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1.
Rev. ciênc. méd., (Campinas) ; 30: e215075, 10 mar. 2021. tab
Artículo en Portugués | LILACS | ID: biblio-1151684

RESUMEN

A quantidade de pessoas obesas vem crescendo significativamente em todo o mundo.Esse fato representa um risco para o aumento do número de portadores de diabetes mellitus tipo 2. A farmacoterapia do diabetes pode alterar o peso corporal, auxiliando tanto na perda como no ganho ponderal. Diante disso, o objetivo do presente trabalho foi revisar os fármacos utilizados no tratamento da diabetes tipo 2 que podem interferir no peso corporal, a fim de auxiliar os profissionais na orientação de indivíduos portadoresda doença. Para tanto, foi realizada uma revisão integrativa nas bases de dados: SciELO, Scholar Google, PubMed, BVS e Portal de Periódicos Capes, a partir de trabalhos publicados entre 2010 e 2019. Observou-se que as biguanidas, os inibidores da α-glicosidade, os análogos de incretinas, os análogos da amilina e os inibidores do cotransportador de sódio/glicose acarretam perda de peso. Por outro lado, as sulfonilureias, as meglitinidas e as glitazonas conferem ganho de peso ao paciente. Sendo assim, a prescrição desses fármacos deve ser feita de maneira individualizada


Obesity has been growing significantly worldwide, representing a risk for the increase of type 2 diabetes mellitus. The pharmacotherapy of diabetes can alter body weight, aiding in weight loss as well as in weight gain. Therefore, the objective of the present study was to review studies on the drugs used in type 2 diabetes that may interfere with body weight, in order to assist professionals in guiding individuals with diabetes. For this, an integrative review was performed in the SciELO, Scholar Google, PubMed, VHL, and Portal of Capes journals databases, considering works published between 2010 and 2019. We observed that biguanides, α-glucosity inhibitors, analogues of incretins, amylin analogues, and sodium / glucose co-transporter inhibitors lead to weight loss. On the other hand, sulphonylureas, meglitinides, and glitazones confer weight gain. Therefore, the prescription of these drugs should be made in an individualized fashion


Asunto(s)
Servicios Farmacéuticos , Peso Corporal , Personal de Salud , Diabetes Mellitus Tipo 2 , Quimioterapia , Hipoglucemiantes , Aumento de Peso , Obesidad
2.
Nutr. hosp ; 38(1): 11-15, ene.-feb. 2021. graf
Artículo en Español | IBECS | ID: ibc-198834

RESUMEN

INTRODUCCIÓN: la instauración de nutrición parenteral al prematuro ha supuesto un importante avance en su pronóstico. Los últimos años han sido muy fructíferos en cuanto a la publicación de guías en este ámbito. OBJETIVOS: conocer los procedimientos de formulación y elaboración de las nutriciones parenterales neonatales (NPN) en los hospitales españoles. MÉTODOS: se llevó a cabo una encuesta multicéntrica dirigida a los servicios de farmacia sobre los procesos anteriormente citados. RESULTADOS: 55 hospitales cumplieron criterios de inclusión. El 51 % disponía de sistemas informáticos de prescripción, y el 65,5 % formulaba siempre de forma individualizada, mientras que el 34,4 % disponía de fórmulas prediseñadas. Los preparados tricamerales eran utilizados por el 13,0 %. En el 52,7 % de los casos se preparaban las nutriciones de primer día bajo demanda, y ésta se iniciaba antes de las 8 horas de vida en un 88,1 % de los casos. El fosfato inorgánico era la primera opción en un 10,4 %. Se añadían diariamente vitaminas, oligoelementos y zinc en el 92,7 %, 90,9 % y 70,9 % de los casos, respectivamente. El 45,4 % de los hospitales elaboraba siempre las NPPN incluyendo los lípidos en la misma bolsa, frente al 34,5 % en los que estos se administraban por separado en todos los casos. El 50,9 % de los hospitales nunca añadía heparina a sus nutriciones. Las bolsas fotoprotectoras eran utilizadas por un 89,1 %. La estabilidad de las nutriciones variaba desde 24 horas a 15 días. CONCLUSIONES: la elaboración de la NPN en España está sujeta a gran variabilidad. Existe controversia respecto al uso de heparina y mezclas ternarias, reflejada en la variabilidad de la práctica clínica


INTRODUCTION: the introduction of parenteral nutrition in preterm infants has meant a major advance in their prognosis, being the last few years very fruitful in terms of publication of guidelines in this area. OBJECTIVES: to know the formulation and preparation procedures of neonatal parenteral nutrition (NPN) in Spanish hospitals. METHODS: a multi-centre survey was conducted in Pharmacy Services on the aforementioned processes. RESULTS: fifty-five hospitals met inclusion criteria. Electronic prescription systems were use by 51 %, 65.5 % always formulated individually, while 34.4 % had predesigned formulas. Tricameral preparations were used by 13.0 %. In 52.7 % of cases, first day nutrition was prepared on demand, starting before 8 hours of life in 88.1 % of cases. Inorganic phosphate was the first option in 10.4 %, vitamins, trace elements and zinc were added daily in 92.7 %, 90.9 % and 70.9 % of cases, respectively. NPN including lipids in the same bag was formulated by 45.4 % of the hospitals, compared to 34.5 % where it was administered separately in all cases. In 50.9 % of hospitals they never added heparin to their NPN. The 89.1 % used photoprotected bags. The stability of the admixture varied from 24 hours to 15 days. CONCLUSION: the elaboration of the PPN in Spain is subject to great variability. There is controversy regarding the use of heparin and ternary mixtures, which is reflected in the variability of clinical practice


