Pharmaceutical care in the rational use of medicines in basic health units: a systematic review

Karoline Tamirys Da Silva Paiva,Luanne Eugênia Nunes,Jéssica Costa De Oliveira,Rosueti Diógenes De Oliveira Filho,Francisco Ernesto De Souza-Neto

doi:10.33448/rsd-v9i9.7021

Abstract

The World Health Organization (WHO) defines the adverse reaction to the medication as a harmful or unwanted reaction that appears after the administration of a medicines used to prevent or treat a disease or symptoms. The irrational use of medications is a serious problem and is related when the patient purchases medicines with no indication or professional guidance on their use. This leads to exposure to problems related to medications, as well as adverse reactions, directing the population to Primary Care units. In this context, there is a need for the insertion of the pharmacist providing clinical services in these units. The work aimed to carry out a systematic review of the literature of studies on Pharmaceutical Care in Basic Health Units and the impacts on the irrational use of medicines, as well as the role of the pharmacist in this process. Initially, 53 articles were selected from the SciELO, LILACS and BVS databases, where only 2 articles met the inclusion criteria of the review. It was evident that the monitoring of a professional providing Pharmaceutical Care and guiding patients to the best use of their medicines received in Primary Care is beneficial to the health of the population. Just as this professional would increase the number of assisted inhabitants, in addition to reducing the practice of self-medication. In addition, the authors of both articles also show that the importance of the pharmacist in Primary Care, acting in addition to Pharmaceutical Assistance, also in Pharmaceutical Care, presents better management of resources used in the municipality's pharmacy.

Highlights

The irrational use of medicines is configured as one of the biggest public health problems worldwide, and it is estimated that more than half of all medicines are prescribed and/or dispensed inappropriately, most of them used incorrectly
drug-related problems (DRP) and Adverse Drug Reaction (ADR) can arise from the irrational use of medicines, defined by the World Health Organization (WHO) as a practice when patients receive medicines for their clinical conditions in doses appropriate to their individual needs, for an appropriate period and at the lowest cost for themselves and the community, and when purchasing drugs in a way where there is no indication or professional guidance on their use, the patient is exposed to such problems and adverse reactions (Aizenstein & Tomassi, 2011)
The first pre-analysis stepe consisted of the phase of identification in the databases and selection of articles regarding duplicity, followed by the step of exploration of the material with the phases of eligibility and inclusion of articles that corresponded to the guiding question of the proposed thematic content, and the treatment of the data of each article for the interpretation and critical discussion that make up the systematic review

Summary

Introduction

The irrational use of medicines is configured as one of the biggest public health problems worldwide, and it is estimated that more than half of all medicines are prescribed and/or dispensed inappropriately, most of them used incorrectly. This condition can trigger overuse or underuse of the medicine (WHO, 2010). DRP and ADR can arise from the irrational use of medicines, defined by the WHO as a practice when patients receive medicines for their clinical conditions in doses appropriate to their individual needs, for an appropriate period and at the lowest cost for themselves and the community, and when purchasing drugs in a way where there is no indication or professional guidance on their use, the patient is exposed to such problems and adverse reactions (Aizenstein & Tomassi, 2011) According to Janebro et al (2008), there are six drug-related problems (DRP) classified as: of necessity, where the patient suffers a problem as a result of not receiving a medication he needs (DRP 1) or the patient suffers a health problem as a result of receiving a medication you don't need (DRP 2); effectiveness, where the patient suffers a health problem as a result of a non-quantitative ineffectiveness of the medication (DRP 3) or the patient suffers a health problem as a result of a quantitative ineffectiveness of the medication (DRP 4); and safety, where the patient suffers a health problem as a result of a non-quantitative insecurity of a medication (DRP 5) or the patient suffers a health problem as a result of a quantitative insecurity of a medication (DRP 6).

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