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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
51

Public-private partnerships : a qualitative approach to prospects for pharmacy in the South African health care environment / Johan Christiaan Lamprecht

Lamprecht, Johan Christiaan January 2007 (has links)
BACKGROUND: Powerful public-private partnerships (PPPs) can only be established if the partners are able to deal with complexity. Such partnerships may serve to stimulate local community and economic development. Thus, it may maximise the effectiveness of local groups and resources in meeting the needs for rebuilding a community through a partnership representative of the public and private sectors. A problem that exists in South Africa, is the uneven distribution of population ratios dependent on public and private sector health care service delivery, in relation to the proportion of pharmaceutical service providers in the different sectors. OBJECTIVE: The main objectives of this qualitative research investigation were to examine the prospects for PPP development in the pharmaceutical sector of South Africa as well as to explore the possibilities of a proposition for a proposed generic public-private partnership model to be managed and used in the pharmaceutical sector of South Africa. METHOD: The study comprises of the exploration of the research questions by means of a qualitative research design. The study design implicated a balance between the in-depth literature study and a qualitative research process. The researcher employed a grounded theory approach to collect and analyse the data. Data collection represented the identifiable role players and opinion formulators in the South African health care sector. By following a combination of the various qualitative sampling methods and techniques, a total of 38 (n=38) interviews were conducted. The data collected from the interviewees and from the literature study were integrated and analysed by making use of computer assisted data analysis. SETTING: The researcher selected interviewees from the South African health care sector. The interviews included role players in the pharmaceutical sector in both the public and private sectors. The interviewees further represented eight different spheres of the pharmaceutical setting in South Africa. KEY FINDINGS: The investigation identified a range of prospects for PPP development in South Africa and these were reported in terms of views, expectations and scope for success. The management elements for developing and sustaining joint ventures between the public and private sectors were identified and a proposition was formulated in theory to serve as a proposed generic PPP model (PGM) in the pharmaceutical sector for the South African health care milieu. CONCLUSION The exploratory qualitative investigation surfaced the various facets of the complexity of PPPs. The investigation concluded that several barriers, such as competition and market entry disparities between the macro and micro level pharmaceutical entities, which impede PPP development, affected the prospects for PPP development in South Africa. The South African legislation, South African Treasury guidelines, regulations and the views of the SA Competition Commission need transformation to accommodate both the micro and macro level pharmaceutical service providers in the formation of PPPs. Capacity building within the sphere of pharmaceutical service delivery to the bigger population of South Africa may become sustainable on removal of these barriers. A series of recommendations were presented and several critical issues in need of supplementary research, have been identified. / Thesis (Ph.D. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2007.
52

An evaluation of the effects of policy changes on pharmacy participation in the Wisconsin Medicaid Pharmaceutical Care Project /

Chou, Chia-Hung. January 1900 (has links)
Thesis (Ph.D.)--University of Wisconsin--Madison, 2006. / Includes bibliographical references (p. 155-163). Also available on the Internet.
53

An evaluation of the effects of policy changes on pharmacy participation in the Wisconsin Medicaid Pharmaceutical Care Project

Chou, Chia-Hung. January 1900 (has links)
Thesis (Ph.D.)--University of Wisconsin--Madison, 2006. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (p. 155-163).
54

Η εικόνα των καταναλωτών για το ελληνικό φαρμακείο και ο βάθμος ικανοποίησης τους από τις παρεχόμενες φαρμακευτικές υπηρεσίες