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Alimentos Formulados , Nutrición Parenteral/métodos , Nutrición Parenteral/normas , Encuestas y Cuestionarios , Servicios Farmacéuticos/estadística & datos numéricos , Estudios Transversales
3.
Nutr. hosp ; 38(1): 23-28, ene.-feb. 2021. tab, graf
Artículo en Inglés | IBECS | ID: ibc-198836

RESUMEN

BACKGROUND: Brazil includes food as a social right, making the State responsible to the courts for the sufficient and adequate supply of enteral food. OBJECTIVES: to evaluate the supply of enteral diets in pharmacies in the state of Espirito Santo. METHODS: to do this, we used the forms filled out by patients or legal representatives, containing medical records, to analyze the nutritional and social profiles of the users over two years, and the compliance of the administrative processes with the ordinance that instituted enteral food supplies was verified. RESULTS: the sample was comprised of 204 patients receiving enteral nutrition, and the administrative procedures required to supply these patients were surveyed in seven (7/9) pharmacies. The data showed that the most common group was that of women (51 %), who were white (51 %), legally represented (91 %), and 73.5 years old (11 to 109 years). Information regarding missing anthropometric data, use of terms and calculations for obtaining enteral food other than those recommended, incomplete documents, alterations to the physical examinations suggestive of error, and nonobservance of inclusion and exclusion criteria were collected for this study. CONCLUSIONS: this study revealed that there were gaps in the process of enteral diet supply by the Espírito Santo pharmacies, both concerning compliance with the protocol and patient follow-up by the professional who assists both the patient and the pharmacist who provides the input


ANTECEDENTES: Brasil incluyó la alimentación como un derecho social, haciendo que el Estado sea responsable ante los tribunales del suministro suficiente y adecuado de alimentos. OBJETIVOS: evaluar el suministro de dietas enterales en las farmacias estatales de Espírito Santo. MÉTODOS: para hacer esto utilizamos los formularios cumplimentados por los pacientes y representantes legales que contienen registros médicos con el fin de analizar los perfiles nutricionales y sociales de los usuarios durante dos años; además, se verificó el cumplimiento de los procesos administrativos con la ordenanza que instituyó el suministro de alimentos. RESULTADOS: la muestra comprendió 204 pacientes que recibieron nutrición enteral, investigándose los procedimientos administrativos requeridos para suministrar a estos pacientes en siete (7/9) farmacias. Los datos mostraron que el grupo más común era el de mujeres (51 %), de raza blanca (51 %) y representadas legalmente (91 %), de 73,5 años de edad (11 a 109 años). Para este estudio se recopiló información sobre los datos antropométricos faltantes, el uso de términos y cálculos para obtener alimentos distintos a los recomendados, documentos incompletos, alteraciones en los exámenes físicos sugestivos de error y la no observancia de los criterios de inclusión y exclusión. CONCLUSIONES: este estudio reveló que había vacíos en el proceso de suministro de dietas enterales por parte de las farmacias de Espírito Santo en lo que respecta tanto al cumplimiento del protocolo como al seguimiento del paciente por el profesional que lo atiende y el farmacéutico que proporciona la información


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Nutrición Enteral/métodos , Sistemas Públicos de Salud , Servicios Farmacéuticos/normas , Nutrición Enteral/normas , Brasil , Estudios Retrospectivos
4.
ABCS health sci ; 46: e021202, 09 fev. 2021. tab
Artículo en Inglés | LILACS | ID: biblio-1147187

RESUMEN

INTRODUCTION: In Brazil, the right to health has a constitutional and universal provision. However, the judicial route has been widely used to access health goods and services. OBJECTIVE: To analyze the lawsuits of medicines filed by citizens of a Brazilian municipality. METHODS: Quantitative and retrospective study evaluating 652 lawsuits filed in 2016 conducted in Uruguaiana, state of Rio Grande do Sul. The information was made available by the State Department of Health. RESULTS: 55.5% of lawsuits filed were related to drugs provided by the public health system Sistema Único de Saúde (SUS). 44.5% did not fit into the guidelines of the Brazilian Policy for Pharmaceutical Services. Most of the lawsuits were filed by women over 60 years old. Regarding the therapeutic classification, the most requested drugs were for the nervous system. The most described pathological condition according to the ICD-10 (International Classification of Diseases) was Diabetes Mellitus. CONCLUSION: These data corroborate the situation found in other parts of the country, demonstrating the need to reorganize the Pharmaceutical Service Policy to ensure universal and equitable access to medicines, as described in the Federal Constitution.


