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An analysis of public dispensing of methylphenidate in Brazil: the case of Espirito Santo state

The Attention Deficit Hyperactivity Disorder (ADHD) expansion and the growth of the consumption of methylphenidate, commonly indicated for its treatment, are current challenges the public health sector in many parts of the world. This research aimed to investigate the public dispensing of methylphenidate hydrochloride by the Brazilian Unified Health System (SUS), stressing the case of the state of Espirito Santo (ES). A map of pharmaceutical care Policies in the Brazilian Federal Units was made based on telephone calls and consultations at their official websites. It was found that among all state's Pharmaceutical Care Management of the country only 4, including the state of ES, have standardized lists for medicine dispensing in wich methylphenidate is included. The characteristics and variations in demand and consumption of methylphenidate registered in public pharmacies of ES between 2009 and 2011 were analyzed, in conjunction with information gathered in three semi-structured interviews with professionals in the Pharmaceutical Care Management. A significant increase in the consumption of this medicine via SUS was found throughout the analyzed period, with an asymmetric distribution between the eight public pharmacies of ES. These data highlight the need for careful analysis, focusing on the multiple aspects that interfere both in the formation of the diagnosis and in the demand for treatment, mainly in relation to the monitoring of public dispensation of methylphenidate. The study is essential in the public health context in order to support the policies formulation and the functioning of public services for ADHD.

attention deficit disorder with hyperactivity; methylphenidate; pharmaceutical care

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