Conceptions on pharmaceutical services in Brazilian primary health care.

Ediná Alves Costa,Juliana Alvares,Karen Sarmento Costa,Silvana Nair Leite,Thais Rodrigues Penaforte,Augusto Afonso Guerra Junior,Joslene Lacerda Barreto,Orlando Mario Soeiro,Patrícia Sodré Araújo,Francisco De Assis Acurcio,Ione Aquemi Guibu,Margô Gomes De Oliveira Karnikowski

doi:10.11606/s1518-8787.2017051007107

Abstract

ABSTRACTOBJECTIVE 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.

Highlights

Since its regulation, in 1990, the Brazilian Unified Health System (SUS) has been implementing several strategies to place pharmaceutical services (PS) as an essential public policy to health care integrality as a social right and duty of the State
The diversity of conceptions expresses the several meanings attributed to pharmaceutical services; we 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
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 aimed to characterize the organization of pharmaceutical services in primary health care/SUS – for promoting the access and rational use of medicines, as well as to identify and discuss the factors that interfere in the consolidation of pharmaceutical services in the cities

Summary

Introduction

In 1990, the Brazilian Unified Health System (SUS) has been implementing several strategies to place pharmaceutical services (PS) as an essential public policy to health care integrality as a social right and duty of the State. Efforts show increases in population access to medicines and the need for change in the organization of pharmaceutical services in the Countrya. We can identify changes in professional practice, from a procedure more focused on the medicine to another that emphasizes the shared responsibility between patients and pharmacists, which demands for the accountability of these professionals when it comes to the medicine dispensing and on the needs of individuals. Traditional roles, which comprise preparation, dispensing, or sale of medicines, are clearly insufficient to characterize PS from an integral perspective regarding actions on health and sectoral policies. In this sense, PS must be established as a set of systematically carried out activities that considers the medicines, but is mainly focused on the patient[12]

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Results

Conclusion