Indicadores de estrutura e processo na implementação de um serviço de revisão da farmacoterapia em ambulatório

Detalhes bibliográficos
Autor(a) principal: Marques, Tatiane Cristina
Data de Publicação: 2015
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UFS
Texto Completo: https://ri.ufs.br/handle/riufs/3572
Resumo: Introduction.The study of quality of health services constitutes a major change tool and incentive for health care services, such as pharmaceutical services, meet minimum quality standards and promote a renewal of its work culture. In Brazil, however the development and evaluation of the quality of services such as Medication Review is still in its infancy and needs to be implemented aiming to improve the practices of patient care. Aim. Evaluate structure and process indicators in the implementation of Medication Review services of the ambulatory of a university hospital. Methods. The study was structured in three stages from February 2012 to March 2015. The first stage corresponded to a methodological development research, in which structure and process indicators were collected from national and international literature for use in evaluating the Medication Review services.The second stage corresponded to translation to Portuguese and the transcultural adaptation to Brazil of Scale of Attitudes Toward Physician-Pharmacist Collaboration . The third stage corresponded to a longitudinal study evaluating the process of a collaborative practice model of Medication Review service in the ambulatory of a University Hospital of Sergipe. Results. From the literature (stage 1) were surveyed in the study, 28 indicators divided into structure criteria: physical installations, human resources, material resources, documentation and financing. The evaluation of the structural indicators of Medication Review service showed that the ambulatory has met most of the criteria submitted. About the process was able to gather 54 indicators divided into two categories: 21 technical-managerial indicators and 33 technicalassistance indicators. The second stage resulted in a translated and adapted scale for the Portuguese of Brazil used to evaluate the collaborative attitudes of pharmacists and physicians. In the third stage, the analysis of Medication Review service found that 146 patients were treated on average 2.1 ± 1.1 times during the study.The prescriptions of these patients contained3,3±1,9 drugs and24,5% of them had five or more drugs. The study identified 366 drug therapy problems (DTPs) and most frequent was a indication category (67,5%) and it was observed that patients who have had four to five pharmaceutical consultations has 1.14 times more likely to have identified their DTPs (χ2= 33,83; p<0,0001). Moreover, the analysis showed that patients who had between 1-2 pharmaceutical consultations had 1.22 times more likely to have not resolved their DTPs when compared to the group with more than 3 pharmaceutical consultations (χ2= 3,44; p<0,05). This study also reported 173 pharmaceutical interventions, of which 52,6% were intended for physicians, 46,2% for students of medicine and the most of them were accepted (98,7%). Conclusion. The structure and process indicators may be used to evaluate the implementation of Medication Review service. The pharmacist can collaborate with physicians identifying and solving DTPs, as well as assisting in the monitoring and decision making on pharmacotherapy, benefiting the patient.
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spelling Marques, Tatiane Cristinahttp://lattes.cnpq.br/6712643081284954Lyra Júnior, Divaldo Pereira dehttp://lattes.cnpq.br/51954591612614472017-09-26T12:07:09Z2017-09-26T12:07:09Z2015-06-30MARQUES, Tatiane Cristina. Structure and process indicators in the implementation of medication review service in ambulatory care. 2015. 