Consultório ambulatorial farmacêutico: viabilização do acesso aos medicamentos na saúde pública

Abstract

Non-communicable diseases are predominant on current epidemiological population profile; this requiring continuous use of medication for the control. Access to pharmaceutical technologies has become a challenge for comprehensive care as will as integration of care levels on the public health system. Objective: To analyze pharmaceutical assistance on clinical management of a hospital pharmacy, focusing on access to medications available in the public health system. Method: This is a descriptive-analytical cross-sectional study that considers cases attended, focused on the need for the drug in the Pharmacy Ambulatory of the Hospital Escola Emílio Carlos, Catanduva, SP, between 2015 and 2017. Associations between the nature of the demand with resolution, medication class and medical specialty by the Mann Whitney test. Results: Regarding the demands at the pharmacy clinic, 86,3% were present at RENAME. As for those unavailable, the most frequent were blood and blood forming organs (29,6%), Musculoskeletal System (17,6%) and Nervous System (16,3%). The nature of the demands; 73,0% comprised adaptations to the PCDT / RENAME; 13,8% were carried out with proposals of exchange with pharmaceutical technology available in public health; 7,7% were required to make requests with administrative process for refractory cases, nonresponsive or lack of equivalent pharmacotherapy available in public health and 5,5% were referred to Basic Care for renewal of the prescription / process of the component of medical specialties. When associating the nature of the demand with resolving cases, 543 were related to adequacies to the PCDT / RENAME, of these 56,4% were compliance of the documentation and 28,5% demanded clinical assistance requiring exams of laboratory tests. It was necessary to carry out the intervention with an exchange proposal with available pharmaceutical technology; 90,2% of the cases in which the prescribed drugs were not included in PCDT / RENAME. Regarding the cases in which administrative procedures were required, 81,6% occurred due to the unavailability of RENAME to inclusion criteria for PCDT. For Primary Health Care, 95,1% of the cases were referred for renewal of the process. Conclusions: It was possible to observe, in this study, the impact of the pharmacist's performance regarding access to medicines available through the public network, which requires from this professional not only technical knowledge in pharmacology and evidence-based medicine, but also communication skills, argumentation. and attitudes towards direct interaction with other team professionals, especially the prescribing physician, to discuss cases and participate in prescribing drugs that meet pharmacotherapeutic needs (indication, effectiveness, safety and convenience), as well as impact on clinical outcomes , economic and humanistic in health.