INTRODUÇÃO: No Brasil, o direito à saúde tem previsão constitucional e universal. No entanto, a via judicial tem sido muito usada para acessar bens e serviços de saúde. OBJETIVO: Analisar as demandas judiciais de medicamentos movidas por cidadãos de um município brasileiro. MÉTODOS: Realizou-se um estudo quantitativo e retrospectivo que avaliou 652 ações judiciais no ano de 2016 em Uruguaiana, estado do Rio Grande do Sul. As informações foram disponibilizadas pela Secretaria de Saúde estadual. RESULTADOS: 55,5% das demandas estavam relacionados a medicamentos fornecidos pelo Sistema Único de Saúde (SUS). 44,5% não se enquadravam em nenhum dos componentes da Política Nacional de Assistência Farmacêutica do Brasil. A maioria dos processos foram movidos por mulheres acima de 60 anos. Em relação à classificação terapêutica, os medicamentos mais solicitados foram para o Sistema Nervoso. A condição patológica mais descrita, segundo o CID-10 (Classificação Internacional de Doenças) foi Diabetes Mellitus. CONCLUSÃO: Tais dados corroboram com a situação encontrada em outras partes do país, demonstrando a necessidade de reorganização da Assistência Farmacêutica para garantir o acesso universal e equitativo aos medicamentos, conforme descrito na Constituição Federal.


Asunto(s)
Humanos , Preparaciones Farmacéuticas , Decisiones Judiciales , Judicialización de la Salud , Servicios Farmacéuticos , Atención Integral de Salud
6.
JAMA Netw Open ; 4(1): e2034059, 2021 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-33449097

RESUMEN

Importance: Simple measures of hypertension treatment, such as achievement of blood pressure (BP) targets, ignore the intensity of treatment once the BP target is met. High-intensity treatment involves increased treatment burden and can be associated with potential adverse effects in older adults. A method was previously developed to identify older patients receiving intense hypertension treatment by low BP and number of BP medications using national Veterans Health Administration and Medicare Part D administrative pharmacy data to evaluate which BP medications a patient is likely taking on any given day. Objective: To further develop and validate a method to more precisely quantify dose intensity of hypertension treatment using only health system administrative pharmacy fill data. Design, Setting, and Participants: Observational, cross-sectional study of 319 randomly selected older veterans in the national Veterans Health Administration health care system who were taking multiple BP-lowering medications and had a total of 3625 ambulatory care visits from July 1, 2011, to June 30, 2013. Measure development and medical record review occurred January 1, 2017, through November 30, 2018, and data analysis was conducted from December 1, 2019, to August 31, 2020. Main Outcomes and Measures: For each BP-lowering medication, a moderate hypertension daily dose (HDD) was defined as half the maximum dose above which no further clinical benefit has been demonstrated by that medication in hypertension trials. Patients' total HDD was calculated using pharmacy data (pharmacy HDDs), accounting for substantial delays in refills (>30 days) when a patient's pill supply was stretched (eg, cutting existing pills in half). As an external comparison, the pharmacy HDDs were correlated with doses manually extracted from clinicians' visit notes (clinically noted HDDs). How well the pharmacy HDDs correlated with clinically noted HDDs was calculated (using C statistics). To facilitate interpretation, HDDs were described in association with the number of medications. Results: A total of 316 patients (99.1%) were male; the mean (SD) age was 75.6 (7.2) years. Pharmacy HDDs were highly correlated (r = 0.92) with clinically noted HDDs, with a mean (SD) of 2.7 (1.8) for pharmacy HDDs and 2.8 (1.8) for clinically noted HDDs. Pharmacy HDDs correlated with high-intensity, clinically noted HDDs ranging from a C statistic of 92.8% (95% CI, 92.0%-93.7%) for 2 or more clinically noted HDDs to 88.1% (95% CI, 85.5%-90.6%) for 6 or more clinically noted HDDs. Conclusions and Relevance: This study suggests that health system pharmacy data may be used to accurately quantify hypertension regimen dose intensity. Together with clinic-measured BP, this tool can be used in future health system-based research or quality improvement efforts to fine-tune, manage, and optimize hypertension treatment in older adults.


Asunto(s)
Algoritmos , Antihipertensivos/administración & dosificación , Hipertensión/tratamiento farmacológico , Veteranos , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Servicios Farmacéuticos , Estados Unidos
7.
Sr Care Pharm ; 36(2): 93-96, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33509332

RESUMEN

Transitions of care (TOC) is becoming an essential component of pharmacy practice, and requires problem solving that is difficult to learn in the classroom. My unique experience of interning in community and inpatient settings along with doing my own TOC research with geriatric patients has allowed me to see patients throughout the spectrum of health care, and how discrepancies arise as they move between settings. This manuscript will provide insight to pharmacy students about why TOC is a critical area for pharmacist involvement, and how we must be prepared to guide patients through these transitions as we become new practitioners.


