Após décadas de afastamento, o farmacêutico busca retornar ao seu local primeiro de atuação, a farmácia. Esse retorno apresenta-se como tendência em muitos países, e também no Brasil. Entidades governamentais e profissionais esforçam-se para revalorizar a atuação do farmacêutico junto às atividades assistenciais, e uma contribuição significativa ocorreu com a publicação, pela Agência Nacional de Vigilância Sanitária (ANVISA), da Resolução de Diretoria Colegiada - RDC 44, em 17/08/2009. A Resolução estabelece critérios e condições mínimas para o cumprimento das Boas Práticas Farmacêuticas, e dá respaldo a vários Serviços Farmacêuticos no ambiente das farmácias e drogarias. Diante da tendência de retorno do farmacêutico à assistência, do crescimento dos cursos de Farmácia no país e do grande número de recém-formados que ingressam no segmento de farmácias e drogarias a cada ano, justifica-se verificar com se desenvolve o trabalho desses profissionais. O objetivo do presente trabalho consistiu em avaliar o perfil e a atuação dos farmacêuticos na vigência da Resolução 44/2009, em farmácias e drogarias do município de São Paulo. O estudo descritivo transversal desenvolveu-se junto às farmácias e drogarias do município de São Paulo, com aplicação de questionário ao farmacêutico. Abordou características gerais desse profissional e do estabelecimento, conhecimento do mesmo sobre a Resolução 44/2009, atividades assistenciais, relacionamento com os componentes da equipe de trabalho, aspectos de documentação, e a visão do farmacêutico, tanto de sua atividade como de si mesmo. As respostas foram testadas estatisticamente, e procurou-se verificar se a Resolução 44/2009 tem provocado mudanças em sua atuação, em relação aos Serviços Farmacêuticos (SF). Buscou-se identificar os principais fatores que se apresentam como obstáculos para o retorno do farmacêutico ao seu papel de agente de saúde. Os resultados indicaram que os farmacêuticos das farmácias e drogarias do município de São Paulo são jovens, formaram-se principalmente em instituições privadas, estão familiarizados com o termo \"atenção farmacêutica\", mas nem todos conhecem as condutas que esta prática envolve. Foram observados aspectos positivos, como a percepção dos profissionais de que a Resolução 44/2009 valorizou seu trabalho e que tem havido reconhecimento crescente de sua atuação. Existe inclinação para a prática assistencial, mas os farmacêuticos não desenvolvem plenamente os SF da Resolução 44/2009. Há, no entanto, muitas barreiras para a efetivação da atenção farmacêutica e demais serviços, o que dificulta a inserção do farmacêutico nas práticas assistenciais. Dentre as mais citadas estão a falta de tempo para tais práticas, formação deficiente ou inadequada, falta de autonomia e autoridade dos farmacêuticos, e a resistência dos empresários em considerar os serviços farmacêuticos como um diferencial de atendimento e possibilidade de ganhos financeiros. / After decades of absence the pharmacist seeks to return to his first workplace, the pharmacy. This return is shown as a trend in many countries, and also in Brazil. Government and professional entities strive to revalue the pharmacist\'s care activities, and in Brazil, a valuable contribution in this direction came with the publication of Collegiate Board Regulation RDC 44, in August 2009, by the National Agency of Sanitary Surveillance (ANVISA). This regulation establishes minimum conditions for Good Pharmaceutical Practices and gives legal backing to several pharmaceutical services in pharmacies. The trend of return to pharmaceutical care, the growth of Pharmacy courses in our country and the large number of new professionals who enter the pharmacy segment every year justify checking how this professional activity develops. The purpose of this study was to evaluate the profile and acting of pharmacists in the presence of Regulation 44/2009, in pharmacies of São Paulo. Data were collected through cross-sectional study with a questionnaire to pharmacists, including general characteristics of pharmacists and pharmacies, checking about the knowledge of Regulation 44/2009 and assistencial activities, documentation aspects (in the context of this Regulation), relationship with other components of the working team, and the vision of the community pharmacist, of himself and of his work. The answers were tested statistically, to check if Regulation 44/2009 has changed the performance of the pharmacists in relation to services listed therein, and which has been the main obstacles to its application. We attempted to identify the most relevant factors that stand out as obstacles to pharmacists on returning to their role as a health agent. The results showed that pharmacists in São Paulo are young, formed mainly in private institutions, are familiar with the term \"pharmaceutical care\", but not all knew about the practices involved. Positive aspects were observed, such as the Regulation 44/2009 valued pharmacist´s job, and there was an increasing recognition of him by the population. There is a tendency to care practice, but pharmacists do not develop, in a regular way, the SF of Regulation 44/2009. Several barriers were identified, however, for the effectiveness of pharmaceutical care and other services: the most cited were lack of appropriate working environment, poor training of pharmacists, lack of autonomy and authority for them, and the vision of businessmen, who show resistance in considering the pharmaceutical services as a differential in attendance.