Πλακούτση, Αγγελική 29 July 2011 (has links)
Η παρούσα εργασία εκπονήθηκε στο πλαίσιο του Μεταπτυχιακού Προγράμματος Σπουδών, στην κατεύθυνση “Φαρμακευτικό Μάρκετινγκ”, του τμήματος Φαρμακευτικής του Πανεπιστημίου Πατρών. Σκοπός της εργασίας ήταν να ερευνηθούν τα κριτήρια με βάση τα οποία οι καταναλωτές επιλέγουν το φαρμακείο που θα κάνουν τις αγορές τους, την εικόνα που έχουν για το ελληνικό φαρμακείο και κυρίως για το φαρμακοποιό, και το βαθμό ικανοποίησής τους από τη στάση του φαρμακοποιού και γενικά από τις υπηρεσίες που παρέχονται στο φαρμακείο. Παράλληλα, επιδίωξη της εργασίας ήταν να μελετήσει τις σχέσεις που μπορεί να υπάρχουν: • μεταξύ των διαφόρων χαρακτηριστικών του φαρμακείου, ως προς τη σημαντικότητά τους, για τους καταναλωτές κατά την επιλογή του φαρμακείου που θα πραγματοποιήσουν τις αγορές τους, • μεταξύ των χαρακτηριστικών-κριτηρίων αυτών και δημογραφικών χαρακτηριστικών, • μεταξύ της εικόνας των καταναλωτών για το φαρμακοποιό ως επιστημονικό σύμβουλο και δημογραφικών χαρακτηριστικών, • μεταξύ του βαθμού ικανοποίησης από τις παρεχόμενες φαρμακευτικές υπηρεσίες και δημογραφικών χαρακτηριστικών. Ειδικότερα στοχεύουμε στη συσχέτιση των δημογραφικών χαρακτηριστικών με: (α) το κριτήριο της τοποθεσίας του φαρμακείου, (β) το κριτήριο της εξυπηρετικότητας στο φαρμακείο, (γ) το κριτήριο του διαθέσιμου χώρου πάρκινγκ του φαρμακείου, (δ) το κριτήριο της ωραίας διακόσμησης του φαρμακείου, (ε) το κριτήριο της παρουσίας εξειδικευμένου επιστήμονα (π.χ. αισθητικός, διαιτολόγος) στο φαρμακείο, (στ) την εικόνα του φαρμακοποιού ως επιστημονικού συμβούλου, (ζ) το βαθμό ικανοποίησης των καταναλωτών από τις παρεχόμενες φαρμακευτικές υπηρεσίες. Για το σκοπό αυτό χρησιμοποιήθηκε πρωτότυπο ερωτηματολόγιο με ερωτήσεις κλειστού τύπου. Το σχήμα που εφαρμόστηκε για την επιλογή του δείγματος είναι η “στρωματοποιημένη τυχαία δειγματοληψία.” Ερωτήθηκαν 200 άτομα σε δείγμα δύο επαρχιακών πόλεων, οι οποίες επιλέχθηκαν σύμφωνα με τη “βολική δειγματοληψία.” Η συλλογή των στοιχείων έγινε τον Ιούλιο του 2008. Από την ανάλυση των δεδομένων βρέθηκε ότι η σειρά μειούμενης σημαντικότητας των κριτηρίων, που επηρεάζουν τους καταναλωτές στην επιλογή του φαρμακείου που θα κάνουν τις αγορές τους, είναι η εξής: η βολική τοποθεσία, οι χαμηλές τιμές, το επίπεδο εξυπηρέτησης, ο ευγενικός φαρμακοποιός, η μεγάλη ποικιλία των προϊόντων, η καλή φήμη του φαρμακείου, η παρουσία εξειδικευμένου επιστήμονα στο φαρμακείο, η ωραία διακόσμηση του φαρμακείου. Επίσης, βρέθηκε ότι δεν υπάρχει στατιστικά σημαντική συσχέτιση: (α) μεταξύ του φύλου και του κριτηρίου της εξυπηρετικότητας, (β) μεταξύ του επιπέδου μόρφωσης, της ηλικίας, του εισοδήματος, και του αριθμού των παιδιών των καταναλωτών, με την εικόνα που έχουν για τον φαρμακοποιό ως επιστημονικό σύμβουλο, (γ) μεταξύ του φύλου, της ηλικίας, του επιπέδου μόρφωσης, της οικογενειακής κατάστασης, και της επαγγελματικής κατάστασης των καταναλωτών, με τον βαθμό ικανοποίησης των καταναλωτών από την αξία των υπηρεσιών που παρέχουν τα φαρμακεία σήμερα. Ακόμη, βρέθηκε ότι οι άνδρες θεωρούν πιο σημαντικό το διαθέσιμο χώρο πάρκινγκ σε ένα φαρμακείο προκειμένου να το επιλέξουν για τις αγορές τους, σε σχέση με τις γυναίκες. Επιπλέον, οι γυναίκες θεωρούν σημαντικότερο κριτήριο την ωραία διακόσμηση στο φαρμακείο από τους άντρες για την επιλογή του φαρμακείου. Σημαντικό εύρημα είναι ότι οι γυναίκες συμφωνούν περισσότερο από τους άντρες στο ότι ο φαρμακοποιός είναι κυρίως επιστημονικός σύμβουλος. / This study is a survey of customers shopping in Greek pharmacies and their satisfaction from purchases, pharmaceutical services and store atmosphere. Concretely, the objective is to study the following: i) the factors that affect patients to choose a pharmacy for their shopping (aesthetical, designing, personnel), ii) patients’ view for the role of pharmacists (consulters, businessman, doctor’s assistant), iii) patients’ satisfaction from pharmaceutical services. The data collected from a sample of 200 patients-customers, in two small Greek cities. The sampling method was convenient sampling and the sampling plan was stratified random sampling. Age was used as layer sampling. SPSS (statistical package for the social sciences) statistical program was used for the inductive data analysis. From the statistical analysis, we found the importance of some factors that affect patients in choosing pharmacy for their shopping. When choosing a pharmacy, its location was considered the most important factor. Less important factors were prices, service, personnel’s attitude, wide choice, specialized scientist in pharmacy (dietician) and pharmacy decoration. It was also found that for men is very important the available parking in order to choose pharmacy. Women consider more important beautiful pharmacy decoration in order to choose it. Relation was not found between sex and pharmacy personnel service, and, location and age. The role of the pharmacy personnel was viewed in three different ways, as: counselor, doctor’s assistant and businessman. It was also believed that sometimes the pharmacy personnel might play a double role-both as doctor and pharmacist. Women, married, separated thought that pharmacist is basically counselor. It is very important that women think of pharmacist as mainly scientific advisor, more than men. It is important that patients believe that pharmacists need more scientific education. Relation was not found between education, age, income, number of children and pharmacy’s view as scientific advisor. Customers were satisfied from their pharmacist’s: behavior-kindness, secrecy, help choosing the right medicine, professional consultation. A percentage of 37% of patients are very satisfied from their pharmacist’s advice. 50% of patients are very satisfied from the existing schedule of pharmacies. Important relation was found between patients’ income, children number and satisfaction. Patients having income above 3000 were more satisfied from pharmaceutical services, than customers with lower income, maybe because they do not experience health system with the same way. Customers with one or two kids feel more satisfaction from pharmaceutical services, maybe because they are new parents and this feeling is unknown. Relation was not found between sex, age, education, professional situation and satisfaction from pharmaceutical services. Customers are more satisfied: i) when their pharmacist helps them to select the correct medicine, despite when their pharmacist provides them some advice with regard to their medication treatment, ii) when their pharmacist is secretive concerning their health problems despite when their pharmacist has polite behavior. The results of research can be the reason for same or similar researches in the future in Greece, as health products are a very important part of economy.
55

