scholarly journals Workforce in the pharmaceutical services of the primary health care of SUS, Brazil

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Marselle Nobre Carvalho ◽  
Juliana Álvares ◽  
Karen Sarmento Costa ◽  
Augusto Afonso Guerra Junior ◽  
Francisco de Assis Acurcio ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Pearson Correlation ◽  
Pharmaceutical Services ◽  
Categorical Variables ◽  
Cross Sectional ◽  
Primary Health ◽  
Geographical Regions ◽  
Municipal Management ◽  
Workforce Composition

OBJECTIVE: To characterize the workforce in the pharmaceutical services in the primary care of the Brazilian Unified Health System (SUS). METHODS: This is a cross-sectional and quantitative study, with data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). For the analysis, we considered the data stratification into geographical regions. We analyzed the data on workers in the municipal pharmaceutical services management and in the medicine dispensing units, according to the country’s regions. For the statistical association analysis, we carried out a Pearson correlation test for the categorical variables. RESULTS: We analyzed 1,175 pharmacies/dispensing units, 507 phone interviews (495 pharmaceutical services coordinators), and 1,139 professionals responsible for medicine delivery. The workforce in pharmaceutical services was mostly constituted by women, aged from 18 to 39 years, with higher education (90.7% in coordination and 45.5% in dispensing units), having permanent employment bonds (public tender), being for more than one year in the position or duty, and with weekly work hours above 30h, working both in municipal management and in medicine dispensing units. We observed regional differences in the workforce composition in dispensing units, with higher percentage of pharmacists in the Southeast and Midwest regions. CONCLUSIONS: The professionalization of municipal management posts in primary health care is an achievement in the organization of the workforce in pharmaceutical services. However, significant deficiencies exist in the workforce composition in medicine dispensing units, which may compromise the medicine use quality and its results in population health

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 Kepuasan Pasien Rawat Jalan terhadap Pelayanan Kefarmasian di Rumah Sakit dan Puskesmas di 11 Provinsi di Indonesia

2020 ◽  
pp. 42-49
Author(s):  
Nita Prihartini ◽  
Yuyun Yuniar ◽  
Andi Leny Susyanty ◽  
Raharni Raharni
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sex Education ◽  
Pharmaceutical Products ◽  
Further Education ◽  
Pharmaceutical Services ◽  
Age Group ◽  
Cross Sectional ◽  
Primary Health

Pharmaceutical services is a direct service and responsible to patients relating to pharmaceutical products aimed to improve the quality of life of patients. Quality of pharmaceutical services can be assessed based on outpatient satisfaction. The aim of the study was to compare the satisfaction of outpatients with pharmaceutical services in hospitals and primary health care. This study used a cross-sectional comparative study design and was conducted in February-November 2017 in 11 provinces, each province consisting of 2 districts/cities selected purposively. Samples were outpatients who got medicines in hospitals or primary health care at least 31 patients in each pharmacy. Satisfaction was assessed by the dimension of responsiveness, reliability, collateral, friendliness, and physical evidence. Data was collected by the questionnaires and analyzed using chi-square test. The results of the study show that outpatient satisfaction with pharmaceutical services in hospital and primary health care was 90,9% and 96.6%, respectively. The largest percentage of outpatients in hospitals and primary health care are in the age group of 40-59 years, female, has further education, and not working/housewives. There were significant differences in the age group, gender, and education of outpatients between hospitals and primary health care. There was no significant relationship between the characteristics (age, sex, education, occupation) of outpatients and satisfaction with pharmaceutical services in hospitals and primary health care

scholarly journals Characterization of the selection of medicines for the Brazilian primary health care

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Margô Gomes de Oliveira Karnikowski ◽  
Dayani Galato ◽  
Micheline Marie Milward de Azevedo Meiners ◽  
Emília Vitória da Silva ◽  
Letícia Farias Gerlack ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
National Survey ◽  
Pharmaceutical Services ◽  
Essential Medicines ◽  
Cross Sectional ◽  
Primary Health ◽  
Health Demands ◽  
Selection Of

OBJECTIVE: To characterize the process of selection of medicines for primary health care in the Brazilian regions. METHODS: This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015), a cross-sectional study that consisted of an information gathering in a sample of cities in the five regions of Brazil. The data used were collected by interviews with those responsible for pharmaceutical services (PS) (n = 506), professionals responsible for the dispensing of medicines (n = 1,139), and physicians (n = 1,558). To evaluate the difference between ratios, we adopted the Chi-square test for complex samples. The differences between the averages were analyzed in generalized linear models with F-test with Bonferroni correction for multiple comparisons. The analyses considered significant had p≤0.05. RESULTS: The professionals responsible for pharmaceutical services reported non-existence of a formally constituted Pharmacy and Therapeutics Committee (PTC) (12.5%). They claimed to have an updated (80.4%) list of Essential Medicines (85.3%) and being active participants of this process (88.2%). However, in the perception of respondents, the list only partially (70.1%) meets the health demands. Of the interviewed professionals responsible for the dispensing of medicines, only 16.6% were pharmacists; even so, 47.8% reported to know the procedures to change the list. From the perspective of most of these professionals (70.9%), the list meets the health demands of the city. Among physicians, only 27.2% reported to know the procedures to change the list, but 76.5% would have some claim to change it. Most of them reported to base their claims in clinical experiences (80.0%). For 13.0% of them, the list meets the health demands. CONCLUSIONS: As this is the first national survey of characterization of the process of selection of medicines within primary health care, it brings unpublished data for the assessment of policies related to medicines in Brazil

scholarly journals Patient satisfaction with pharmaceutical services in Brazilian primary health care

