Pharmaceutical services to grow for another year

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

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An evaluation of the adequacy of pharmaceutical services for the provision of antiretroviral treatment in primary health care clinics

Health SA Gesondheid ◽

10.4102/hsag.v20i1.923 ◽

2015 ◽

Vol 20 (1) ◽

Author(s):

Talitha Crowley ◽

Ethelwynn L. Stellenberg

Keyword(s):

Antiretroviral Treatment ◽

Resource Constraints ◽

Pharmaceutical Services ◽

Storage Space ◽

Health Care Clinics ◽

Primary Health ◽

Kwazulu Natal ◽

Professional Nurses ◽

Quantitative Descriptive ◽

Service Standards

Background: With the introduction of nurse-initiated and -managed antiretroviral therapy (NIMART), new challenges have emerged with regard to the prescribing and dispensing of ART by nurses. One of the key challenges is ensuring adequate pharmaceutical services at PHC clinics.Objective: The objective of the study was to evaluate the adequacy of pharmaceutical services for the provision of ART in PHC clinics.Method: A quantitative descriptive study was undertaken in 20 (43%) randomly selected, eligible clinics in the uMgungundlovu district of KwaZulu-Natal, South Africa.Results: Clinics used allocated medicine rooms for storing medication, as there were no pharmacies. Problems identified were: insufficient storage space (50%; n = 10); inadequates ecurity (40%; n = 8); poor air conditioning (20%; n = 4), and functional stock-outs of essential drugs (80%; n = 16). Professional nurses performed the tasks of managing drug supply and prescribing and dispensing medication as there were no pharmacists or pharmacist's assistants in these clinics.Conclusion: Human resource constraints necessitate professional nurses to manage drug supplies and to prescribe and dispense medication in resource-constrained PHC clinics. Clear guidelines tailored for PHC are needed to assist nurses in maintaining pharmaceutical service standards when ART services are decentralised.

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Regular access and adherence to medications of the specialized component of pharmaceutical services

Revista de Saúde Pública ◽

10.11606/s1518-8787.2017051006932 ◽

2017 ◽

Vol 51 ◽

pp. 109

Author(s):

Janaína Soder Fritzen ◽

Fabiane Raquel Motter ◽

Vera Maria Vieira Paniz

Keyword(s):

Cross Sectional Study ◽

Pharmaceutical Services ◽

Free Access ◽

Rio Grande Do Sul ◽

Sectional Study ◽

Cross Sectional ◽

Robust Variance ◽

Free Data ◽

Drug Policies ◽

Continuous Use

OBJECTIVE: To investigate the prevalence of the adherence to the medications of the Specialized Component of Pharmaceutical Services and its association with regular access in users of these medications in the municipality of São Leopoldo, State of Rio Grande do Sul, Brazil. METHODS: This is a cross-sectional study with adults aged 20 years and over, who are users of medications of the Specialized Component of Pharmaceutical Services. Sampling was carried out consecutively for users who accessed the service of the Specialized Component of Pharmaceutical Services during the period from December 2014 to March 2015. Adherence was measured by the Brief Medication Questionnaire, and adherents were defined as those who did not present barriers to adherence in the three domains. Regular access was defined as getting all edications in the last three months, regardless of how it was obtained (paying or for free). Data analysis was performed using Poisson regression with robust variance. RESULTS: We nterviewed 414 subjects, being them mostly women (60.9%), with mean age of 55 years (SD = 13), and using a single medication of the Specialized Component of Pharmaceutical Services (68.1%). The prevalence of adherence to the medications used in the last seven days was 28.3% and the prevalence of free regular access was 46.1%, and 25.7% did not have access to all treatment. After adjusting for the number of medications in the Specialized Component of Pharmaceutical Services and the number of medications of continuous use, users who had free regular access in the last three months were 60% more likely to show adherence. For individuals with paid regular access, no association was found between access and adherence. CONCLUSIONS: The regularity in the free access to the medications of the Specialized Component of Pharmaceutical Services has an impact on the behavior of users, contributing to their commitment to treatment and self-care. The Specialized Component of Pharmaceutical Services needs programming in order to avoid irregular access, which suggests a significant limitation of the drug policies in Brazil.

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