Estudo de utilização de medicamentos antieméticos no serviço de oncologia pediátrica de um hospital do sul do Brasil

Sampaio, Gabriella Calvi January 2014 (has links)
A náusea e o vômito são um importante efeito adverso do tratamento antineoplásico. Impactam na redução da qualidade de vida, sendo citados como as piores manifestações pelos pacientes oncológicos. O fator de risco primário para o desenvolvimento destes sintomas é o Potencial Emetogênico da Quimioterapia. Sendo assim, é importante a utilização de uma adequada farmacoterapia antiemética com as alternativas terapêuticas eficazes e seguras disponíveis. Neste contexto, os Estudos de Utilização de Medicamentos são uma ferramenta valiosa para verificar padrões de utilização de medicamentos em instituições de cuidado em saúde. Além disto, alia-se a importância da discussão sobre este tema em crianças, visto que esta faixa etária é especialmente vulnerável e não participa de estudos clínicos para a aprovação de fármacos. O objetivo deste estudo foi avaliar a prescrição e utilização dos medicamentos antieméticos na unidade de oncologia pediátrica do Hospital de Clínicas de Porto Alegre. Trata-se de um estudo descritivo, transversal e retrospectivo, através de consulta ao prontuário eletrônico dos pacientes. Foram analisadas um total de 262 internações. Observou-se o predomínio da prescrição de quimioterapia de moderado e de alto Potencial Emetogênico. Constatou-se a presença de vômito em 82 internações, enquanto que a náusea ocorreu em 117 internações. Na maioria das internações foram administrados de 2 a 3 antieméticos com intervalos fixos, porém uma grande parte das prescrições não seguiu o recomendado pelos guidelines consultados, observando-se a falta de um protocolo antiemético. É importante a escolha do tratamento apropriado para cada paciente, levando-se em consideração a história pregressa do aparecimento de náuseas e vômitos para que se obtenha a melhor resposta terapêutica. A oncologia pediátrica necessita continuidade de Estudos de Utilização de Medicamentos para ampliar o conhecimento nesta área de forma a garantir a melhor qualidade de vida destes pacientes. / Nausea and vomiting are an important adverse effect of antineoplastic treatment. Their impact consists of a significant reduction in the quality of life, being mentioned by these patients as the worst side effects. The primary risk factor for the development of these symptoms is the emetogenic potential of chemotherapy. Therefore, it is important to use an appropriate antiemetic pharmacotherapy with the safest and most effective therapeutic alternatives available. In this context, the Drug Utilization Studies are a valuable tool to check patterns of medication use in health care institutions. Furthermore, it is necessary to emphasize the importance of discussion on this topic concerning children, since this age group is particularly vulnerable and does not participate in clinical trials for the approval of drugs. The objective of this study was to evaluate the prescription and use of antiemetic medications in the pediatric oncology unit in Hospital de Clínicas de Porto Alegre. This is a descriptive, cross-sectional retrospective study, made by consulting the electronic medical records of patients. A total of 262 hospitalization cases were analyzed. There was a predominance of prescriptions of chemotherapy with moderate and high emetogenic potential. There was vomiting in 82 cases, while there was nausea in 117 cases. In most hospitalizations, 2-3 antiemetics were administered at fixed intervals, but a large proportion of prescriptions did not follow what is recommended by the guidelines consulted, which highlights the fact that no antiemetic protocol is followed. It is important to choose the appropriate treatment for each patient, taking into account their past history of nausea and vomiting in order to obtain the best therapeutic response. The pediatric oncology needs further Drug Utilization Studies to contribute to the knowledge in this area to ensure the best quality of life of these patients.
56

