: Malaria is a serious public health problem in

Cited by 7 publications

References 6 publications

Prescrições para tratamento de malária não complicada em gestantes na Amazônia Legal: evidências do Projeto Mafalda*

Prescrições para tratamento de malária não complicada em gestantes na Amazônia Legal: evidências do Projeto Mafalda*

Dispensing and determinants of non-adherence to treatment for non complicated malaria caused by Plasmodium vivax and Plasmodium falciparum in high-risk municipalities in the Brazilian Amazon

Pharmaceutical services as shared responsibility in SUS: a logical framework proposal

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