scholarly journals Management of pharmaceutical services in the Brazilian primary health care

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Letícia Farias Gerlack ◽  
Margô Gomes de Oliveira Karnikowski ◽  
Camila Alves Areda ◽  
Dayani Galato ◽  
Aline Gomes de Oliveira ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Pharmaceutical Services ◽  
Limiting Factors ◽  
Health Board ◽  
Complex Samples ◽  
Financial Autonomy ◽  
Unified Health System ◽  
Primary Health

OBJECTIVE: To identify limiting factors in the management of pharmaceutical services in the primary health care provided by the Brazilian Unified Health System (SUS). METHODS: This study was based on the data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), and it was conducted by interviews with professionals responsible for pharmaceutical services in Brazilian cities, in 2015. To identify the management limiting factors, we considered the organizational, operational, and sustainability indicators of the management. For the analyses, we included the weights and structure of analysis plan for complex samples. The results were expressed by frequencies and measures of central tendency with 95% confidence interval, considering the Brazilian geographic regions. RESULTS: We identified the following limiting factors: lack of pharmaceutical services in the Municipal Health Secretariat organization chart (24%) and in the health plan (18%); lack of participation of managers in the Health Board and the absence of reference to this topic in the agenda of meetings (58.4%); lack of financial autonomy (61.5%) and lack of knowledge on the available values (81.7%); lack of adoption of operational procedures (about 50%) for selection, scheduling, and acquisition; and the fact that most professionals evaluate the organization of pharmaceutical services as good and great (58.8%), despite the worrisome indicators. CONCLUSIONS: Pharmaceutical services management is currently supported by a legal and political framework that should guide and contribute to improve the pharmaceutical services in the Brazilian Unified Health System primary health care. However, there is a mismatch between the goals established by these guidelines and what is actually happening

scholarly journals Pharmaceutical services in primary health care: interfederative agreement in the development of pharmaceutical policies in the Brazilian Unified Health System (SUS)

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Karen Sarmento Costa ◽  
Noêmia Urruth Leão Tavares ◽  
José Miguel Do Nascimento Júnior ◽  
Sotero Serrate Mengue ◽  
Juliana Álvares ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Pharmaceutical Services ◽  
Unified Health System ◽  
Pharmaceutical Policies ◽  
Primary Health

scholarly journals Technical issues and conservation conditions of medicines in the primary health care of the Brazilian Unified Health System

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Ediná Alves Costa ◽  
Patrícia Sodré Araújo ◽  
Marcelo Tavares Pereira ◽  
Ana Cristina Souto ◽  
Gisélia Santana Souza ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Pharmaceutical Services ◽  
Cross Sectional ◽  
Unified Health System ◽  
Technical Requirements ◽  
Primary Health ◽  
Wide Range ◽  
Technical Issues

OBJECTIVE: To characterize the technical issues and conditions of medicines conservation in Primary Health Care of Brazilian regions, responsible for pharmacy/dispensing unit profile; environmental, storage, and dose fractioning conditions; inventory control and waste management; fire and electrical failure safety items; transportation problems; advertising regulation; and pharmacovigilance. METHODS: This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços (National Survey on Access, Use and Promotion of Rational Use of Medicines – Services)–, a cross-sectional and exploratory study, of evaluative nature, consisting of an information survey within a representative sample of municipalities, stratified by Brazilian regions, which constitute the study domains, and a sample of Primary Health Care services. Pharmaceutical services (PS) were directly observed with photographic record and face-to-face interviews with those responsible for the dispensing of medicines and over the telephone with those responsible for pharmaceutical services. Data were processed with the SPSS® software version 21.RESULTS: The investigated dimensions showed relevant deficiencies and inequalities between the regions, generally more favorable in the Southeast and Midwest regions and weaker in the Northeast and North regions. We verified non-compliance with technical requirements and conditions essential to the conservation of medicines, which may interfere with the maintenance of stability and, thus, on their quality, efficacy, and safety. The regulation of advertising/promotion of medicines is still incipient and there is some progress in the structuring of mechanisms regarding pharmacovigilance. CONCLUSIONS: The sanitary situation of medicines in Brazilian Primary Health Care is alarming due to the violation of the specific sanitary legislation for dispensing establishments and due to a wide range of requirements essential to the conservation of medicines. We observed a disconnection between the efforts made in the Brazilian Unified Health System to promote access to medicines for all population and the organization and qualification of pharmaceutical services

scholarly journals Access to medicines by patients of the primary health care in the Brazilian Unified Health System

