Characterization of the institutionalization of pharmaceutical services in Brazilian primary health care

Abstract

OBJECTIVE To characterize the current stage of the institutionalization of pharmaceutical services in Brazilian cities.METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), a cross-sectional, exploratory, and evaluative study composed by an information survey in a representative sample of cities, stratified by Brazilian regions. We interviewed municipal secretaries of health, responsible for pharmaceutical services, and pharmacists responsible for the dispensing of medicines. The variables selected from the interviews were grouped into five dimensions that defined three stages of pharmaceutical services institutionalization: incipient (0%-34.0%), partial (35.0%-69.0%), and advanced (70.0%-100%), estimated based on the interviewees’ answers. Frequencies were estimated with 95% confidence intervals. For the statistical association analysis, the Chi-square test was applied, with significance level of p<0.05.RESULTS Our results show a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazil, and an advanced stage in formal structures, such as the municipal health plans and the existence of a standardized list of medicines. The analysed variables in the “organization, structure, and financing” dimension configured stages that range from partial to advanced. The management presented partial institutionalization, positively showing the existence of computerized system, but also disparate results regarding the autonomy in the management of financial resources. Indispensable items related to the structure expressed disparities between the regions, with statistically significant differences.CONCLUSION The study showed a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazilian cities, showing regional disparities. Variables related to the normative aspects of institutionalization were positively highlighted in all dimensions; however, it is necessary to conduct new studies to evaluate the institutionalization of pharmaceutical services’ finalistic activities.

Primary Health Care Planning workshops: construction and validation of an assessment instrument

“…The incorporation of assessment in the routine of health organizations can be carried out through instruments that integrate the planning process and the management of policies and programs. There is a long way to the institutionalization of the assessment, result of a joint work of parties and conquest of political space for autonomy of the necessary resources and strengthening of the evaluative capacity (20)(21)(22) .…”

Evidências sobre tipos de intervenções para a institucionalização da assistência farmacêutica: revisão integrativa

“…Remondi, 2018Barbosa et al, 2017;Goya, et al, 2017;Rover et al, 2017. Araújo et al, 2017;Barbosa et al, 2017;Barros et al, 2017;Gerlack et al, 2017;Goya, et al, 2017;Pontes et al, 2017;Rover et al (2017); Souza et al (2017). Barberato et al, 2019; Remondi, (2018); Barbosa et al, 2017;Goya, et al, 2017;Rover et al (2017).…”

“…A Assistência Farmacêutica, por meio da organização e ofertas de serviços, de instrumentos de planejamento, governança, gestão e o financiamento e envolvimento do controle socialcomo parte da atenção integral à saúdeproporciona o acesso ao medicamento e seu uso com qualidade (Souza et al, 2017;Brasil, 2019;Ferreira & Soler, 2021;Torres et al, 2021;Ferreira et al, 2022). Khalil et al, (2017), categoriza os tipos de intervenções farmacêuticas em intervenções educacionais, organizacionais, políticas setoriais, financeiras, regulatórias e multifacetadas, correlacionando-as ao aperfeiçoamento e/ou aprimoramento dos serviços farmacêuticos ofertados à população.…”

Avaliação Do Serviço De Conciliação Medicamentosa Na Admissão Hospitalar

“…A multiplicidade de sentidos e insuficiente discussão conceitual acerca das concepções sobre a Assistência Farmacêutica no país, o excesso de funções a serem exercidas pelo farmacêutico na atenção básica, a qualificação exígua dos profissionais e as incipientes institucionalização e implementação das políticas para o setor, são algumas das questões apontadas como causas dos problemas mencionados ainda persistirem (ARAÚJO, et al, 2017;COSTA, E., et al, 2017b;SOUZA, et al, 2017).…”