Access to medicines: relations with the institutionalization of pharmaceutical services
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.11606/S1518-8787.2017051007138 http://hdl.handle.net/1843/56534 https://orcid.org/0000-0002-5662-2058 https://orcid.org/0000-0002-4492-9802 https://orcid.org/0000-0002-5258-9684 https://orcid.org/0000-0002-2638-9275 https://orcid.org/0000-0001-6289-4896 https://orcid.org/0000-0002-0210-0721 https://orcid.org/0000-0001-5256-0577 https://orcid.org/0000-0002-5880-5261 https://orcid.org/0000-0002-2218-6024 |
Resumo: | OBJETIVE: To analyze the relationship between access to medicines by the population and the institutionalization of pharmaceutical services in Brazilian primary health care. 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), a cross-sectional, exploratory, and evaluative study composed of an information survey in a representative sample of cities, stratified by Brazilian regions. Access was defined based on the acquisition of medicines reported by the patient, ranging between: total, partial, or null. The institutionalization of pharmaceutical services was analyzed based on information provided by pharmaceutical services providers and by those responsible for medicines delivery. Chi-square test and multinomial logistic regression were used in the statistical analysis. RESULTS: Full access to medicines was greater when professionals affirmed there were the following aspects of the dimensions: “management tools,” “participation and social control,” “financing,” and “personnel structure,” with significant associations in the bivariate analysis. The “pharmaceutical care” dimension did not achieve such an association. After multinomial logistic regression, full access was more prevalent when those in charge of pharmaceutical services stated that: they always or repeatedly attend meetings of the Municipal Health Council, OR = 3.3 (95%CI 1.5-7.3); there are protocols for medicines delivery, OR = 2.7 (95%CI 1.2-6.1); there is computerized system for managing pharmaceutical services, OR = 3.9 (95%CI 1.9-8.0); those responsible for medicines delivery reported having participated in a course or training for professionals in the past two years, OR = 2.0 (95%CI 1.1-3.5); there is computerized system for pharmaceutical services management, OR = 4.3 (95%CI 2.4-7.5). CONCLUSIONS: Aspects related to the institutionalization of pharmaceutical services have been strongly related to access to medicines. Our results indicate the need to prioritize its implementation, contributing to its consolidation in Brazil and to the effectiveness of health services regarding the purposes of pharmaceutical services policies. |
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2023-07-17T21:42:35Z2023-07-17T21:42:35Z20175121s11shttps://doi.org/10.11606/S1518-8787.20170510071381518-8787http://hdl.handle.net/1843/56534https://orcid.org/0000-0002-5662-2058https://orcid.org/0000-0002-4492-9802https://orcid.org/0000-0002-5258-9684https://orcid.org/0000-0002-2638-9275https://orcid.org/0000-0001-6289-4896https://orcid.org/0000-0002-0210-0721https://orcid.org/0000-0001-5256-0577https://orcid.org/0000-0002-5880-5261https://orcid.org/0000-0002-2218-6024OBJETIVE: To analyze the relationship between access to medicines by the population and the institutionalization of pharmaceutical services in Brazilian primary health care. 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), a cross-sectional, exploratory, and evaluative study composed of an information survey in a representative sample of cities, stratified by Brazilian regions. Access was defined based on the acquisition of medicines reported by the patient, ranging between: total, partial, or null. The institutionalization of pharmaceutical services was analyzed based on information provided by pharmaceutical services providers and by those responsible for medicines delivery. Chi-square test and multinomial logistic regression were used in the statistical analysis. RESULTS: Full access to medicines was greater when professionals affirmed there were the following aspects of the dimensions: “management tools,” “participation and social control,” “financing,” and “personnel structure,” with significant associations in the bivariate analysis. The “pharmaceutical care” dimension did not achieve such an association. After multinomial logistic regression, full access was more prevalent when those in charge of pharmaceutical services stated that: they always or repeatedly attend meetings of the Municipal Health Council, OR = 3.3 (95%CI 1.5-7.3); there are protocols for medicines delivery, OR = 2.7 (95%CI 1.2-6.1); there is computerized system for managing pharmaceutical services, OR = 3.9 (95%CI 1.9-8.0); those responsible for medicines delivery reported having participated in a course or training for professionals in the past two years, OR = 2.0 (95%CI 1.1-3.5); there is computerized system for pharmaceutical services management, OR = 4.3 (95%CI 2.4-7.5). CONCLUSIONS: Aspects related to the institutionalization of pharmaceutical services have been strongly related to access to medicines. Our results indicate the need to prioritize its implementation, contributing to its consolidation in Brazil and to the effectiveness of health services regarding the purposes of