155 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Sergipe, São Cristóvão, 2015.https://ri.ufs.br/handle/riufs/3572Introduction.The study of quality of health services constitutes a major change tool and incentive for health care services, such as pharmaceutical services, meet minimum quality standards and promote a renewal of its work culture. In Brazil, however the development and evaluation of the quality of services such as Medication Review is still in its infancy and needs to be implemented aiming to improve the practices of patient care. Aim. Evaluate structure and process indicators in the implementation of Medication Review services of the ambulatory of a university hospital. Methods. The study was structured in three stages from February 2012 to March 2015. The first stage corresponded to a methodological development research, in which structure and process indicators were collected from national and international literature for use in evaluating the Medication Review services.The second stage corresponded to translation to Portuguese and the transcultural adaptation to Brazil of Scale of Attitudes Toward Physician-Pharmacist Collaboration . The third stage corresponded to a longitudinal study evaluating the process of a collaborative practice model of Medication Review service in the ambulatory of a University Hospital of Sergipe. Results. From the literature (stage 1) were surveyed in the study, 28 indicators divided into structure criteria: physical installations, human resources, material resources, documentation and financing. The evaluation of the structural indicators of Medication Review service showed that the ambulatory has met most of the criteria submitted. About the process was able to gather 54 indicators divided into two categories: 21 technical-managerial indicators and 33 technicalassistance indicators. The second stage resulted in a translated and adapted scale for the Portuguese of Brazil used to evaluate the collaborative attitudes of pharmacists and physicians. In the third stage, the analysis of Medication Review service found that 146 patients were treated on average 2.1 ± 1.1 times during the study.The prescriptions of these patients contained3,3±1,9 drugs and24,5% of them had five or more drugs. The study identified 366 drug therapy problems (DTPs) and most frequent was a indication category (67,5%) and it was observed that patients who have had four to five pharmaceutical consultations has 1.14 times more likely to have identified their DTPs (χ2= 33,83; p<0,0001). Moreover, the analysis showed that patients who had between 1-2 pharmaceutical consultations had 1.22 times more likely to have not resolved their DTPs when compared to the group with more than 3 pharmaceutical consultations (χ2= 3,44; p<0,05). This study also reported 173 pharmaceutical interventions, of which 52,6% were intended for physicians, 46,2% for students of medicine and the most of them were accepted (98,7%). Conclusion. The structure and process indicators may be used to evaluate the implementation of Medication Review service. The pharmacist can collaborate with physicians identifying and solving DTPs, as well as assisting in the monitoring and decision making on pharmacotherapy, benefiting the patient.Introdução. O estudo da qualidade e da implementação de serviços de saúde configura um importante instrumento de mudança e incentivo para que os serviços de atenção à saúde, como os serviços farmacêuticos, cumpram padrões mínimos e promovam uma renovação da sua cultura de trabalho. No Brasil, entretanto o desenvolvimento e a avaliação da qualidade de serviços como a Revisão da Farmacoterapia ainda é incipiente e precisa ser implementada visando aprimorar as práticas de cuidado ao paciente. Objetivo. Avaliar indicadores de estrutura e processo na implementação de um serviço de Revisão da Farmacoterapia no ambulatório de um Hospital Universitário. Metodologia. O estudo foi estruturado em três etapas, de fevereiro de 2012 a março de 2015. A primeira correspondeu a uma pesquisa de desenvolvimento metodológico, na qual indicadores de estrutura e processo foram reunidos da literatura nacional e internacional para serem utilizados na avaliação do Serviço de Revisão da Farmacoterapia. A segunda etapa correspondeu tradução para o português e adaptação transcultural para o Brasil da Scale of Attitudes Toward Physician-Pharmacist Collaboration . A terceira etapa correspondeu a um estudo longitudinal que avaliou o processo de um modelo colaborativo de serviço de Revisão da Farmacoterapia no ambulatório de um Hospital Universitário de Sergipe. Resultados. A partir da literatura (etapa 1) foram levantados, no estudo, 28 indicadores de estrutura divididos nos critérios: instalações físicas, recursos humanos, recursos materiais, documentação e financiamento. A avaliação dos indicadores de estrutura do serviço de Revisão da Farmacoterapia do ambulatório estudado revelou que o mesmo atendeu a maioria dos critérios apresentados. Quanto ao processo foi possível reunir 54 indicadores divididos em duas categorias: 21 indicadores técnico-gerencias e 33 técnico-assistenciais. Da segunda