Luz, Tatiana Chama Borges; Costa, Maria Emília Silva de Souza; Portes, Daniela Santana; Santos, Lucas Barbi Costa e; Sousa, Samuel Rodrigues Almeida e; Luiza, Vera Lucia

doi:10.1590/1413-81232017228.29642016

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Sumário

ARTICLE • Ciênc. saúde colet. 22 (8) • Ago 2017 • https://doi.org/10.1590/1413-81232017228.29642016 copiar

Serviços farmacêuticos na Atenção Básica: há sintonia entre farmacêuticos e usuários?

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

Este estudo investigou características estruturais e organizacionais de serviços farmacêuticos na Atenção Primária à Saúde, a partir do ponto de vista de farmacêuticos e de usuários. Foi utilizado delineamento de métodos mistos, combinando entrevistas semiestruturadas com 69 usuários e 4 farmacêuticos responsáveis pelos 5 serviços que dispensam medicamentos para a população, com análise de dados provenientes de banco de dados municipal. Coletaram-se os dados de fevereiro a agosto de 2014, em Divinópolis, município de Minas Gerais. Os serviços foram similares em termos das atividades realizadas e do perfil profissional dos trabalhadores. Enquanto os usuários preocupavam-se com a disponibilidade de medicamentos e desejavam a melhoria da estrutura dos serviços e dos recursos humanos, os farmacêuticos apontaram problemas relativos ao armazenamento dos medicamentos. Apesar da maioria dos usuários relatarem poucas informações sobre a utilização de seus medicamentos, nenhum farmacêutico declarou participar de atividades de dispensação. Houve pouca concordância entre os pontos de vistas de usuários e de farmacêuticos. A vantagem de se concentrar a dispensação de medicamentos em um número reduzido de unidades dispensadoras não foi observada na prática.

Atenção Primária à Saúde; Serviços farmacêuticos; Farmacêuticos; Usuários

Characteristic	PHCPS(1) n=14	PHCPS(2) n=13	PHCPS(3) n=14	PHCPS(4) n=15	PHCPS (5) n=13
Female gender (%)	78.6	53.8	78.6	50.0	50.0
Age, mean (SD)	53.3 (14.9)	51.0 (14.2)	48.4 (15.0)	59.3 (9.2)	56 (9.6)
Married ^(a) (%)	64.3	69.2	50.0	71.4	58.3
Schooling ≤ 7 years(%)	78.6	61.6	64.3	46.7	66.7
Monthly personal income < 2 ^(b) (%)	57.1	92.3	64.3	53.3	50.0
Continuous use of medicines (%)	92.9	81.8	100.0	93.3	91.7
Average number of medicines taken, number (SD)	4.3 (2.7)	4.2 (2.3)	3.7 (1.7)	2.9 (1.6)	3.3 (1.4)

Characteristic	PHCPS(1)	PHCPS(2)	PHCPS(3)	PHCPS(4)	PHCPS(5)
Physical space for users	Inadequate	Inadequate	Adequate	Adequate	Inadequate
Comfort for users	Uncomfortable	Uncomfortable	Comfortable	Comfortable	Uncomfortable
Waiting time	Long	Adequate	Adequate	Reasonable	Reasonable
Users are able to obtain all needed medicines	No	Partially	Yes	No	No
Service delivery evaluation	Good	Very good	Good	Good	Very good

Characteristic	Users Viewpoints (%)

	PHCPS(1)	PHCPS(2)	PHCPS(3)	PHCPS(4)	PHCPS(5)

Infrastructure and service organization
Physical Space
Adequate	61.5	23.1	0.0	77.8	91.7
Reasonable	15.4	7.7	7.1	22.2	0.0
Inadequate	23.1	69.2	92.9	0.0	8.3
Comfort
Comfortable	35.7	15.4	7.1	73.3	63.6
Reasonable	28.6	7.7	21.4	20.0	0.0
Uncomfortable	35.7	76.9	71.4	6.7	36.4
Waiting time
Adequate	40.0	16.7	7.1	53.3	70.0
Reasonable	0.0	33.3	7.1	20.0	10.0
Too long / long	60.0	50.0	85.7	26.7	20.0

Dispensing practices and medicines availability

Previous contact with the Pharmacist
Yes	0.0	0.0	0.0	6.7	7.7
No	100.0	100.0	100.0	93.3	92.3
Given reasons for not contacting the pharmacist
Did not know that there was an available pharmacist	0.0	22.2	36.4	30.8	0.0
Never needed a pharmacist	100.0	77.7	63.6	69.2	100.0
Information on medicines’ names and indications were provided
Yes	0.0	0.0	15.4	0.0	7.7
No	100.0	100.0	84.6	100.0	92.3
Instructions on how to take medicines were provided
Yes	0.0	30.8	15.4	6.7	45.5
No	100.0	69.2	84.6	93.3	54.5
Instructions on adverse reactions or potential problems with medicines were provided
Yes	0.0	0.0	0.0	14.3	7.7
No	100.0	100.0	100.0	85.7	92.3
Knowledge about the daily dosage
Yes	21.4	84.6	92.9	86.7	30.8
No	78.6	15.4	7.1	13.3	69.2
Able to obtain all prescribed medicines
Yes	57.1	46.2	35.7	33.3	57.1
No	42.9	53.8	64.3	66.7	42.9
Able to obtain all dispensed medicines in the appropriate quantity
Yes	69.2	58.3	57.1	73.3	100.0
No	30.8	41.7	42.9	26.7	0.0

Participant	Main Themes

	PHCPS(1)	PHCPS(2)	PHCPS(3)	PHCPS(4)	PHCPS(5)
Users	Acceptability Infrastructure Medicines’ availability Human Resources Service organization	Acceptability Infrastructure Medicines’ availability Human Resources Service organization	Acceptability Counseling and monitoring Geographic accessibility Human Resources Infrastructure Medicines’ availability Service organization	Acceptability Counseling and monitoring Geographic accessibility Human Resources Infrastructure Medicines’ availability Service organization	Infrastructure Medicines’ availability Service organization
Pharmacists	Service organization Infrastructure Human Resources	Infrastructure	–^(a)	Infrastructure Medicines’ selection	Infrastructure

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

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[1] Collaborations

Luz was responsible for funding acquisition, study conception, design, data analysis and interpretation, manuscript writing and final manuscript review. Costa e Santos, Portes and Barbi contributed to data analysis and interpretation, results discussion and to final manuscript review. Sousa contributed to results discussion and to final manuscript review. Luiza contributed to funding acquisition, results discussion, manuscript writing and final manuscript review. All authors read and approved the final manuscript.