pharmaceutical services policies.OBJETIVO: Analisar as relações entre o acesso a medicamentos pela população e a institucionalização da assistência farmacêutica, na atenção básica. MÉTODOS: Este artigo integra a Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços 2015, estudo transversal, exploratório, de natureza avaliativa, composto por um levantamento de informações em amostra representativa de municípios, estratificada pelas regiões do Brasil. O acesso a medicamentos foi definido a partir do referencial de obtenção pelo usuário, variando entre: total, parcial ou nulo. A institucionalização da assistência farmacêutica foi analisada a partir das informações prestadas por responsáveis pela assistência farmacêutica e por responsáveis pela entrega de medicamentos. Na análise estatística foram utilizados o teste Qui-quadrado e regressão logística multinomial.RESULTADOS: O acesso total a medicamentos foi maior quando os profissionais afirmaram haver aspectos das dimensões: “ferramentas de gestão”, “participação e controle social”, “financiamento” e “estrutura de pessoal”, constatando-se associações significantes na análise bivariada. A dimensão “atenção farmacêutica” não obteve tal associação. Após regressão logística multinomial, o acesso total foi mais prevalente quando responsáveis pela assistência farmacêutica afirmaram: participar sempre ou repetidamente das reuniões do Conselho Municipal de Saúde, RP= 3,3 (IC95% 1,5–7,3); existir protocolos para a entrega de medicamentos, RP= 2,7 (IC95% 1,2–6,1); existir sistema informatizado para gestão da assistência farmacêutica, RP= 3,9 (IC95% 1,9–8,0); e quando responsáveis pela entrega de medicamentos afirmaram ter participado de curso ou capacitação para profissionais nos últimos dois anos, RP= 2,0 (IC95% 1,1–3,5) e haver sistema informatizado para gestão da assistência farmacêutica, RP= 4,3 (IC95% 2,4–7,5). CONCLUSÕES: Aspectos relacionados com a institucionalização da assistência farmacêutica se mostraram fortemente relacionados com o acesso a medicamentos. Os resultados indicam a necessidade de priorizar a sua implementação, contribuindo para sua consolidação no Brasil e efetividade dos serviços de saúde quanto às finalidades das políticas de assistência farmacêutica.porUniversidade Federal de Minas GeraisUFMGBrasilFAR - DEPARTAMENTO DE FARMÁCIA SOCIALRevista de Saúde PúblicaServiços FarmacêuticosOrganização e administraçãoCuidados Primários de SaúdeAcesso aos serviços de saúdeSistema Único de Saúde (Brasil)Pharmaceutical ServicesOrganization & administrationHealth Services AccessibilityPrimary Health CareHealth Services ResearchUnified Health SystemAccess to medicines: relations with the institutionalization of pharmaceutical servicesAcesso a medicamentos: relações com a institucionalização da assistência farmacêuticainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://www.revistas.usp.br/rsp/article/view/139772Rafael Damasceno DebarrosMargô Gomes de Oliveira KarnikowskiOrlando Mario SoeiroSilvana Nair LeiteEdiná Alves CostaDjanilson Barbosa Dos SantosGisélia Santana SouzaJuliana Alvares TeodoroAugusto Afonso Guerra JuniorFrancisco de Assis AcurcioIone Aquemi GuibuKaren Sarmento Costainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/56534/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALAccess to medicines relations with the institutionalization of pharmaceutical services.pdfAccess to medicines relations with the institutionalization of pharmaceutical services.pdfapplication/pdf244434https://repositorio.ufmg.br/bitstream/1843/56534/2/Access%20to%20medicines%20relations%20with%20the%20institutionalization%20of%20pharmaceutical%20services.pdf10180f3ad9a7ef417290855799f27478MD521843/565342023-07-17 18:42:35.158oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-07-17T21:42:35Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Access to medicines: relations with the institutionalization of pharmaceutical services |
dc.title.alternative.pt_BR.fl_str_mv |
Acesso a medicamentos: relações com a institucionalização da assistência farmacêutica |
title |
Access to medicines: relations with the institutionalization of pharmaceutical services |
spellingShingle |
Access to medicines: relations with the institutionalization of pharmaceutical services Rafael Damasceno Debarros Pharmaceutical Services Organization & administration Health Services Accessibility Primary Health Care Health Services Research Unified Health System Serviços Farmacêuticos Organização e administração Cuidados Primários de Saúde Acesso aos serviços de saúde Sistema Único de Saúde (Brasil) |
title_short |
Access to medicines: relations with the institutionalization of pharmaceutical services |
title_full |
Access to medicines: relations with the institutionalization of pharmaceutical services |
title_fullStr |
Access to medicines: relations with the institutionalization of pharmaceutical services |
title_full_unstemmed |
Access to medicines: relations with the institutionalization of pharmaceutical services |
title_sort |
Access to medicines: relations with the institutionalization of pharmaceutical services |
author |
Rafael Damasceno Debarros |
author_facet |