etapa resultou uma escala traduzida e adaptada para o português do Brasil usada para avaliar as atitudes colaborativas de farmacêuticos e médicos. Na terceira etapa, a análise do serviço de Revisão da Farmacoterapia verificou que 146 pacientes foram atendidos em média 2,1±1,1 vezes durante o estudo. As prescrições médicas desses pacientes continham 3,3±1,9 medicamentos e 24,5% das mesmas tinham cinco ou mais medicamentos. No estudo foram identificados 366 problemas relacionados ao uso de medicamentos (PRMs) sendo a maioria de necessidade (67,5%) e foi observado que os pacientes que tiveram 4 a 5 atendimentos farmacêuticos tem 1,14 vezes mais probabilidade de terem seus PRMs identificados (χ2= 33,83; p<0,0001). Ademais, a análise demonstrou que os pacientes que tiveram entre 1 a 2 atendimentos farmacêuticos apresentaram 1,22 vezes mais probabilidade de não terem seus PRMs resolvidos quando comparado ao grupo com mais de 3 atendimentos farmacêuticos (χ2= 3,44; p<0,05). Neste estudo ainda foram notificadas 173 intervenções farmacêuticas, das quais 52,6% foram destinadas aos médicos, 46,2% aos estudantes de Medicina e a maioria delas (98,7%) foi aceita. Conclusão. Os indicadores de estrutura e processo reunidos podem ser utilizados para avaliar a implementação do Serviço de Revisão da Farmacoterapia. O farmacêutico pode colaborar com os médicos identificando e resolvendo PRMs, bem como auxiliando no monitoramento e na tomada de decisão sobre a farmacoterapia, beneficiando o paciente.Coordenação de Aperfeiçoamento de Pessoal de Nível Superiorapplication/pdfporUniversidade Federal de SergipePós-Graduação em Ciências da SaúdeUFSBRConduta do tratamento medicamentosoIndicadores de qualidade em Assistência a SaúdeAmbulatórioImplementaçãoAtitudes colaborativasRelações interprofissionaisMedication Therapy ManagementQuality indicators, health careAmbulatory careImplementation researchCooperative behaviorInterprofessional relationsCNPQ::CIENCIAS DA SAUDEIndicadores de estrutura e processo na implementação de um serviço de revisão da farmacoterapia em ambulatórioStructure and process indicators in the implementation of medication review service in ambulatory careinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSTEXTTATIANE_CRISTINA_MARQUES.pdf.txtTATIANE_CRISTINA_MARQUES.pdf.txtExtracted texttext/plain320729https://ri.ufs.br/jspui/bitstream/riufs/3572/2/TATIANE_CRISTINA_MARQUES.pdf.txt860751569dbffdde920798166fada77dMD52THUMBNAILTATIANE_CRISTINA_MARQUES.pdf.jpgTATIANE_CRISTINA_MARQUES.pdf.jpgGenerated Thumbnailimage/jpeg1342https://ri.ufs.br/jspui/bitstream/riufs/3572/3/TATIANE_CRISTINA_MARQUES.pdf.jpg13f6da1d07e873d631295fe0721d6dadMD53ORIGINALTATIANE_CRISTINA_MARQUES.pdfapplication/pdf2749356https://ri.ufs.br/jspui/bitstream/riufs/3572/1/TATIANE_CRISTINA_MARQUES.pdff3e15bc94ded8a4abb7924ca03794e73MD51riufs/35722017-11-28 16:49:06.785oai:ufs.br:riufs/3572Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2017-11-28T19:49:06Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false
dc.title.por.fl_str_mv Indicadores de estrutura e processo na implementação de um serviço de revisão da farmacoterapia em ambulatório
dc.title.alternative.eng.fl_str_mv Structure and process indicators in the implementation of medication review service in ambulatory care
title Indicadores de estrutura e processo na implementação de um serviço de revisão da farmacoterapia em ambulatório
spellingShingle Indicadores de estrutura e processo na implementação de um serviço de revisão da farmacoterapia em ambulatório
Marques, Tatiane Cristina
Conduta do tratamento medicamentoso
Indicadores de qualidade em Assistência a Saúde
Ambulatório
Implementação
Atitudes colaborativas
Relações interprofissionais
Medication Therapy Management
Quality indicators, health care
Ambulatory care
Implementation research
Cooperative behavior
Interprofessional relations
CNPQ::CIENCIAS DA SAUDE
title_short Indicadores de estrutura e processo na implementação de um serviço de revisão da farmacoterapia em ambulatório
title_full Indicadores de estrutura e processo na implementação de um serviço de revisão da farmacoterapia em ambulatório
title_fullStr Indicadores de estrutura e processo na implementação de um serviço de revisão da farmacoterapia em ambulatório
title_full_unstemmed Indicadores de estrutura e processo na implementação de um serviço de revisão da farmacoterapia em ambulatório
title_sort Indicadores de estrutura e processo na implementação de um serviço de revisão da farmacoterapia em ambulatório