Análise de papéis, formas de comunicação e fluxos de informação para o atendimento ao usuário na assistência farmacêutica : um estudo pela percepção do serviço de farmácia

Facó, Renata Tilemann January 2016 (has links)
A Assistência Farmacêutica (AF) é um conceito de prática profissional onde o usuário que precisa do medicamento é o mais importante beneficiário das ações do farmacêutico e dos demais profissionais de saúde que atendem este serviço, ou seja, o usuário é o centro da atenção destes profissionais. Ela, entretanto, não pode ser visualizada apenas pela função de dispensar medicamentos, mas sim como um serviço que complementa as ações em saúde, com um enfoque amplo, incorpora a multidisciplinaridade e a integralidade. O sucesso deste processo depende da participação das diferentes classes de profissionais da saúde, além dos usuários. Este trabalho tem como objetivo analisar os papéis, as formas de comunicação e os fluxos de informação que influenciam nas operações multiprofissionais de atendimento ao usuário na Assistência Farmacêutica. Para tanto, foi escolhido o município de Arroio do Tigre/RS onde foram entrevistados os médicos, enfermeiros, técnicos de enfermagem, farmacêuticos, agentes de saúde, dentistas, psicólogos e assistentes sociais envolvidos na rede multiprofissional de Assistência Farmacêutica do município. Os dados obtidos nas entrevistas foram analisados qualitativamente, com o apoio de planilhas no software Excel para identificação de padrões entre os respondentes. Os fluxos de comunicação/informação foram analisados com o auxílio da ferramenta de análise de redes sociais, o NodeXL. O estudo permitiu observar que há uma necessidade de melhoria da comunicação e do fluxo de informação existente entre os profissionais além de um aumento da clareza do conceito do sistema entre os envolvidos na rede de atendimento ao usuário, esclarecendo as responsabilidades e papéis de cada um dentro da rede para uma gestão de atendimento na AF mais eficaz. / The Pharmaceutical Services consists of a set of people with different relations among them, exchanging lots of information on a daily basis. Thus, it cannot be seen as just a function of dispensing drugs, but as a resource complementing healthcare actions, with a wide approach that incorporates a multidisciplinary and integrality. The success of this process depends on the participation of different classes of healthcare professionals, besides users. The aim of this paper is to study the roles, the forms of communication and information flows that influence multidisciplinary operations of service to users in Pharmaceutical Services. Therefore, the city of Arroio do Tigre/RS was chosen and interviews occurred with professionals such as doctors, nurses, nursing technicians, pharmacists, health workers, dentists, psychologists and social workers involved in the city’s Pharmaceutical Services multidisciplinary network. The data obtained from the interviews were qualitatively analyzed, with the support of Microsoft Excel’s spreadsheets for the identification of patterns among the interviewed. The communication/information flows were analyzed with the aid of NodeXL, a social network analysis tool. The study concluded that there is a need of communication and information flow improvement as well as a more clarity regarding the system concept among the professionals involved in the user service network, clarifying the accountabilities and roles of each one inserted in the network for a more effective drug management.
57

Ensino-aprendizagem da política nacional de medicamentos (RENAME e URM) na Graduação Médica da Universidade Federal do Tocantins / Brazilian National Drugs Policy teaching and learning at the Federal University of Tocantins to medical students