2017 ◽  
Vol 51 ◽  
pp. 20s ◽  
Author(s):  
Juliana Álvares ◽  
Augusto Afonso Guerra Junior ◽  
Vânia Eloisa de Araújo ◽  
Alessandra Maciel Almeida ◽  
Carolina Zampirolli Dias ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Developed Countries ◽  
Access To Medicines ◽  
Essential Medicines ◽  
Unified Health System ◽  
Primary Health ◽  
Significant Difference ◽  
Good For

OBJECTIVE: To evaluate the access to medicines in primary health care of the Brazilian Unified Health System (SUS), from the patients’ perspective. METHODS: This is a cross-sectional study that used data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Services, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), conducted by interviews with 8,591 patients in cities of the five regions of Brazil. Evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, accessibility, accommodation, acceptability, and affordability. Each dimension was evaluated by its own indicators. RESULTS: For the “availability” dimension, 59.8% of patients reported having full access to medicines, without significant difference between regions. For “accessibility,” 60% of patients declared that the basic health unit (UBS) was not far from their house, 83% said it was very easy/easy to get to the UBS, and most patients reported that they go walking (64.5%). For “accommodation,” UBS was evaluated as very good/good for the items “comfort” (74.2%) and “cleanliness” (90.9%), and 70.8% of patients reported that they do not wait to receive their medicines, although the average waiting time was 32.9 minutes. For “acceptability,” 93.1% of patients reported to be served with respect and courtesy by the staff of the dispensing units and 90.5% declared that the units’ service was very good/good. For “affordability,” 13% of patients reported not being able to buy something important to cover expenses with health problems, and 41.8% of participants pointed out the expense with medicines. CONCLUSIONS: Results show 70%–90% compliance, which is compatible with developed countries. However, access to medicines remains a challenge, because it is still heavily compromised by the low availability of essential medicines in public health units, showing that it does not occur universally, equally, and decisively to the population

Resolution And Continuity Of Primary Health Care: Reference And Counter-Reference In The Sus (Unified Health System)

2017 ◽  
Vol 04 (01) ◽  
Author(s):  
Maria Beatriz Rodrigues Criscuolo ◽  
Duane Ferreira Melo ◽  
Selma Maria da Fonseca Viegas
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Unified Health System ◽  
Primary Health

scholarly journals Availability of dental treatment is associated with satisfaction derived from Primary Health Care Services accessed by elderly

2016 ◽  
Vol 45 (6) ◽  
pp. 344-350 ◽  
Author(s):  
Aline Blaya MARTINS ◽  
Creta SEIBT ◽  
Matheus NEVES ◽  
Juliana Balbinot HILGERT ◽  
Fernando Neves HUGO
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Health Care Services ◽  
Dental Treatment ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Unified Health System ◽  
Primary Health

Abstract Objective This research evaluated whether having dental treatment available in the primary health care centers of the Brazilian Unified Health System was associated with greater satisfaction with the services accessed. The offering of dental care within the health service that elders usually access may improve their satisfaction with the services as a whole. Material and method In this cross-sectional study, 401 elders living in the districts of Lomba do Pinheiro and Partenon in Porto Alegre, Brazil were interviewed. Elders were selected using a cluster sampling design process from census tract drawings. Result Poisson Regression revealed that age and dental treatment supply were associated with outcome, and age, number of teeth, and the presence of dental treatment were associated with a higher prevalence of satisfaction with health services. Conclusion These results provide new contributions for health system qualification because this study demonstrated the importance of having dental treatment available to improve the satisfaction of older people with the Primary Health Care (PHC) services accessed.

scholarly journals Implementation of pharmaceutical services in Brazilian primary health care: a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Nathália Cano Pereira ◽  
Vera Lucia Luiza ◽  
Mônica Rodrigues Campos ◽  
Luisa Arueira Chaves
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Care Management ◽  
Implementation Fidelity ◽  
Federal District ◽  
Cross Sectional Study ◽  
Pharmaceutical Services ◽  
Cross Sectional ◽  
Primary Health