Asunto(s)
Educación en Farmacia/métodos , Transferencia de Pacientes/métodos , Estudiantes de Farmacia , Anciano , Curriculum , Geriatría , Humanos , Servicios Farmacéuticos
8.
São Paulo; s.n; 2021'. 69 p.
Tesis en Portugués | Sec. Est. Saúde SP, CONASS, SESSP-ISPROD, Sec. Est. Saúde SP, SESSP-ISACERVO, SESSP-ESPECIALIZACAOSESPROD, Sec. Est. Saúde SP | ID: biblio-1151760

RESUMEN

Introdução: Em 11 de março de 2020, a Organização Mundial da Saúde declarou formalmente a existência de uma pandemia causada por um novo coronavírus, o SARS-CoV-2. Objetivo: Identificar os desafios e as respostas da Secretaria Municipal de Saúde de Franco da Rocha, no âmbito da Assistência Farmacêutica, frente à pandemia. Metodologia: Estudo de abordagem qualitativa, com análise de conteúdo temática, de entrevistas com médicos e farmacêuticos da Atenção Primária à Saúde e da Unidade de Pronto Atendimento do município. Resultados: Os relatos mostram que foram adotadas medidas efetivas para a proteção de usuários e trabalhadores de saúde; que houve intercâmbio de conhecimentos e experiências entre médicos e farmacêuticos para lidar com as incertezas acerca de tratamentos para a COVID-19; que foram seguidos protocolos relativos ao distanciamento social, com dispensa de medicamentos por tempo mais prolongado com intuito de reduzir a frequência de usuários nas farmácias; que houve preferência por buscar informações em fontes confiáveis; e que responderam a contento às necessidades de medicamentos apesar do aumento excessivo de prescrição de alguns, incluindo os não recomendados para tratamento da COVID-19. Sobre possível influência do Instituto de Saúde, que vem prestando assessoria na área da saúde desde 2014, parece ter contribuído para a atuação de profissionais farmacêuticos, porém os materiais produzidos não foram amplamente disponibilizados e poucos médicos mostraram ter conhecimento sobre isto. Conclusão: A Assistência Farmacêutica do município de Franco da Rocha, na visão de médicos e farmacêuticos, tem respondido a contento aos desafios deste período pandêmico.


Asunto(s)
Humanos , Servicios Farmacéuticos , Infecciones por Coronavirus , Pandemias , Atención Primaria de Salud , Investigación Cualitativa
9.
Res Social Adm Pharm ; 17(1): 1799-1806, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33317760

RESUMEN

BACKGROUND: Since the start of the new Coronavirus (COVID-19) outbreak in December 2019, pharmacists worldwide are playing a key role adopting innovative strategies to minimize the adverse impact of the pandemic. OBJECTIVES: To identify and describe core services provided by the pharmacist during the COVID-19 pandemic. METHODS: A literature search was performed in MEDLINE, Embase, Scopus, and LILACS for studies published between December 1st, 2019 and May 20th, 2020 without language restriction. Studies that reported services provided by pharmacists during the COVID-19 pandemic were included. Two independent authors performed study selection and data extraction with a consensus process. The pharmacist's intervention identified in the included studies were described based on key domains in the DEPICT v.2. RESULTS: A total of 1189 records were identified, of which 11 studies fully met the eligibility criteria. Most of them were conducted in the United States of America (n = 4) and China (n = 4). The most common type of publication were letters (n = 4) describing the workplace of the pharmacist in hospitals (n = 8). These findings showed the different roles of pharmacists during the COVID-19 pandemic, such as disease prevention and infection control, adequate storage and drug supply, patient care and support for healthcare professionals. Pharmacists' interventions were mostly conducted for healthcare professionals and patients (n = 7), through one-to-one contact (n = 11), telephone (n = 6) or video conference (n = 5). The pharmacists' main responsibility was to provide drug information for healthcare professionals (n = 7) as well as patient counseling (n = 8). CONCLUSIONS: A reasonable number of studies that described the role of the pharmacists during the COVID-19 pandemic were found. All studies reported actions taken by pharmacists, although without providing a satisfactory description. Thus, future research with more detailed description as well as an evaluation of the impact of pharmacist intervention is needed in order to guide future actions in this and/or other pandemic.


Asunto(s)
/terapia , Servicios Farmacéuticos/organización & administración , Farmacéuticos/organización & administración , /epidemiología , Humanos , Rol Profesional
10.
Res Social Adm Pharm ; 17(1): 1838-1844, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33317762