Background: The Alliance for Patient Medication Safety (APMS) helps community pharmacies comply with continuous quality improvement requirements of many states and third party payment contracts through use of their Pharmacy Quality Commitment (PQC) program. Aims: To assess changes in the incidence of prescription Quality Related Events (QREs) and adoption of patient safety culture attitudes after guided PQC implementation. Methods: Twenty-one pharmacies were randomized to standard PQC practices (control) or guided PQC implementation (treatment). Pharmacy staff completed retrospective pre and post safety culture questionnaires. Negative binomial mixed and linear regression analyses were employed to examine changes in QREs rates and attitudes, respectively. Rasch analysis was used to assess questionnaire validity and reliability. Results: During the 2-month study period 3,343 QREs were reported to the online PQC system. At baseline, no difference in the average QRE reporting rate was identified between groups. Treatment group QRE reporting rates differed in one category post treatment (more incorrect safety caps QREs reported in treatment group, p<0.034). Seventy-one employees completed the questionnaire (70% response). Attitude improvement in the treatment group was 36% greater than in control (p<0.0001). The questionnaire demonstrated acceptable reliability and validity evidence. Conclusions: Guided PQC implementation increased reporting of certain QREs and increased the adoption of patient safety culture attitudes among staff pharmacy.

Tikslas: Remiantis slapto paciento metodika ištirti galimybę įsigyti antibiotikus Lietuvos visuomenės vaistinėse be recepto ir įvertinti pacientui suteikiamą informaciją konsultacijos metu. Uždaviniai: 1. Nustatyti galimybę įsigyti antibiotikus be recepto Lietuvos visuomenės vaistinėse. 2. Palyginti antibiotikų išdavimą be recepto slaptam pacientui simuliuojant alerginio rinito ir peršalimo simptomus. 3. Įvertinti pacientui suteikiamą informaciją, kai antibiotikai išduodami be recepto. 4. Išanalizuoti pacientui pateikiamą informaciją, kai antibiotikai be recepto neišduodami. Metodika: Tyrimui naudota slapto paciento metodika. Tyrimas vykdytas nuo 2011 m. rugsėjo iki 2012 m. birželio mėn. Tyrimo metu aplankyta 264 Lietuvos visuomenės vaistinės 4 Lietuvos miestuose: Vilniuje, Kaune, Panevėžyje ir Alytuje. Tyrimo metu buvo pateikti du skirtingi scenarijai: vaistinėje buvo simuliuojamos peršalimo ir alerginio rinito simptomai. Surinkta informacija buvo žymima tyrimo formoje. Duomenys analizuoti statistine programa SPSS 17.00. Rezultatai: 8 proc. (p<0,001) iš aplankytų vaistinių išdavė antibiotikus be recepto. Antibiotikai dažniau buvo išduoti simuliuojant peršalimo simptomus – 10 proc. ir rečiau simuliuojant alerginio rinito simptomatiką - 5 proc. Daugiau nei pusė farmacijos specialistų (57 proc.), kurie atsisakė išduoti antibiotikus, tęsė bendravimą su pacientais. 45 proc. farmacijos specialistų, atsisakiusių išduoti antibiotikus, kaip priežastį, nurodė sveikatos įstatymą, 17... [toliau žr. visą tekstą] / Aim: To explore availability of antibiotics without prescription in Lithuanian community pharmacies and to evaluate the provision of appropriate health information. Tasks: 1. To identify potential to obtain antibiotics without prescription in community pharmacies 2. Compare antibiotics issuing when cold and allergy rhinitis are simulating. 3. To evaluate information for patient when antibiotics are issued. 4. To estimate information for patient when antibiotics are not issued. Methodology: A research was developed based on the methodology of secret patient. Total 264 pharmacies in 4 different Lithuanian cities were visited. Study was performed from September 2011 through June 2012. Two different cases were presented at pharmacies. The secret patient tried to buy amoxicillin without providing a prescription for cold symptoms and for allergy rhinitis symptoms. The reason for dispensing or refusing to dispense antibiotics was recorded in standardized visit form. Data were entered and analyzed with the SPSS Statistics 17.0 package. Results: Antibiotics were dispensed in 8 % (p<0,001) of visited pharmacies. They were obtained from 10% of pharmacies when cold was simulated and from 5% of pharmacies when allergic rhinitis was simulated. More than half pharmacy specialists (57 %), that refused to sell antibiotics without prescription continued consultation. 45 % of visited pharmacy specialists refused to dispense antibiotics because of health law. Pharmacy specialists from 17 % of... [to full text]

