Orlando Mario Soeiro

Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos: métodos

RESUMO A Pesquisa Nacional sobre Acesso, Utilizacao e Promocao do Uso Racional de Medicamentos (PNAUM) – componente Servicos teve por objetivo caracterizar a organizacao dos servicos de assistencia farmaceutica na Atencao Basica do Sistema Unico Saude. A PNAUM – Servicos foi um estudo transversal, avaliativo, com amostra planejada de 600 municipios, realizado entre 2014 e […]ABSTRACT The Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos –Serviços (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services) aimed to characterize the organization of pharmaceutical services in the Primary Health Care of the Brazilian Unified Health System (SUS). PNAUM – Services is a cross-sectional and evaluative study, with planned sample of 600 cities, held between 2014 and 2015, composed of a remote phase, with telephone interviews with health managers. Of these 600 cities, 300 were selected for a survey on health services. We selected the 27 capitals, the 0.5% largest cities of each region, and the remaining cities were drawn. The estimate of the representative national sample size considered three levels: cities, medicine dispensing services, and patients. The interviews were carried out with a structured questionnaire specific for: municipal secretaries of health, professionals responsible for pharmaceutical services in the city, professionals responsible for the dispensing of medicines, physicians, and patients. The secondary data were obtained in official databases, in the latest update date. PNAUM – Services was the first nationwide research aimed at the assessment and acquisition of national and regional indicators on access to medicines, as well as use and rational use, from the perspective of various social subjects.

Indicators related to the rational use of medicines and its associated factors

OBJETIVO Avaliar indicadores relacionados ao uso racional de medicamentos e seus fatores associados em unidades basicas de saude. METODOS Estudo transversal realizado em amostra representativa de municipios do Brasil incluidos na Pesquisa Nacional sobre Acesso, Utilizacao e Promocao do Uso Racional de Medicamentos – Servicos, 2015. Os dados foram coletados por meio de entrevista com […]

Concepções de assistência farmacêutica na atenção primária à saúde, Brasil

OBJETIVO Identificar e discutir as concepcoes de assistencia farmaceutica segundo distintos atores, na Atencao Primaria a Saude, no Brasil. METODOS Estudo integrante da Pesquisa Nacional sobre Acesso, Utilizacao e Promocao do Uso Racional de Medicamentos – Servicos, 2015, composta por levantamento de informacoes numa amostra representativa de municipios, estratificada pelas regioes do Brasil, e sub-amostra […]ABSTRACT OBJECTIVE To identify and discuss the conceptions of pharmaceutical services in Brazilian Primary Health Care, according to different subjects. METHODS This study 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), which is composed of an information survey in a representative sample of cities, stratified according to Brazilian regions, and a subsample of primary health care services. Municipal secretaries of health, those responsible for pharmaceutical services, and those responsible for medicine delivery in pharmacies/dispensing units of the selected services were interviewed. The questionnaires included one question about the understanding of the interviewee regarding pharmaceutical services. The content analysis technique was used to apprehend, in the statements, the meanings attributed to pharmaceutical services, which were subsequently classified into categories according to their main conceptions. RESULTS Among the wide diversity of conceptions on pharmaceutical services (PS), we highlight the ones focused on 1) logistic control of medicines with activities concerning guidance or information on their use and 2) guidance or information to users on the use of medicine. The findings reveal a shifting tendency from a medicine-focused conception to one that considers the users and their needs as the final recipient of these actions. However, the lack of references to conceptions regarding care management and integrality point out the slowness of this change; after all, this is a social and historical process that comprises the production of meanings that transcend legal, logistic, and technical arrangements in pharmaceutical services. CONCLUSIONS The diversity of conceptions expresses the several meanings attributed to pharmaceutical services; we also identified, in their reorientation process, a movement that reflects a gradual shift in the technical paradigm, from the focus on medicine logistics to a user-oriented approach of health services.

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

OBJETIVO Caracterizar o processo de selecao de medicamentos na atencao primaria a saude, nas regioes brasileiras. METODOS Artigo integrante da Pesquisa Nacional sobre Acesso, Utilizacao e Promocao do Uso Racional de Medicamentos – Servicos 2015, um estudo transversal que envolveu o levantamento de informacoes numa amostra de municipios das cinco regioes do Brasil. Os dados […]ABSTRACT 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.