Andrade, Elizangela Braga [UNIFESP] 21 March 2014 (has links) (PDF)
Made available in DSpace on 2018-06-06T11:36:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-03-21 / O estudo teve por objetivo geral caracterizar o ensino sobre a Política Nacional de Medicamentos (PNM) na graduação médica da Universidade Federal do Tocantins, focalizando a instituição e seus atores - coordenador do curso, docentes e alunos. Trata-se de um estudo descritivo, em caráter exploratório, apoiado em abordagem qualitativa, que comportou três movimentos investigativos. O primeiro se propôs a identificar, por meio do Projeto Político e Pedagógico, as disposições relativas ao ensino disponibilizado na instituição. O segundo, através de entrevistas semiestruturadas, buscou apreender o ensino da questão do medicamento na perspectiva do coordenador do curso e de docentes das disciplinas de Saúde Coletiva, Saúde da Família: Vivências em Atenção Básica I, Farmacologia Básica e Farmacologia Médica. O terceiro movimento, por sua vez, utilizando a estratégia de grupos focais, viabilizou a qualificação deste ensino sob a perspectiva de estudantes no ciclo básico (sétimo período) e no internato (nono e décimo períodos). Para efeito de análise, foi utilizada a técnica de análise do conteúdo, modalidade temática. Os resultados mostram que o PPP especificou o propósito de formar o aluno para atuar no SUS, com conhecimento aprimorado para as necessidades da população amazônica. Para tanto, em conformidade às Diretrizes Curriculares Nacionais, preconiza a articulação entre a instituição formadora e os serviços de saúde. De forma coerente, ao lado da valorização do ensino pela prática, na perspectiva pedagógica, o projeto aponta para o recurso às metodologias de participação ativa do aluno. No entanto, o PPP não permite antever o tratamento político explícito da questão dos medicamentos. As ementas das áreas de conhecimento da Saúde Coletiva e Farmacologia não abordam a questão formalmente e seus conteúdos não se cruzam. No Internato, algumas áreas discutem o tema, mas de forma pontual. Na perspectiva do coordenador do curso a temática não é priorizada na universidade como deveria. Os professores, por sua vez, afirmaram a falta de preparo a respeito da PNM. Segundo eles não constam do conteúdo programático das disciplinas a abordagem sobre a RENAME. A URM constitui tema mais valorizado, particularmente na Farmacologia, prevalecendo o foco restrito do ensino ao tratamento individual. Os estudantes declararam, enfim, que não foram orientados de forma sistemática sobre a assistência farmacêutica no SUS e reconheceram que esta falta de orientação compromete a prescrição e o acesso dos pacientes aos medicamentos (por eles) indicados. Diante do exposto, emerge a sugestão de aprimorar a relação teórico-prática desde o início do curso, sendo apontada “a prescrição e o acesso aos medicamentos no SUS” como temática relevante a ser explorada em todas as oportunidades existentes no currículo. / The proposed study aimed to characterize the teaching concerning the Brazilian National Drugs Policy (NDP) offered to medical students at the Federal University of Tocantins, focusing on the medicine course coordination, faculty members, students as well as on the institution itself. This is a qualitative descriptive study, of exploratory nature. It has three investigative movements. The first one, based on the medical Political and Pedagogical Project (PPP) of the University, aimed to identify provisions related to the education provided by the institution. The second one, through semi-structured interviews, sought to grasp the teaching of the National Drugs Policy from the perspective of the Medicine course coordinator and the faculty members, specifically those responsible for the Public Health and Family Health courses: Experiences in Primary Care I, Basic Pharmacology and Medical Pharmacology. The third movement, in turn, using focal groups strategy enabled the qualification of the teaching from the perspective of students still in a basic cycle semester (seventh semester) and in the first year of their clinical rotation internship (ninth and tenth semesters). Content and thematic terms analysis technique have been used for analysis purposes. Results showed that the specified PPP aims to prepare students to work in the Brazilian National Health System (NHS), enhancing their knowledge to fulfill the Amazonian population needs. For that, pursuant to the National Curriculum Guidelines, it is necessary to enhance a good educational institution versus health services articulation. In a coherent fashion, valuing teaching by practice, based on a pedagogical perspective, the project aims to use active student participation methodologies. However, the project does not allow to predict explicit political treatment addressing the Drugs issue. Menus covering Public Health and Pharmacology courses do not cover it formally either and their contents do not intersect well. During medical Internship that issue may be discussed but just occasionally. According to the course coordinator, that thematic is not prioritized at the university. Faculty members, in turn , point out that there is a lack of preparation regarding the Brazilian National Drugs Policy and affirm that the National Essential Drugs List (NEDL) is not part of the medical regular curriculum. The Rational Use of Drugs (RUD) is the most valued related subject, particularly in Pharmacology, placing teaching on an individual treatment basis. Students at last declared they have not been systematically instructed about legal aspects concerning pharmaceutical care in the NHS and admitted that it impacts negatively on their prescriptions practice, compromising patients access to medicines. Given the above, it is suggested the improvement of the theory-practice relationship since the beginning of the medical school activities. It is important to single out "the prescription and access to medicines in the NHS" as a relevant topic to be explored in every opportunity found in the curriculum.
58