author Marques, Tatiane Cristina
author_facet Marques, Tatiane Cristina
author_role author
dc.contributor.author.fl_str_mv Marques, Tatiane Cristina
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/6712643081284954
dc.contributor.advisor1.fl_str_mv Lyra Júnior, Divaldo Pereira de
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/5195459161261447
contributor_str_mv Lyra Júnior, Divaldo Pereira de
dc.subject.por.fl_str_mv Conduta do tratamento medicamentoso
Indicadores de qualidade em Assistência a Saúde
Ambulatório
Implementação
Atitudes colaborativas
Relações interprofissionais
topic Conduta do tratamento medicamentoso
Indicadores de qualidade em Assistência a Saúde
Ambulatório
Implementação
Atitudes colaborativas
Relações interprofissionais
Medication Therapy Management
Quality indicators, health care
Ambulatory care
Implementation research
Cooperative behavior
Interprofessional relations
CNPQ::CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv Medication Therapy Management
Quality indicators, health care
Ambulatory care
Implementation research
Cooperative behavior
Interprofessional relations
dc.subject.cnpq.fl_str_mv CNPQ::CIENCIAS DA SAUDE
description Introduction.The study of quality of health services constitutes a major change tool and incentive for health care services, such as pharmaceutical services, meet minimum quality standards and promote a renewal of its work culture. In Brazil, however the development and evaluation of the quality of services such as Medication Review is still in its infancy and needs to be implemented aiming to improve the practices of patient care. Aim. Evaluate structure and process indicators in the implementation of Medication Review services of the ambulatory of a university hospital. Methods. The study was structured in three stages from February 2012 to March 2015. The first stage corresponded to a methodological development research, in which structure and process indicators were collected from national and international literature for use in evaluating the Medication Review services.The second stage corresponded to translation to Portuguese and the transcultural adaptation to Brazil of Scale of Attitudes Toward Physician-Pharmacist Collaboration . The third stage corresponded to a longitudinal study evaluating the process of a collaborative practice model of Medication Review service in the ambulatory of a University Hospital of Sergipe. Results. From the literature (stage 1) were surveyed in the study, 28 indicators divided into structure criteria: physical installations, human resources, material resources, documentation and financing. The evaluation of the structural indicators of Medication Review service showed that the ambulatory has met most of the criteria submitted. About the process was able to gather 54 indicators divided into two categories: 21 technical-managerial indicators and 33 technicalassistance indicators. The second stage resulted in a translated and adapted scale for the Portuguese of Brazil used to evaluate the collaborative attitudes of pharmacists and physicians. In the third stage, the analysis of Medication Review service found that 146 patients were treated on average 2.1 ± 1.1 times during the study.The prescriptions of these patients contained3,3±1,9 drugs and24,5% of them had five or more drugs. The study identified 366 drug therapy problems (DTPs) and most frequent was a indication category (67,5%) and it was observed that patients who have had four to five pharmaceutical consultations has 1.14 times more likely to have identified their DTPs (χ2= 33,83; p<0,0001). Moreover, the analysis showed that patients who had between 1-2 pharmaceutical consultations had 1.22 times more likely to have not resolved their DTPs when compared to the group with more than 3 pharmaceutical consultations (χ2= 3,44; p<0,05). This study also reported 173 pharmaceutical interventions, of which 52,6% were intended for physicians, 46,2% for students of medicine and the most of them were accepted (98,7%). Conclusion. The structure and process indicators may be used to evaluate the implementation of Medication Review service. The pharmacist can collaborate with physicians identifying and solving DTPs, as well as assisting in the monitoring and decision making on pharmacotherapy, benefiting the patient.
publishDate 2015
dc.date.issued.fl_str_mv 2015-06-30
dc.date.accessioned.fl_str_mv 2017-09-26T12:07:09Z
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