Tikslas: Išanalizuoti Lietuvos visuomenės vaistinėse dirbančių farmacijos specialistų požiūrį į pacientams suteikiamą informaciją apie galimus vaistų nepageidaujamus poveikius. Darbo metodika: Tyrimui atlikti buvo taikomas analizės metodas – anketavimas. Apklausta 230 farmacijos specialistų dirbančių visuomenės vaistinėse. Tyrimo duomenys apdoroti naudojant SPSS 17.0 versiją. Darbe pateikiami grafikai ir lentelės sudaryti MS Excel 2007 programa. Rezultatai: Daugumos farmacijos specialistų (98,2%) nuomone, teikti informaciją apie NRV yra būtina. Pagrindiniai veiksmai, pacientui pasireiškus NRV, yra paciento nukreipimas pas gydytoją (93,8%) arba konsultavimas (73,0%). Tik 4 proc. respondentų nesusiduria su problemomis teikiant informaciją susijusią su NRV. Pagrindiniai barjerai iš farmacijos specialisto pusės yra laiko (83,7%) bei žinių (57,2%) trūkumas, o iš paciento pusės – nenoras išklausyti suteikiamos informacijos (63,9%), nedrąsa klausti (44,6%), konfidencialumo (42,1%) bei išsilavinimo (41,6%) trūkumas. Nustatyta, kad ne visos vaistų grupės yra vienodai svarbios suteikiant informaciją apie NRV (p<0,05). Pagrindinės vaistų grupės yra antidepresantai (82,4%), krešumo sistemą veikiantys vaistai (82,4%), antibiotikai (79,4%), antipsichoziniai vaistai (73,5%) bei NVNU (67,6%). Išvados: 1. Farmacijos specialistų nuomone, informacijos apie NRV teikimas pacientams yra būtinas, tačiau ne visi sutinka, kad jis yra pagrindinis asmuo, galintis suteikti šią informaciją. Daugiau nei... [toliau žr. visą tekstą] / Objective: To analyze the attitude of pharmaceutical professionals working in Lithuanian community pharmacies towards providing information about adverse drug reactions. Methods: A questionnaire method was aplied during this research. 230 of 264 pharmacists working in community pharmacies participated in the survey (response rate 87,1%). Results: The majority of pharmaceutical professionals (98,2%) believed that the provision of information about adverse drug reactions (ADRs) is necessary. 97,8% of respondents said that they spoke to patients about reported adverse effects to drugs.The main pharmacists actions after receiving information that patients experienced ADRs were consulting (93,8%) or reffering the patient to a doctor (73,0%). Almost all (96%) respondents told that they have problems when providing information about ADRs. 3 out of 4 specialists point out that the main problem is the lack of time. Approximately half of them think that they lack of knowledge to provide such information. Problems encountered from the patient‘s side is their unwillingness to listen to the information provided (63,9%), timidity to ask for such information (44,6%), lack of privacy (42,1%) and education (41,6%).It was found that not all drug groups are equally important in providing information about ADRs (p<0,05). The main groups of medicines are antidepressants (82.4%), coagulation system drugs (82.4%), antibiotics (79.4%), antipsychotics (73.5%) and NSAIDs (67.6%). Conclusion: According... [to full text]

Diss. (sammanfattning) Stockholm : Karol inst., 2003. / Härtill 6 uppsatser.