Utilização de medicamentos em pacientes pediátricos ambulatoriais com fibrose cística / Drug utilization in outpatient pediatric patients with cystic fibrosis

Alves, Stella Pegoraro January 2016 (has links)
A Fibrose Cística (FC) é uma doença hereditária sendo a pneumopatia obstrutiva crônica e a insuficiência pancreática suas manifestações clínicas mais clássicas. Exige um controle intenso e tratamento crônico e complexo que envolve a utilização de diversos medicamentos e procedimentos. O diagnóstico afeta a estrutura e altera a dinâmica de uma família. E o cuidado com o paciente geralmente recai sobre um único familiar que chamamos de cuidador principal. Conhecer aspectos qualitativos e quantitativos do consumo dos medicamentos, os hábitos dos pacientes e de seus cuidadores, pode influenciar diretamente no curso da doença. Objetivo: Caracterizar a utilização de medicamentos de pacientes fibrocísticos, caracterizar tanto pacientes quanto cuidadores, além de identificar as dificuldades existentes no cumprimento do plano terapêutico medicamentoso. Métodos: Estudo transversal com análise dos prontuários e entrevista do farmacêutico com o cuidador de pacientes com FC, acompanhados em um centro de referência de um hospital de ensino. Foram coletadas informações sobre a clínica dos pacientes, informações gerais sobre os cuidadores, assim como informações sobre o entendimento da doença, os medicamentos em uso e forma de utilização do tratamento em domicilio. Resultados: Foram analisados os dados de 78 pacientes e entrevistados 75 cuidadores. Maioria dos pacientes foi do sexo feminino, branca, homozigota para F508del, eutrófica e procedente do interior do Estado. Entre os cuidadores, a maioria também era do sexo feminino, mãe do paciente e não trabalhava fora do domicílio. Foi possível verificar a utilização de polifarmacoterapia e regimes terapêuticos complexos no tratamento da FC, além de dificuldades referentes à aquisição de medicamentos e em relação ao restante do tratamento, mesmo sendo observado o bom entendimento sobre a doença e da utilização dos medicamentos na maioria dos cuidadores. Conclusões: Os estudos de utilização de medicamentos permitem que conheçamos a dinâmica do tratamento, o funcionamento e as necessidades do paciente e de sua rede de apoio, planejando ações e intervindo com o objetivo de contribuir para o bem estar das crianças e adolescentes fibrocísticos e de seus cuidadores. / Cystic Fibrosis is a hereditary disease being the pneumopathies chronic obstructive and the pancreatic failure its clinical manifestations. This disease demands a high control and a complex treatment. The diagnosis affects the structure and changes a family routine. The patient caring usually relies on only one family member that we understand as the main caregiver. The knowledge of qualitative and quantitative aspects of medicines consumption, besides the patients’ their caregivers’ routines may directly affect the development of the disease. Objective: To describe the use of medicines by Cystic Fibrosis patients, outlining the patients and the caregivers profile, as well as identifying difficulties existing in the medication therapeutic plan fulfillment. Methods: Cross-sectional study through the analysis of medical records and interviews conducted by the pharmacist with caregivers of cystic fibrosis patients accompanied in a reference center of a teaching hospital. The study collected clinical information about the patients, general information about the caregivers and also information about the understanding of the disease, the medicines in use and the ways of utilization of treatment at home. Results: The study analyzed data from 78 patients and 75 caregivers were interviewed. Most of the patients were female, white, homozygotic for F508del, eutrophic and from the state’s countryside. Among the caregivers, most of them were female, patient’s mother and not working out of home. It was possible to verify the use of polypharmacotherapy and complex therapeutic regimes on the treatment of cystic fibrosis, besides the difficulties regarding the purchase of medicines and also regarding the rest of the treatment, even observed the knowledge about the disease and about the use of medicines in the most of the caregivers. Conclusions: The studies about the use of medicines allow us to know the dynamic of the treatment, the evolution and the needs of the patients and their supporting network, planning actions and interfering with the purpose to contribute with the well-being of the cystic fibrosis children and adolescents and their caregivers.
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Perfil clínico e caracterização do uso de medicamentos em cuidados paliativos / Clinical profile and characterization of the use of drugs in palliative care