RESUMEN

BACKGROUND: The newly emerged coronavirus pandemic (COVID-19) has collapsed the entire global health care system. Due to these settings, a lot of strategic changes are adopted by healthcare facilities to ensure continuity in patient-centered services. OBJECTIVE: This study aims to evaluate the effectiveness of structural and operational changes made in ambulatory care pharmacy services during the COVID-19 pandemic. METHODS: A retrospective comparative study was conducted to evaluate the impact and effectiveness of patient-centered interventions and consequent access to medication management care within Johns Hopkins Aramco Health Care ambulatory care pharmacy services during the COVID-19 pandemic by comparing patient-centered key performance indicators before and during COVID-19 pandemic for a total of 4 months. RESULTS: As a result of the structural and operational changes made in patient-centered ambulatory care pharmacy services during the COVID-19 pandemic, a 48% prescriptions requests and 90% prescriptions fills are increased through online health portal application. A three-fold increase in the pharmacy call center utilization resulted in around 10% abandoned calls. In the number of physical visits to ambulatory care pharmacies, a 37% reduction was also noted. The decrease in staff schedule efficiency and an increase in average prescription waiting time were also noticed. The prescription collection through remote area pick up locations, and medication home delivery services were successful during COVID-19 pandemic as supported by statistical data. CONCLUSION: The access to ambulatory care pharmacy services during COVID-19 pandemic has been successfully maintained via medication home delivery, remote area pickup locations, pharmacy call-center consultations and refill requests, online health portal application services, and other measures, while reducing the number of physical visits to the JHAH hospital/clinic to ensure compliance with infection control and prevention measures.


Asunto(s)
Atención Ambulatoria/organización & administración , Atención Dirigida al Paciente/organización & administración , Servicios Farmacéuticos/organización & administración , Atención Ambulatoria/estadística & datos numéricos , Instituciones de Atención Ambulatoria/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Atención Dirigida al Paciente/estadística & datos numéricos , Servicios Farmacéuticos/estadística & datos numéricos , Estudios Retrospectivos
11.
Res Social Adm Pharm ; 17(1): 1929-1933, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33317767

RESUMEN

The International Pharmaceutical Federation (FIP), as the global leadership body for pharmacists, pharmaceutical scientists and pharmaceutical educators, coordinated and produced as of January 2020 an international response to the COVID-19 pandemic. FIP's response included professional guidance, a programme of digital events and other resources, as well as advocacy and policy tools to support national pharmacists' associations and academic institutions, as well as individual practitioners, in their response at country level. This article describes the strategy adopted by FIP in collaboration with an international group of experts to support the valuable service that pharmacists and their teams provide to communities throughout the pandemic, and their important contribution to easing the huge strain being placed on health systems around the world.


Asunto(s)
/epidemiología , Cooperación Internacional , Servicios Farmacéuticos/organización & administración , Farmacéuticos/organización & administración , Prestación de Atención de Salud/organización & administración , Humanos , Agencias Internacionales , Internacionalidad , Rol Profesional
12.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 39(6): 375-379, nov.-dic. 2020. ilus, graf
Artículo en Español | IBECS | ID: ibc-194659

RESUMEN

En esta publicación se presentan criterios y fundamentos para la organización del trabajo en la práctica segura de la Radiofarmacia Hospitalaria, a fin de minimizar el riesgo de transmisión viral durante la pandemia de COVID-19, en una instalación de referencia de la Comisión Nacional de Energía Atómica de Argentina, mientras se continúan desempeñando servicios esenciales para el sistema de salud. Con este fin se consultaron como referencia documentos de la Comisión Nacional de Energía Atómica, OIEA, la OMS y otras publicaciones científicas. Estas recomendaciones se encuentran en proceso de revisión constante y son actualizadas de manera permanente. En este marco se propone el presente modelo de organización laboral para esta actividad esencial incluyendo recomendaciones generales, particulares y su fundamento epidemiológico e inmunológico


This publication presents criteria and bases for the work organization in the safe practice of Hospital Radiopharmacy, in order to minimize the risk of viral transmission during the COVID-19 pandemic, in a reference facility of the National Energy Commission Atomic of Argentina, while continuing to perform essential services for the health system. For this purpose, documents from the National Energy Commission Atomic, IAEA, WHO and other scientific publications were consulted as reference. These recommendations are under constant review and are permanently updated. Within this framework, the present model of work organization for this essential activity is proposed, including general and specific recommendations and its epidemiological and immunological basis


Asunto(s)
Humanos , Virus del SRAS/patogenicidad , Infecciones por Coronavirus/epidemiología , Radiofármacos/provisión & distribución , Servicios Farmacéuticos/organización & administración , Factores de Riesgo , Infecciones por Coronavirus/prevención & control , Pandemias/estadística & datos numéricos , Argentina/epidemiología , Transmisión de Enfermedad Infecciosa/prevención & control , Precauciones Universales/métodos , Buenas Prácticas de Dispensación
13.
Rev. Saúde Pública Paraná (Online) ; 3(supl. 1): 212-225, dez. 11, 2020.
Artículo en Portugués | LILACS, Coleciona SUS, CONASS, SESA-PR | ID: biblio-1151291