A farmácia comunitária ocupa um importante espaço no cenário da saúde pública brasileira, como local de dispensação de medicamentos e de contínua promoção do consumo de medicamentos para a população. Nesses estabelecimentos, o usuário busca através do consumo de produtos, prescritos ou não, o restabelecimento da sua saúde. O farmacêutico é o profissional de saúde com formação específica sobre medicamentos e que, pelo imperativo da legislação sanitária, é colocado como responsável técnico, nesse lócus. Qual sua motivação para ingressar nessa carreira? Como é a sua práxis e qual a realidade percebida por ele nesse cotidiano? Este trabalho teve como objetivo identificar a concepção que os farmacêuticos responsáveis técnicos, atuantes em farmácias comunitárias do estado do Rio de Janeiro, têm sobre a sua prática profissional e como essa visão pode estar relacionada à implementação de práticas focadas no paciente, tais como a Atenção Farmacêutica. Foram realizadas 15 entrevistas semi-estruturadas com farmacêuticos responsáveis técnicos de farmácias do estado do Rio de Janeiro, representando a seguinte tipologia: farmácias de rede estadual, de rede local e familiar. A categorização do discurso dos farmacêuticos mostrou, pelo menos, quatro convergências: a deficiência no processo de formação acadêmica, a prática farmacêutica migrando para o paciente, as contínuas dificuldades da população quanto ao uso de medicamentos e o conhecimento superficial do conceito de Atenção Farmacêutica. Pensa-se que a realidade encontrada possa não ser muito diferente da de grande número de farmácias comunitárias do próprio estado do Rio de Janeiro, sendo necessário fazer reflexões sobre esse tema, para nos conduzir a um momento de discussão sobre quais elementos poderão vir a garantir, que a práxis farmacêutica se insira com complementaridade nos serviços de saúde. / The community pharmacy has an important scene in the Brazilian public health, and local medication dispensing and continuously promote the consumption of medicines to the population. In these establishments, the user search through the consumption of products, prescribed or no, the restoration of his health. The pharmacist is a health professional with specific training on drugs and that the imperative of health legislation, is placed as technical manager, this locus. What is your motivation to enter this career? How is your practice and what is perceived by him in everyday reality? This study aimed to identify the conception that pharmaceutical technicians responsible, active in community pharmacies in the state of Rio de Janeiro, have on their professional practice and how this vision can be related to the implementation of patient-focused practices, such as pharmaceutical care. 15 semi-structured interviews with pharmacy technicians in the state of Rio de Janeiro were held responsible pharmacists, representing the following typology: pharmacies statewide network of local and family network. The categorization of the speech of pharmacists showed at least four convergences: a deficiency in the academic learning process, pharmaceutical practice migrating to the patient, the continuing difficulties of the population regarding the use of drugs and the superficial knowledge of the concept of pharmaceutical care. It is thought that the actual situation may not be very different from the large number of community pharmacies in the state of Rio de Janeiro itself, calling for thoughts on this topic to bring us to a moment of discussion about which elements are likely to ensure , the pharmaceutical insert with complementary praxis in health services.

A farmácia comunitária ocupa um importante espaço no cenário da saúde pública brasileira, como local de dispensação de medicamentos e de contínua promoção do consumo de medicamentos para a população. Nesses estabelecimentos, o usuário busca através do consumo de produtos, prescritos ou não, o restabelecimento da sua saúde. O farmacêutico é o profissional de saúde com formação específica sobre medicamentos e que, pelo imperativo da legislação sanitária, é colocado como responsável técnico, nesse lócus. Qual sua motivação para ingressar nessa carreira? Como é a sua práxis e qual a realidade percebida por ele nesse cotidiano? Este trabalho teve como objetivo identificar a concepção que os farmacêuticos responsáveis técnicos, atuantes em farmácias comunitárias do estado do Rio de Janeiro, têm sobre a sua prática profissional e como essa visão pode estar relacionada à implementação de práticas focadas no paciente, tais como a Atenção Farmacêutica. Foram realizadas 15 entrevistas semi-estruturadas com farmacêuticos responsáveis técnicos de farmácias do estado do Rio de Janeiro, representando a seguinte tipologia: farmácias de rede estadual, de rede local e familiar. A categorização do discurso dos farmacêuticos mostrou, pelo menos, quatro convergências: a deficiência no processo de formação acadêmica, a prática farmacêutica migrando para o paciente, as contínuas dificuldades da população quanto ao uso de medicamentos e o conhecimento superficial do conceito de Atenção Farmacêutica. Pensa-se que a realidade encontrada possa não ser muito diferente da de grande número de farmácias comunitárias do próprio estado do Rio de Janeiro, sendo necessário fazer reflexões sobre esse tema, para nos conduzir a um momento de discussão sobre quais elementos poderão vir a garantir, que a práxis farmacêutica se insira com complementaridade nos serviços de saúde. / The community pharmacy has an important scene in the Brazilian public health, and local medication dispensing and continuously promote the consumption of medicines to the population. In these establishments, the user search through the consumption of products, prescribed or no, the restoration of his health. The pharmacist is a health professional with specific training on drugs and that the imperative of health legislation, is placed as technical manager, this locus. What is your motivation to enter this career? How is your practice and what is perceived by him in everyday reality? This study aimed to identify the conception that pharmaceutical technicians responsible, active in community pharmacies in the state of Rio de Janeiro, have on their professional practice and how this vision can be related to the implementation of patient-focused practices, such as pharmaceutical care. 15 semi-structured interviews with pharmacy technicians in the state of Rio de Janeiro were held responsible pharmacists, representing the following typology: pharmacies statewide network of local and family network. The categorization of the speech of pharmacists showed at least four convergences: a deficiency in the academic learning process, pharmaceutical practice migrating to the patient, the continuing difficulties of the population regarding the use of drugs and the superficial knowledge of the concept of pharmaceutical care. It is thought that the actual situation may not be very different from the large number of community pharmacies in the state of Rio de Janeiro itself, calling for thoughts on this topic to bring us to a moment of discussion about which elements are likely to ensure , the pharmaceutical insert with complementary praxis in health services.