Rafael Damasceno Debarros Margô Gomes de Oliveira Karnikowski Orlando Mario Soeiro Silvana Nair Leite Ediná Alves Costa Djanilson Barbosa Dos Santos Gisélia Santana Souza Juliana Alvares Teodoro Augusto Afonso Guerra Junior Francisco de Assis Acurcio Ione Aquemi Guibu Karen Sarmento Costa |
author_role |
author |
author2 |
Margô Gomes de Oliveira Karnikowski Orlando Mario Soeiro Silvana Nair Leite Ediná Alves Costa Djanilson Barbosa Dos Santos Gisélia Santana Souza Juliana Alvares Teodoro Augusto Afonso Guerra Junior Francisco de Assis Acurcio Ione Aquemi Guibu Karen Sarmento Costa |
author2_role |
author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Rafael Damasceno Debarros Margô Gomes de Oliveira Karnikowski Orlando Mario Soeiro Silvana Nair Leite Ediná Alves Costa Djanilson Barbosa Dos Santos Gisélia Santana Souza Juliana Alvares Teodoro Augusto Afonso Guerra Junior Francisco de Assis Acurcio Ione Aquemi Guibu Karen Sarmento Costa |
dc.subject.por.fl_str_mv |
Pharmaceutical Services Organization & administration Health Services Accessibility Primary Health Care Health Services Research Unified Health System |
topic |
Pharmaceutical Services Organization & administration Health Services Accessibility Primary Health Care Health Services Research Unified Health System Serviços Farmacêuticos Organização e administração Cuidados Primários de Saúde Acesso aos serviços de saúde Sistema Único de Saúde (Brasil) |
dc.subject.other.pt_BR.fl_str_mv |
Serviços Farmacêuticos Organização e administração Cuidados Primários de Saúde Acesso aos serviços de saúde Sistema Único de Saúde (Brasil) |
description |
OBJETIVE: To analyze the relationship between access to medicines by the population and the institutionalization of pharmaceutical services in Brazilian primary health care. 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), a cross-sectional, exploratory, and evaluative study composed of an information survey in a representative sample of cities, stratified by Brazilian regions. Access was defined based on the acquisition of medicines reported by the patient, ranging between: total, partial, or null. The institutionalization of pharmaceutical services was analyzed based on information provided by pharmaceutical services providers and by those responsible for medicines delivery. Chi-square test and multinomial logistic regression were used in the statistical analysis. RESULTS: Full access to medicines was greater when professionals affirmed there were the following aspects of the dimensions: “management tools,” “participation and social control,” “financing,” and “personnel structure,” with significant associations in the bivariate analysis. The “pharmaceutical care” dimension did not achieve such an association. After multinomial logistic regression, full access was more prevalent when those in charge of pharmaceutical services stated that: they always or repeatedly attend meetings of the Municipal Health Council, OR = 3.3 (95%CI 1.5-7.3); there are protocols for medicines delivery, OR = 2.7 (95%CI 1.2-6.1); there is computerized system for managing pharmaceutical services, OR = 3.9 (95%CI 1.9-8.0); those responsible for medicines delivery reported having participated in a course or training for professionals in the past two years, OR = 2.0 (95%CI 1.1-3.5); there is computerized system for pharmaceutical services management, OR = 4.3 (95%CI 2.4-7.5). CONCLUSIONS: Aspects related to the institutionalization of pharmaceutical services have been strongly related to access to medicines. Our results indicate the need to prioritize its implementation, contributing to its consolidation in Brazil and to the effectiveness of health services regarding the purposes of pharmaceutical services policies. |
publishDate |
2017 |
dc.date.issued.fl_str_mv |
2017 |
dc.date.accessioned.fl_str_mv |
2023-07-17T21:42:35Z |
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2023-07-17T21:42:35Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/56534 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://doi.org/10.11606/S1518-8787.2017051007138 |
dc.identifier.issn.pt_BR.fl_str_mv |
1518-8787 |
dc.identifier.orcid.pt_BR.fl_str_mv |
https://orcid.org/0000-0002-5662-2058 https://orcid.org/0000-0002-4492-9802 https://orcid.org/0000-0002-5258-9684 https://orcid.org/0000-0002-2638-9275 https://orcid.org/0000-0001-6289-4896 https://orcid.org/0000-0002-0210-0721 https://orcid.org/0000-0001-5256-0577 https://orcid.org/0000-0002-5880-5261 https://orcid.org/0000-0002-2218-6024 |
url |
https://doi.org/10.11606/S1518-8787.2017051007138 http://hdl.handle.net/1843/56534 https://orcid.org/0000-0002-5662-2058 https://orcid.org/0000-0002-4492-9802 https://orcid.org/0000-0002-5258-9684 https://orcid.org/0000-0002-2638-9275 https://orcid.org/0000-0001-6289-4896 https://orcid.org/0000-0002-0210-0721 https://orcid.org/0000-0001-5256-0577 https://orcid.org/0000-0002-5880-5261 https://orcid.org/0000-0002-2218-6024 |
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1518-8787 |
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por |
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Revista de Saúde Pública |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
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FAR - DEPARTAMENTO DE FARMÁCIA SOCIAL |
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Universidade Federal de Minas Gerais |
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