RESUMEN

A chegada da epidemia de Covid-19 ao Paraná tornou necessária a adoção de medidas pela Assistência Farmacêutica da Secretaria de Estado da Saúde que reduzisse a circulação de pessoas e reorientasse os trabalhos nas farmácias das Regionais de Saúde. Cerca de 112 mil usuários são atendidos nessas farmácias para recebimento de medicamentos do Componente Especializado e elenco complementar. Dentre as estratégias para diminuição de circulação de usuários estão entrega antecipada de medicamentos, renovações automáticas do tratamento, ferramenta para cadastro online de novos usuários e ampliação do serviço de entrega em casa. A entrega antecipada de medicamentos, o cadastro online e a entrega domiciliar proporcionaram jun-tos uma redução da presença de cerca de 80 mil usuários nas farmácias das RS entre março e julho de 2020. As ações adotadas foram efetivas na redução da circulação de pessoas protegendo usuários e equipe da AF. (AU)


The arrival of the Covid-19 epidemic in Paraná required the Pharmaceutical Assistance Department (AF) of the Paraná Secretary of Health to adopt measures to reduce people's circulation and redirect the efforts of the pharmacies of all Regional Health Offices (RS). About 112 thousand users count on these pharmacies to receive medicines included in the Specialized Component and Complementary medicines list. Among the strategies to reduce the circulation of users are early delivery of medicines; automated renewals of treatment; a tool for online registration of new users and expansion of the home delivery service. The early delivery of medicines, online registration and home delivery together made it possible for 80 thousand users not to have to physically visit RS pharmacies between March 2020 and July of the same year, protecting not only the users themselves but also AF people. (AU)


Asunto(s)
Farmacias , Servicios Farmacéuticos , Infecciones por Coronavirus , Sistema Único de Salud
14.
Rev Saude Publica ; 54: 130, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33331524

RESUMEN

OBJECTIVE: To analyze whether lawsuits for medicines filed against the state of Rio Grande do Norte agree with medical-sanitary and pharmaceutical assistance management criteria established by the public policies of access to medicines in force in Brazil. METHODS: This is a descriptive and retrospective study of the individual lawsuits that claimed medicines in the state of Rio Grande do Norte between 2013 and 2017. Information was collected from the procedural documents on the requested medicines, the diagnoses referred and the origin of the medical prescription, in order to analyze medical-sanitary and pharmaceutical assistance management characteristics. RESULTS: We analyzed 987 lawsuits, which requested 1,517 medications. Of these, 60.7% were not part of the National List of Essential Medicines, and, in 75% of the cases, there was a therapeutic alternative in the Brazilian Unified Health System. In 13.6% of the actions, at least one drug was prescribed for off-label use. Prescribers of philanthropic and private services often request medicines not covered by the pharmaceutical care policy. Even judicialized drugs that are part of the national list are constantly requested for non-standard indications. CONCLUSIONS: Court decisions for the supply of medicines violate health rules and make it difficult to manage pharmaceutical assistance, which may weaken the implementation of these policies.


Asunto(s)
Medicamentos Esenciales , Accesibilidad a los Servicios de Salud , Legislación como Asunto , Servicios Farmacéuticos , Política Pública , Brasil , Política de Salud , Humanos , Estudios Retrospectivos , Derecho a la Salud
15.
RECIIS (Online) ; 14(4): 926-941, out.-dez. 2020. ilus, graf
Artículo en Portugués | LILACS | ID: biblio-1145569

RESUMEN

O objetivo desse artigo é analisar como os sites das Secretarias Estaduais de Saúde da Paraíba, Bahia, Santa Catarina e Rio Grande do Sul disponibilizam informações sobre a política de medicamentos brasileira para os usuários do SUS. Com base em uma metodologia qualitativa, observa-se uma variedade de formas de organização e apresentação das informações estruturadas em uma linguagem predominantemente técnica, em desacordo com o nível de instrução da população, em oposição à uma comunicação pública que deve ser, segundo a norma legal, acessível e compreensível por gestores, profissionais e atores da sociedade civil, superando o linguajar do corpo técnico-burocrático para que a política pública seja apropriada pela sociedade. Ao identificar uma distância existente entre lei e realidade, conclui-se enunciando limites e desafios a serem superados pelos agentes políticos no aprofundamento e desenvolvimento de metodologias voltadas para a qualidade do acesso às informações da política pública de medicamentos pela população.


The objective of this article is to analyze how the websites of the State Health Departments of Paraíba, Bahia, Santa Catarina and Rio Grande do Sul provide information about the Brazilian drug policy for SUS users. Based on a qualitative methodology, a variety of forms of organization and presentation of structured information are observed in a predominantly technical language, in disagreement with the level of education of the population of these states, as opposed to a public communication that must be, according to the legal norm, accessible and understandable by managers, professionals and civil society actors, overcoming the language of the technical-bureaucratic body so that public policy is appropriated by society. When identifying a distance between law and reality, it concludes by stating a limits and challenges to be overcome by the political agents in the deepening and development of methodologies focused on the quality of access to information on public policy of medicines by the population.