No description available.

No description available.

<p>  </p> <p><strong>OBJECTIVES:</strong> Medication synchronization (med-sync) aligns patients’ chronic medications to a predetermined routine pickup date at a community pharmacy. An appointment-based model (ABM) med-sync service includes a comprehensive medication review at the pharmacy. We had the following objectives: (1) To systematically characterize literature describing healthcare utilization, cost clinical, and humanistic outcomes for patients enrolled in medication synchronization, (2) to determine the characteristics of Medicare Part D beneficiaries’ receipt of medication synchronization program and (3) to compare healthcare utilization outcomes of Medicare beneficiaries enrolled in an ABM med-sync program to beneficiaries not enrolled in such a program.</p> <p><br></p> <p><strong>METHODS:</strong> A systematic literature review was conducted using electronic databases from January 2008 to October 2022. The retrospective cohort study analyzed Medicare claims data from 2014-16 for a sample of 1 million beneficiaries utilizing community pharmacies identified as offering a med-sync program. Medicare inpatient, outpatient, emergency, and pharmacy claims data were used to create med-sync and non-med-sync cohorts. We applied Andersen’s Health Services Utilization model to determine factors associated with med-sync enrollment. We constructed logistic regression models with med-sync enrollment as the dependent variable adding predisposing, enabling, and need variables. Descriptive statistics and bi-variate analysis were performed on the cohorts. All patients were followed longitudinally for 12 months before and after a 2015 index/enrollment month to calculate healthcare utilization. Difference-in-differences (DID) was used to compare mean changes in utilization outcomes between cohorts before and after enrollment.</p> <p><br></p> <p><strong>RESULTS:</strong> Through systematic review, we found limited studies related to costs and healthcare utilization. Med-sync programs have shown to increase drug adherence to medications and improve patient satisfaction. For our study with Medicare beneficiaries, we identified 13,193 beneficiaries in the med-sync cohort and 156,987 beneficiaries in non-med sync (control) cohort. As age of beneficiaries increased, likelihood of med-sync enrollment increased (AOR=1.003, 95% CI:1.001-1.005). There were ​higher odds of enrollment for beneficiaries residing in Northeast (AOR=1.094, 95% CI:1.018-1.175), South (AOR=1.109, 95% CI:1.035-1.188), and West (AOR=1.113, 95% CI:1.020-1.215) than the Midwest. Beneficiaries residing in non-metro areas had lower odds of enrollment​ (AOR: 0.914, 95% CI: 0.863-0.969) than metro areas. Beneficiaries with less previous inpatient hospitalizations (AOR=0.945, 95% CI:0.914-0.977) were less likely to be enrolled whereas those with higher outpatient visits (AOR=1.003, 95% CI:1.001-1.004) were more likely to be enrolled. Beneficiaries taking a higher number of oral chronic medications (AOR=1.005, 95% CI:1.002-1.008) had greater odds of enrollment in med-sync. After propensity matching, 13,193 beneficiaries in each cohort were used for analysis. Mean pharmacy utilizations increased before and after enrollment for both cohorts while mean outpatient utilization decreased before and after enrollment for med-sync cohort only. Healthcare utilization mean DID were significantly less in the med-sync cohort compared to the non-med-sync cohort for outpatient visits (DID: 0.01, p=0.0073) and pharmacy fills (DID: 0.01, p<0.0001). There was no significant DID for inpatient and emergency visits between cohorts.</p> <p><br></p> <p><strong>CONCLUSION:</strong> Disparities in age, geographic region, type of residence and prior health utilization for med-sync enrollment were identified. Outpatient and pharmacy utilization changes were significantly lower in med-sync cohort compared to the non-med-sync cohort in the 12-months after enrollment. Lower pharmacy utilization could be due to optimization of therapy during medication reviews of ABM med-sync. As Medicare is approaching to a value-based system, there needs to be a greater focus on systems such as med-sync that has shown to improve a patient’s adherence. </p>