2017 ◽  
Vol 51 ◽  
pp. 21s ◽  
Author(s):  
Orlando Mario Soeiro ◽  
Noêmia Urruth Leão Tavares ◽  
José Miguel do Nascimento Júnior ◽  
Augusto Afonso Guerra Junior ◽  
Ediná Alves Costa ◽  
...  
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Patient Satisfaction ◽  
Primary Health Care ◽  
Pharmaceutical Services ◽  
Chi Square ◽  
Cross Sectional ◽  
Patient’S Satisfaction ◽  
Primary Health ◽  
Chi Square Test

OBJECTIVE: To evaluate patient satisfaction with pharmaceutical services in Brazilian primary health care. METHODS: This is a cross-sectional, exploratory, and evaluative study on a representative sample from the five Brazilian geopolitical regions resulting from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). The outcome was the patient’s satisfaction, obtained using the item response theory. Associations were tested using Pearson’s Chi-square test with sociodemographic and health variables, and multiple logistic regression analyses were carried out. The Hosmer-Lemeshow test was used to verify the adequacy of the final model. Logistic regression results were presented as odds ratio. RESULTS: The overall percentage of patients satisfied with these services was 58.4% (95%CI 54.4-62.3). The “opportunity/convenience” aspect had the lowest satisfaction percentage (49.5%; 95%CI 46.4-52.6) and “interpersonal aspects,” the highest percentage (90.5%; 95%CI 88.9-91.8), significantly higher than other aspects. Sex, age group, limitations due to disease, and self-perception of health remained associated in the final multiple logistic model regarding general satisfaction. CONCLUSIONS: Most of the interviewed users were satisfied with pharmaceutical services in Brazilian cities, and the satisfaction with the customer’s service was determinant in the patient’s overall satisfaction

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 Convergent and discriminative validity of the Frail-VIG index with the EQ-5D-3L in people cared for in primary health care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juan-José Zamora-Sánchez ◽  
Edurne Zabaleta-del-Olmo ◽  
Vicente Gea-Caballero ◽  
Iván Julián-Rochina ◽  
Gemma Pérez-Tortajada ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Convergent Validity ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Programme ◽  
Discriminative Validity ◽  
Primary Health ◽  
Related Quality

Abstract Background The Frail-VIG frailty index has been developed recently. It is an instrument with a multidimensional approach and a pragmatic purpose that allows rapid and efficient assessment of the degree of frailty in the context of clinical practice. Our aim was to investigate the convergent and discriminative validity of the Frail-VIG frailty index with regard to EQ-5D-3L value. Methods We carried out a cross-sectional study in two Primary Health Care (PHC) centres of the Catalan Institute of Health (Institut Català de la Salut), Barcelona (Spain) from February 2017 to January 2019. Participants in the study were all people included under a home care programme during the study period. No exclusion criteria were applied. We used the EQ-5D-3L to measure Health-Related Quality of Life (HRQoL) and the Frail-VIG index to measure frailty. Trained PHC nurses administered both instruments during face-to-face assessments in a participant’s home during usual care. The relationships between both instruments were examined using Pearson’s correlation coefficient and multiple linear regression analyses. Results Four hundred and twelve participants were included in this study. Frail-VIG score and EQ-5D-3L value were negatively correlated (r = − 0.510; P < 0.001). Non-frail people reported a substantially better HRQoL than people with moderate and severe frailty. EQ-5D-3L value declined significantly as the Frail-VIG index score increased. Conclusions Frail-VIG index demonstrated a convergent validity with the EQ-5D-3L value. Its discriminative validity was optimal, as their scores showed an excellent capacity to differentiate between people with better and worse HRQoL. These findings provide additional pieces of evidence for construct validity of the Frail-VIG index.

scholarly journals Factors Related to Primary Health Care Provision: A Cross-Sectional Study in an Elderly Rural Population

2015 ◽  
Vol 38 (5) ◽  
pp. 343-356
Author(s):  
Ana Maseda ◽  
José Carlos Millán-Calenti ◽  
Julia Carpente ◽  
José Luis Rodríguez-Villamil ◽  
Carmen de Labra
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Rural Population ◽  
Cross Sectional Study ◽  
Health Care Provision ◽  
Care Provision ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health

scholarly journals The situation of nursing education in Latin America and the Caribbean towards universal health

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Silvia Helena De Bortoli Cassiani ◽  
Lynda Law Wilson ◽  
Sabrina de Souza Elias Mikael ◽  
Laura Morán Peña ◽  
Rosa Amarilis Zarate Grajales ◽  
...  
Keyword(s):  
Health Care ◽  
Latin America ◽  
Primary Health Care ◽  
Nursing Education ◽  
Clinical Decision Making ◽  
Clinical Experiences ◽  
Cross Sectional ◽  
Primary Health ◽  
The Caribbean ◽  
Universal Health

Objective: to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health. Method: quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. Results: a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods. Conclusion: there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care.

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