Use of medicines by patients of the primary health care of the Brazilian Unified Health System

OBJETIVO Caracterizar o perfil de utilizacao de medicamentos pelos usuarios da Atencao Primaria do Sistema Unico de Saude no Brasil. METODOS Estudo transversal, exploratorio, de natureza descritiva, integrante da Pesquisa Nacional Sobre Acesso, Utilizacao e Promocao do Uso Racional de Medicamentos – Servicos, 2015. Foram realizadas entrevistas com usuarios presentes nos servicos por meio de […]

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

OBJETIVO Caracterizar o estagio atual da institucionalizacao da assistencia farmaceutica nos municipios brasileiros. METODOS Artigo integrante da Pesquisa Nacional sobre Acesso, Utilizacao e Promocao do Uso Racional de Medicamentos, um estudo transversal, exploratorio, de natureza avaliativa, composto por um levantamento de informacoes numa amostra representativa de municipios estratificada pelas regioes do Brasil. Foram entrevistados os […]

Pharmaceutical care in Brazil’s primary health care

OBJETIVO Caracterizar as atividades de natureza clinica desenvolvidas pelos farmaceuticos nas unidades basicas de saude e sua participacao em atividades educativas de promocao da saude. METODOS O artigo integra a Pesquisa Nacional sobre Acesso, Utilizacao e Uso Racional de Medicamentos – Servicos 2015, estudo transversal, exploratorio, de natureza avaliativa, composto por levantamento de informacoes numa […]

Infrastructure of pharmacies of the primary health care in the Brazilian Unified Health System

OBJETIVO Caracterizar a infraestrutura das farmacias da atencao basica do Sistema Unico de Saude, visando condicao para a humanizacao dos servicos ofertados. METODOS Trata-se de estudo transversal, de abordagem quantitativa, a partir de dados obtidos da Pesquisa Nacional sobre Acesso, Utilizacao e Promocao do Uso Racional de Medicamentos – Servicos, 2015. As informacoes de 1.175 […]ABSTRACT OBJECTIVE To characterize the infrastructure of the primary health care pharmacies of the Brazilian Unified Health System, aiming at humanizing the offered services. METHODS This is a cross-sectional study, of quantitative approach, from data obtained in the Pesquisa Nacional de 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). Information on 1,175 pharmacies/dispensing units were gathered from direct observation and assessment of dispensing units installations conducted by trained researchers who used a standardized form. The analyzed variables refer to the physical structure of pharmacies or medicine dispensing units of the health units under research. RESULTS The pharmacy area was greater than 14 m2 in 40.3% of the sampled units, highlighting those from Midwest (56.9%) and Southeast (56.2%) regions and those of Northeast, with only 23.3%. About 80.2% units had waiting rooms with chairs for patients, 31.8% of them had dispensing areas inferior to 5m2, while in 46.2% these areas were superior to 10m2. Bars were found in service counters in 23.8% of health units, thus separating the patient from the professional; 44.1% had internet access. In most units, the area of medicine storage had no refrigerator or freezer for their exclusive storage and 13.7% had a specific room for pharmaceutical consultation. CONCLUSION Aiming at achieving care humanization and improving working conditions for professionals, the structuring of the environment of pharmacy services is necessary. This would contribute to the better qualification of pharmacy services, comprising more than medicine delivery. Data on the Northeast region indicated less favorable conditions to the development of adequate dispensing services. Based on the panorama pointed out, we suggest the expansion of stimulus concerning the physical structure of pharmaceutical services, considering regional specificities.

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

OBJETIVO Caracterizar a forca de trabalho da assistencia farmaceutica na atencao basica do Sistema Unico de Saude. METODOS Trata-se de estudo transversal de abordagem quantitativa com dados da Pesquisa Nacional sobre Acesso, Utilizacao e Promocao do Uso Racional de Medicamentos – Servicos, 2015. Para a analise, foi considerada a estratificacao dos dados por regiao geografica. […]

Availability of essential medicines in primary health care of the Brazilian Unified Health System

OBJETIVO Caracterizar a disponibilidade fisica de medicamentos tracadores nos servicos de assistencia farmaceutica na atencao primaria do Sistema Unico de Saude. METODOS Estudo transversal de natureza avaliativa, integrante da Pesquisa Nacional Sobre Acesso, Utilizacao e Promocao do Uso Racional de Medicamentos – Servicos, 2015. Para a analise da disponibilidade fisica, foram verificados 50 itens selecionados […]