Baggio, Stéphanie Oliveira January 2017 (has links)
Cuidados paliativos podem ser vistos como uma prioridade de saúde pública diante da transição demográfica que vem ocorrendo a nível mundial. Estudos preliminares indicam que o acesso precoce a esses cuidados pode melhorar o controle dos sintomas e a qualidade de vida dos pacientes, sendo que a compreensão da forma como os medicamentos estão sendo utilizados é imprescindível para atingir o alívio do sofrimento. Objetivo: diante da escassez de referenciais bibliográficos nesta temática, o presente estudo teve como objetivo descrever o perfil de utilização dos medicamentos mais utilizados por pacientes em cuidados paliativos internados no Hospital de Clínicas de Porto Alegre e relatar as características demográficas e clínicas destes pacientes. Métodos: estudo observacional, transversal, retrospectivo realizado com uma amostra de 267 pacientes internados na unidade de cuidados paliativos de um hospital universitário geral de grande porte com capacidade instalada de 843 leitos. Resultados: as prescrições totalizaram 178 medicamentos diferentes; dentre estes, os mais prescritos foram: dipirona, morfina, metoclopramida, ondansetron, heparina sódica, paracetamol, lactulose, omeprazol, cloreto de sódio 0,9%, clonazepam, dexametasona, docusato + bisacodil, amitriptilina, enema de glicerina 12%, metadona, haloperidol, cefepime, codeína, escopolamina, dimenidrinato, glicose 50%, óleo mineral líquido, furosemida, ranitidina, amoxicilina + ácido clavulânico e clorpromazina. O percentual de polifarmácia foi de 94,5%. Conclusões: conhecer a terapia medicamentosa e compreender a forma de utilização desta é fundamental para proporcionar o alívio dos diversos sintomas que impactam na qualidade de vida dos pacientes internados em cuidados paliativos. / Palliative care can be seen as a public health priority in the face of the demographic transition that is happening at a global level. Preliminary studies indicate that early access to these care can improve the control of symptoms and the quality of life of patients, therefore, understanding how drugs are used is essential to achieve the relief of suffering. Aim: in the face of the scarcity of bibliographic references on this topic, the aim of the present research is to describe the profile of use of drugs most often adopted by patients in palliative care admitted to Hospital de Clínicas de Porto Alegre and to report the demographic and clinical characteristics of these patients. Methods: observational, transversal, retrospective study was conducted with a sample of 267 patients admitted to palliative care of a large general university hospital with an installed capacity of 843 beds. Results: the prescriptions totaled 178 different drugs; among these, the most frequently prescribed ones were: dipyrone, morphine, metoclopramide, ondansetron, sodium heparin, paracetamol, lactulose, omeprazole, sodium chloride 0.9%, clonazepam, dexamethasone, docusate + bisacodyl, amitriptyline, glycerin enema (12%), methadone, haloperidol, cefepime, codeine, scopolamine, dimenhydrinate, glucose (50%), mineral oil liquid, furosemide, ranitidine, amoxicillin + clavulanic acid and chlorpromazine. The percentage of polypharmacy was 94.5%. Conclusions: it is essential to gain knowledge of drug therapies and to understand how to use them in order to provide the relief of several symptoms that impact the quality of life of hospitalized patients in palliative care.
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Padrão de dispensação de medicamentos em uma farmácia pública municipal do estado do Rio Grande do Sul