Abstract Background In the Brazilian public health system, primary health care (PHC) is provided by the municipalities and is considered the entry level of the Unified Health System (SUS). Governmental pharmaceutical services (PharmSes) are part of the SUS, including PHC, and are the most significant way in which patients access medicine and services. Considering the diversity of the country, the municipalities have the autonomy to decide how PharmSes are implemented. Even though policies and procedures should be implemented as expected by policy makers and experts, municipality characteristics may interfere with implementation fidelity. Therefore, this study evaluated the degree to which the PharmSes in PHC were delivered as intended in Brazilian municipalities. Methods We analysed data from a secondary database originating from a cross-sectional nationwide study carried out by the Ministry of Health and the World Bank from 2013 to 2015. Data on 465 municipalities and the Federal District were collected from 4939 governmental PharmSes. A rating system comprising 43 indicators was developed and applied to the dataset to obtain the implementation degree (ID) of each PharmSe. Additionally, the IDs of the two PharmSes dimensions and the nine components were measured. Results Overall, the ID of the PharmSes in Brazilian PHC was evaluated as critical. The ID was critical in 81% of the municipalities (n = 369), incipient in 14% (n = 65) and unsatisfactory in 4.8% (n = 22). Regarding the PharmSes dimensions, the ‘medicine management’ (MM) ID was considered critical (Mean = 46%), while the ‘care management’ (CM) ID was incipient (Mean = 22%). In terms of the PharmSes components, the highest ID was achieved by ‘forecasting’ (58%). In contrast, ‘continuing education and counselling’ showed the lowest figure (ID = 11%) in the whole sample, followed by ‘information and communication’ and ‘teamwork’. Conclusions The degree to which PharmSes were implemented was critical (ID< 50%). This analysis demonstrated that PharmSes were implemented with low fidelity, which may be related to the low availability of medicine in PHC. Although the care management component requires more attention, considering their incipient ID, all components must be reviewed. Municipalities must increase their investment in PharmSes implementation in order to maximize the benefits of these services and guarantee the essential right of access to medicine.

scholarly journals De Médico de Família a Preceptor de Estudantes no Sistema Único de Saúde: Relato de Experiência

2020 ◽  
Vol 44 (4) ◽  
Author(s):  
Daniel Almeida de Oliveira ◽  
Eder Viana de Souza
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Population Level ◽  
Health Unit ◽  
Typical Structure ◽  
Clinical Method ◽  
Basic Health ◽  
Unified Health System ◽  
Primary Health

Abstract: Introduction: This article reports the experience of a physician, specialist in Family and Community Medicine, who works in a Basic Health Unit in the southern region of the city of São Paulo, in the Primary Health Care of the Unified Health System, when he became a Preceptor of Medical students at Universidade São Caetano do Sul. Method: The students learned about the typical structure of a Basic Health Unit. They learned how to acquire the medical history during anamnesis, under supervision, and the physical examination, as they acquired the necessary skills. They also learned how to request complementary examinations. With this training, they learned how to apply the clinical method during practice. The students also learned the competence to apply the clinical method in uncontrolled environments through the home visit, which also made it possible to know the reality of the patient in loco. The follow-up of families and the index cases for a few years gave the students the opportunity to experience the different care cycles of the Family Health Strategy, including the question of death, which started in the socio-family context. They also participated and carried out assistance and knowledge transmission groups for the community, in which students were able to train communication and adaptation at the population level. They met and participated in the team meetings, which allowed showing the weekly planning of activities, the interdisciplinary discussion of more complex cases and the created strategies. Results: The promising results of the Active Methodologies based on student autonomy, in relation to the learning process, are applied to the teaching of Medicine in clinical practice environments, since the contact with reality improves learning, challenges the students to research and reflect with autonomy to think about what they must do with the established learning goals and teaches them to use previous experiences to interrelate new knowledge with previous information through Evidence-Based Medicine and reflect on medical practice. Conclusion: Comments are also made on the National Curricular Guidelines, which request the inclusion of the medical student within the scope of the Unified Health System, aimed mainly at Primary Health Care learning.

scholarly journals Primary health care policy and vision for community pharmacy and pharmacists in Colombia

2020 ◽  
Vol 18 (4) ◽  
pp. 2159
Author(s):  
Pedro Amariles ◽  
Mauricio Ceballos ◽  
Cesar Gonzalez-Giraldo
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Well Being ◽  
Pharmaceutical Services ◽  
Pharmacy Education ◽  
Private Companies ◽  
Rational Use ◽  
Rational Use Of Medicines ◽  
Primary Health

