Abstract
ABSTRACTOBJECTIVE To characterize the medicine dispensing services in the primary health care network in Brazil and in its different regions, aiming to promote the access and rational use of medicines.METHODS This is a cross-sectional, quantitative study with data obtained from the Pesquisa Nacional sobre Acesso, Utilização e Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), 2015. Observation visits were carried out in 1,175 dispensing units, and interviews were held with 1,139 professionals responsible for the dispensation of medicines in the dispensing units and 495 municipal coordinators of pharmaceutical services.RESULTS More than half (53%) of the units presented a space smaller than 10 m2 for dispensing of medicines; 23.8% had bars or barriers between users and dispenser; 41.7% had computerized system; and 23.7% had counters for individual care. Among those responsible for dispensation, 87.4% said they always or repeatedly inform users how to use the medicines, and 18.1% reported developing some type of clinical activity. Isolated pharmacies presented a more developed physical and personal structure than those belonging to health units, but we found no significant differences regarding the information provided and the development of clinical activities.CONCLUSIONS There are major differences in the organization models of dispensation between cities, with regional differences regarding the physical structure and professionals involved. The centralization of medicine dispensing in pharmacies separated from the health services is associated with better structural and professional conditions, as in the dispensing units of the South, Southeast, and Midwest regions. However, the development of dispensation as health service does not prevail in any pharmacy or region of the Country yet.
Highlights
The availability of safe, effective, and required medicines, especially those considered essential to face the health problems of developing countries, was the keynote of international recommendations in recent decades, under the general title of “access to essential medicines.” access to medicines has increased in all countries, according to a survey of the World Health Organization[11]
Dispensing units that are isolated, not sharing spaces and structures with other health services, were considered as “isolated pharmacy”; dispensing units located with other health services and belonging to the municipal primary health care network were considered as “health unit pharmacy.”
We analyzed the 1,175 pharmacies/medicine dispensing units of the primary health care network surveyed by PNAUM, as well as the 1,139 interviewed professionals responsible for dispensing medicines in the dispensing units and the 495 municipal pharmaceutical services coordinators
Summary
The availability of safe, effective, and required medicines, especially those considered essential to face the health problems of developing countries, was the keynote of international recommendations in recent decades, under the general title of “access to essential medicines.” access to medicines (and their consumption) has increased in all countries, according to a survey of the World Health Organization[11]. The emphasis has been redirected beyond availability, covering the wider field of the qualification of use of medicines. Such an approach includes strategies so that patients receive the right medicine at the right time, using them properly and with benefit. To this end, health services need to develop activities and employ their capacity and existing resources to promote sustainable solutions that improve the outcomes of patients, which include the organization and qualification of medicine dispensing services as fundamental action[27]
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