Costa, Mariana Portal da January 2017 (has links)
Introdução: Nos últimos anos, o consumo de medicamentos tem aumentado em todo o mundo e também no Brasil. Investigar este consumo numa determinada população é relevante para a gestão da política de medicamentos e o gerenciamento dos recursos em saúde, pois serve como ferramenta no planejamento de ações de prevenção e promoção de saúde. Objetivo: Descrever a prevalência e a tendência de consumo de medicamentos por intermédio da dispensação numa Farmácia Pública Municipal no período de oito anos. Metodologia: Trata-se de um estudo descritivo, retrospectivo, baseado em dados secundários obtidos por meio dos relatórios de dispensação de medicamentos do sistema informatizado da Farmácia Pública Municipal de Glorinha (RS) no período de 2008 a 2015. A população do estudo constitui-se de todos os usuários que tiveram pelo menos um medicamento da Relação Municipal de Medicamentos. As variáveis demográficas foram sexo e idade. Para fins de análise, os medicamentos foram categorizados no primeiro (Grupo Anatômico – GA), segundo (Grupo Terapêutico Principal – GTP) e quinto nível (Substância Química – SQ) da classificação Anatomical Therapeutic Chemical (ATC) e seu consumo analisado pela Dose Diária Definida (DDD) por 1.000 habitantes por dia. Resultados: A população do estudo foi 9.967 pessoas, sendo o maior percentual do sexo feminino (52,8%) e a faixa etária mais prevalente de 0 a 9 anos (16,2%). O consumo pelas mulheres é maior que os homens em todas as faixas etárias. Em relação ao consumo de medicamentos dispensados por usuário por ano: os GA mais prevalentes foram sistema nervoso (22,1%) e sistema cardiovascular (19,5%); os GTP mais prevalentes foram anti-inflamatórios e antirreumáticos (11,3%) e analgésicos (10,5%) e as SQ mais consumidas foram ibubrofeno (11,3%) e paracetamol (9,9%). Quanto à quantidade de unidades farmacêuticas dispensadas por ano: os GA mais prevalentes foram sistema (43,1%) e sistema nervoso (26,7%); os GTP mais prevalentes foram os agentes com ação no sistema renina-angiotensina (18,0%) e psicoanalépticos (10,8%) e as SQ mais consumidas foram captopril (8,9%) e enalapril (7,9%). Sobre o total da DDD (DDD/1.000 habitantes/dia): os GA de maior consumo foram os medicamentos do sistema cardiovascular (47,6%) e do sistema nervoso (15,3%); os GTP mais utilizados foram os medicamentos com ação no sistema renina-angiotensina (22,7%) e os diuréticos (10,3%) e as SQ mais utilizadas foram enalapril (14,7%) e omeprazol (9,6%). Dentre os medicamentos disponibilizados foi observado um maior decréscimo de dispensação nos seguintes grupos terapêuticos principais: ação no sistema renina-angiotensina (93,0%), na diabetes (82,4%) e os diuréticos (79,0%). Conclusões: Apesar da ampliação do acesso da população aos medicamentos pelas políticas públicas vigentes de Assistência Farmacêutica, a expressiva e crescente prevalência de consumo e a sua utilização de forma não racional causa preocupação. Dentro deste contexto, o profissional farmacêutico desempenha um papel relevante na compreensão e enfrentamento do problema e, desta forma, pode também contribuir na elaboração de estratégias para educação em saúde e para o uso racional de medicamentos na população por intermédio de estudos na área de Farmacoepidemiologia. / Introduction: In recent years, the consumption of medicinal products has increased worldwide and also in Brazil. Investigating this consumption in a given population is relevant for the management of health resources, as it serves as a tool in the planning of health preventive and promotion actions. Objectives: Describing the prevalence and trend of the consumption of medicinal products through the dispensing procedure at a Municipal Public Pharmacy over a period of eight years. Methodology: This is a descriptive, retrospective study, based on secondary data obtained through the reports of dispensing procedures of medicines from the computerized system of the Municipal Public Pharmacy in Glorinha (RS), from 2008 to 2015. The studied population consisted of all users who got at least one medication from the Municipal Medication List. Demographic variables were sex and age. For the purposes of analysis, the medicinal products were categorized in the first (Anatomical Group – AG), second (Therapeutic Subgroup – TS) and fifth level (Chemical Substance – CS) of the Anatomical Therapeutic Chemical (ATC) classification, and its consumption analyzed by the Defined Daily Dose DDD (1,000 inhabitants per day). Results: The studied population was 9,967 people, the highest percentage being female (52.8%) ant the most prevalent age group that of 0 to 9 years old (16.2%). Consumption by women is greater than men in all age groups. Respecting the consumption of medicines dispensed to users per year: the most prevalent AG were nervous system (22.1%) and cardiovascular system (19.5%); the most prevalent TS were antiinflammatory and antirheumatic (11.3%) and analgesics (10.5%), and the most commonly consumed CS were ibuprofen (11.3%), and acetaminophen (9.9%). Regarding the quantity of pharmaceutical units dispensed per year: the most prevalent AG were cardiovascular system (43.1%) and nervous system (26.7%); the most prevalent TS were agents action on the renin angiotensin system (18.0%) and psychoanalytics (10.8%), and the most commonly used CS were captopril (8.9%) and enalapril (7.9%). About the total DDD (DDD/1,000 inhabitants/day): the most consumed AG were the cardiovascular system medications (47.6%) and the nervous system (15.3%); the most used TS were the medicines with action in the renin angiotensin system (22.7%) and the diuretics (10.3%) and the most used CS were enalapril (14.7%) and omeprazole (9.6%). Among the medicinal products available, a greater decrease in the following main therapeutic groups was observed: action in the renin angiotensin system (93.0%), diabetes (82.4%) and diuretics (79.0%). Conclusions: Despite the increasing access of the population to medication by the current public policies of Pharmaceutical Assistance, the expressive and growing prevalence of consumption and its use of form non-rational causes concern. Within this context, the pharmacy professional plays a relevant role in understanding and coping with the problem and, in this way, can also contribute in the elaboration of strategies for health education and for the rational use of medicines in the population through studies in the area of Pharmacoepidemiology.

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