El propósito de este documento es analizar cómo los sitios web de los Departamentos de Salud del Estado de Paraíba, Bahía, Santa Catarina y Rio Grande do Sul proporcionan información sobre la política de drogas de Brasil a los usuarios del SUS. Basado en una metodología cualitativa, se puede observar una variedad de formas de organización y presentación de información estructurada en un lenguaje predominantemente técnico, en desacuerdo con el nivel educativo de la población, en oposición a una comunicación pública que debe ser, según la norma, legal, accesible y comprensible para gerentes, profesionales y actores de la sociedad civil, superando el lenguaje del cuerpo técnico-burocrático para que la sociedad se apropie de las políticas públicas. Al identificar una distancia existente entre la ley y la realidad, concluimos estableciendo límites y desafíos que deben superar los agentes políticos en la profundización y el desarrollo de metodologías dirigidas a la calidad del acceso a la información de las políticas públicas sobre medicamentos por parte de la población.


Asunto(s)
Humanos , Servicios Farmacéuticos , Políticas Públicas de Salud , Acceso a Medicamentos Esenciales y Tecnologías Sanitarias , Gobierno Electrónico , Sistema Único de Salud , Redes de Comunicación de Computadores , Asignación de Costos , Investigación Cualitativa , Política Nacional de Medicamentos , Salud Poblacional
16.
Int J Pharm Compd ; 24(6): 451-458, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33217734

RESUMEN

In pharmaceutical compounding, ensuring the safety of staff in the workplace is an issue of prime importance to pharmacy owners and managers and the focus of international, federal, state, and local agencies charged with enforcing adherence to the prevention of job-related injuries and illnesses. In this third article in a 3-part series on hazard communications, fire- and life-safety codes established by authorities having such jurisdiction over U.S. businesses (including compounding facilities) are discussed, safety inspections are described, required fire-safety equipment is reviewed, and an effective safety plan that includes building evacuation is presented.


Asunto(s)
Preparaciones Farmacéuticas , Servicios Farmacéuticos , Farmacias , Farmacia , Composición de Medicamentos , Humanos
17.
Yakugaku Zasshi ; 140(11): 1365-1372, 2020.
Artículo en Japonés | MEDLINE | ID: mdl-33132272

RESUMEN

Japan's health care system can be regarded as one of the best worldwide, provided it remains sustainable. It has relatively low costs, short wait times, low disease incidence, and high life expectancy. However, universal coverage in Japan faces financial challenges due to the country's rapidly aging population. Canada is another of the few developed countries that have universal health coverage. In contrast to Japan, Canada's health care spending is still sustainable according to recent studies. Effective cost control by payers has played a major role, with providers being steered toward evidence-based and cost-effective drug therapies. Furthermore, expanded pharmacy services have been important in suppressing spending on prescription drugs and minor health care services such as vaccination, government-funded smoking cessation, and medication review programs. This article outlines the services provided by Canadian pharmacists with expanded scope of practice. The pharmaceutical profession and its advocacy body in Canada have not only played a role in regulatory changes, but also put in place technological infrastructure called PharmaNet and contributed to appropriate prescribing. Given the current economic situation and demographic trends in Japan, more options should be explored in order to maintain universal health coverage by meeting the funding gap. Utilizing community pharmacies and pharmacists is proposed as one option.


Asunto(s)
Ahorro de Costo , Análisis Costo-Beneficio , Prestación de Atención de Salud , Práctica Clínica Basada en la Evidencia , Costos de la Atención en Salud , Servicios Farmacéuticos/economía , Cobertura Universal del Seguro de Salud/economía , Canadá , Servicios Comunitarios de Farmacia , Humanos , Japón , Formulación de Políticas , Medicamentos bajo Prescripción/economía , Cese del Hábito de Fumar
18.
BMC Health Serv Res ; 20(1): 913, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33008384

RESUMEN

BACKGROUND: Novel Coronavirus is a global pandemic affecting all walks of life and it significantly changed the health system practices. Pharmacists are at the front line and have long been involved in combating this public health emergency. Therefore, the study was aimed to explore pharmacy preparedness and response to prevent and control coronavirus disease 2019 (COVID-19). METHODS: A qualitative study was conducted in six pharmacies in Aksum, Ethiopia in May, 2020. We conducted six in-depth interviews with purposively selected key informants. Direct observation measures were made to assess the activities made in the medicine retail outlets for the prevention and control of the pandemic. Interview data were audio-recorded, translated and transcribed verbatim. Thematic analysis was employed to analyze the data and OpenCode version 4.02 software was used to facilitate the data analysis. RESULTS: The thematic analysis has resulted in seven major themes. Good preparedness measures were undertaken to control and prevent COVID-19. Study informants had good knowledge about the pandemic disease and reported they had used different resource materials to update themselves. Preparing of alcohol-based hand-rub, availing finished sanitizers and alcohol, and advising clients to maintain physical distancing were the major counseling information being delivered to prevent the disease. Some tendencies of irrational drug use and false claims of COVID-19 were observed at the beginning of the pandemic. Interview informants had reported they were working with relevant stakeholders and appropriate patient education and support were given to combat the pandemic. CONCLUSION: The study revealed necessary pharmacy services has been rendered to all clients. However, availability of drugs and medical supplies were scarce which negatively affected the optimal delivery of pharmacy services. The government and other responsible bodies should work together to solve such problems and contain the pandemic.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Servicios Farmacéuticos/organización & administración , Farmacéuticos/psicología , Neumonía Viral/prevención & control , Adulto , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Etiopía/epidemiología , Femenino , Investigación sobre Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Preparaciones Farmacéuticas/provisión & distribución , Farmacéuticos/estadística & datos numéricos , Investigación Cualitativa
19.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(10): 1380-1389, 2020 Oct 30.
Artículo en Chino | MEDLINE | ID: mdl-33118508