Colombia is a decentralized republic with a population of 50 million, constituted by 32 departments (territorial units) and 1,204 municipalities. The health system provides universal coverage and equal access to health care services to 95% of the population. Primary health care is seen as a practical approach that guarantees the health and well-being of whole-of-society. The National Pharmaceutical Policy (NPP, 2012) goal is "to develop strategies that enable the Colombian population equitable access to effective medicines, through quality pharmaceutical services (PS)”. There are 4,351 providers certified to deliver PS: 3,699 (85%) ambulatory and 652 (15%) hospital care. The goals for PS are: a) promoting healthy lifestyles; b) preventing risk factors arising from medication errors; c) promoting rational use of medicines; and d) implementing Pharmaceutical Care. There are a number of ways that ambulatory patients access medications: through intermediary private companies, public and private hospitals pharmacies, and retail establishments (drugstores and pharmacies). Intermediary private companies are similar to Pharmaceutical Benefits Management in the U.S. health system, and act as intermediaries between health insurers, pharmaceutical laboratories, and patients. Pharmacists are being employed by these companies and in health insurance companies managing, auditing and delivering rational use of medicines programs. In 2014 there were approximately 20,000 pharmacies and drugstores, (private establishments) where a significant number of prescription-only medicines are sold without medical prescription. Colombian laws allow personal without pharmacy education to be a “director” in these establishments, so the training and education of persons working in drugstores and pharmacies is an important challenge. There about 8,000 registered pharmaceutical chemists with 25% to 30% working in patient care. Since the 90´s, there are more favorable conditions for pharmacist’s participation and contribution to health system and patient’s health outcome. These environmental facilitators include: a) laws and regulations regarding pharmaceutical services (2005-2007), b) establishment of a NPP (2012), and c) opportunities associated with the consolidation of private health management companies providing health services with an interest in pharmaceutical services (since 1995). Finally, telepharmacy, comprehensive care routes for pharmaceutical services, and further strengthen of postgraduate training in pharmacy practice are future strategies to improve the pharmacy profession in Colombia. They provide an opportunity to influence the recognition and value of the pharmacist as the health care professional.

scholarly journals Teledentistry and the Unified Health System: An Important Tool for the Resumption of Primary Health Care in the Context of the COVID-19 Pandemic

2020 ◽  
Vol 20 (suppl 1) ◽  
Author(s):  
Fernanda Campos de Almeida Carrer ◽  
Bruno Fernandes Matuck ◽  
Edson Hilan Gomes de Lucena ◽  
Fábio Carneiro Martins ◽  
Gilberto Alfredo Pucca Junior ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Unified Health System ◽  
Primary Health

scholarly journals A interface entre a atenção primária à saúde e práticas integrativas e complementares no sistema único de saúde: formas de promover as práticas na APS

2021 ◽  
Vol 3 (2) ◽  
pp. 102-109
Author(s):  
Lucas Gaspar Ribeiro ◽  
Daiane Marcondes
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Family Health ◽  
Unified Health System ◽  
Primary Health ◽  
Health Strategy ◽  
Politica Publica ◽  
Family Health Strategy ◽  
The Individual

Um marco para a saúde no Brasil foi a implantação do Programa Saúde da Família (PSF) em 1994, com a reorientação das práticas assistenciais pelos princípios doutrinários e organizacionais do Sistema Único de Saúde. Esse sistema também oferta as práticas integrativas e complementares, abordando o indivíduo na sua multidimensionalidade, estimulando os mecanismos naturais de cura. Elas foram inseridas como política pública em 2006, no mesmo ano que o PSF foi modificado para estratégia. Ambas possuem relevantes afinidades e pontos que fortalecem o cuidado. O objetivo desse artigo é apresentar essa aproximação teórico-prática através de uma revisão narrativa, encontrando diversas premissas e ferramentas de cuidado compartilhados pela abordagem da Atenção Primária à Saúde (APS) e pelas práticas integrativas e complementares, além das práticas contribuindo para a desmedicalização, acesso e resolutividade da APS com o trabalho interprofissional, individualmente e coletivamente.       Palavras-chave: atenção primária à saúde, práticas integrativas e complementares, estratégia saúde da família, políticas públicas em saúde, sistema único de saúde.   Abstract A milestone for health in Brazil was the implementation of the Programa Saúde da Família (PSF) in 1994, with the reorientation of care practices based on doctrinal and organizational principles of the Unified Health System. This system also offers integrative and complementary practices, addressing the individual in its multidimensionality, stimulating the natural healing mechanisms. They were inserted as public policy in 2006, at the same year that the PSF was changed to strategy. Both contain affinities and points that strengthen care. The objective of the article is to present this theoretical-practical approach of a narrative review, finding several premisse and tools of care shared by the approach of Primary Health Care (PHC) and by integrative and complementary practices, in addition to the practices contributing to demedicalization, access and resolution of PHC with interprofessional work, individually and collective Keywords: primary health care, integrative and complementary practices, family health strategy, public health policy, unified health system.

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