RESUMEN

OBJECTIVE: To assess the clinical value of individualized pharmaceutical services for patients receiving vancomycin for severe infections and establish clinical monitoring procedures during vancomycin treatment. METHODS: Data were collected from patients with severe infections who received vancomycin treatment with individualized pharmacy services (test group, 144 cases) or without such services (control group, 884 cases) between January, 2017 and December, 2018. Using propensity score matching, the patients in the two groups with comparable baseline data were selected for inclusion in the study (62 in each group), and the efficacy, safety and economic indicators were compared between the two groups. RESULTS: The curative effects of the treatment did not differ significantly between the two groups, with the overall response rates of 95.16% in the test group and 91.94% in the control group (P > 0.05). The percentage of neutrophils before vancomycin treatment and calcitonin level after the treatment differed significantly between the two groups (P < 0.05). No significant difference was found in the incidence of adverse events associated with the treatment between the test and control groups (8.06% vs 9.68%, P > 0.05); a significant difference in creatinine level was noted between the two groups after vancomycin treatment (P < 0.05). The number of days of medication, the cost of vancomycin and its proportion in the total expenses differed significantly between the two groups (P < 0.05). Cost-effectiveness analysis showed a better cost-effectiveness in the test group than in the control group (50052.78 vs 57601.23). The intensity of vancomycin use was also lower in the test group than in the control group (0.11 vs 0.36). CONCLUSIONS: The participation of clinical pharmacists during the treatment can improve the clinical benefits of vancomycin in patients with severe infections.


Asunto(s)
Infecciones , Servicios Farmacéuticos , Antibacterianos/uso terapéutico , Humanos , Infecciones/tratamiento farmacológico , Estudios Retrospectivos , Vancomicina/uso terapéutico
20.
J Manag Care Spec Pharm ; 26(11): 1468-1474, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33119445

RESUMEN

The COVID-19 pandemic and the social unrest pervading U.S. cities in response to the killings of George Floyd and other Black citizens at the hands of police are historically significant. These events exemplify dismaying truths about race and equality in the United States. Racial health disparities are an inexcusable lesion on the U.S. health care system. Many health disparities involve medications, including antidepressants, anticoagulants, diabetes medications, drugs for dementia, and statins, to name a few. Managed care pharmacy has a role in perpetuating racial disparities in medication use. For example, pharmacy benefit designs are increasingly shifting costs of expensive medications to patients, creating affordability crises for lower income workers, who are disproportionally persons of color. In addition, the quest to maximize rebates serves to inflate list prices paid by the uninsured, among which Black and Hispanic people are overrepresented. While medication cost is a foremost barrier for many patients, other factors also propagate racial disparities in medication use. Even when cost sharing is minimal or zero, medication adherence rates have been documented to be lower among Blacks as compared with Whites. Deeper understandings are needed about how racial disparities in medication use are influenced by factors such as culture, provider bias, and patient trust in medical advice. Managed care pharmacy can address racial disparities in medication use in several ways. First, it should be acknowledged that racial disparities in medication use are pervasive and must be resolved urgently. We must not believe that entrenched health system, societal, and political structures are impermeable to change. Second, the voices of community members and their advocates must be amplified. Coverage policies, program designs, and quality initiatives should be developed in consultation with those directly affected by racial disparities. Third, the industry should commit to dramatically reducing patient cost sharing for essential medication therapies. Federal and state efforts to limit annual out-of-pocket pharmacy spending should be supported, even though increased premiums may be an undesirable (yet more equitable) consequence. Finally, information about race should be incorporated into all internal and external reporting and quality improvement activities. DISCLOSURES: No funding was received for the development of this manuscript. Kogut is partially supported by Institutional Development Award Numbers U54GM115677 and P20GM125507 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds Advance Clinical and Translational Research (Advance-CTR), and the RI Lifespan Center of Biomedical Research Excellence (COBRE) on Opioids and Overdose, respectively. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.


Asunto(s)
Grupos de Población Continentales/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Disparidades en el Estado de Salud , Programas Controlados de Atención en Salud/organización & administración , Servicios Farmacéuticos/organización & administración , Neumonía Viral/epidemiología , Afroamericanos , Betacoronavirus , Seguro de Costos Compartidos , Industria Farmacéutica , Grupo de Ascendencia Continental Europea , Honorarios Farmacéuticos , Femenino , Gastos en Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Hispanoamericanos , Humanos , Masculino , Programas Controlados de Atención en Salud/economía , Cumplimiento de la Medicación , Pandemias , Servicios Farmacéuticos/economía , Estudios Retrospectivos , Factores Socioeconómicos , Estados Unidos/epidemiología
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