Revista de Saúde Pública (Nov 2017)

Characterization of the selection of medicines for the Brazilian primary health care

  • Margô Gomes de Oliveira Karnikowski,
  • Dayani Galato,
  • Micheline Marie Milward de Azevedo Meiners,
  • Emília Vitória da Silva,
  • Letícia Farias Gerlack,
  • Ângelo José Gonçalves Bós,
  • Silvana Nair Leite,
  • Juliana Álvares,
  • Ione Aquemi Guibu,
  • Orlando Mario Soeiro,
  • Karen Sarmento Costa,
  • Ediná Alves Costa,
  • Augusto Afonso Guerra Junior,
  • Francisco de Assis Acurcio

DOI
https://doi.org/10.11606/s1518-8787.2017051007065
Journal volume & issue
Vol. 51, no. suppl 2

Abstract

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ABSTRACT OBJECTIVE To characterize the process of selection of medicines for primary health care in the Brazilian regions. METHODS This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015), a cross-sectional study that consisted of an information gathering in a sample of cities in the five regions of Brazil. The data used were collected by interviews with those responsible for pharmaceutical services (PS) (n = 506), professionals responsible for the dispensing of medicines (n = 1,139), and physicians (n = 1,558). To evaluate the difference between ratios, we adopted the Chi-square test for complex samples. The differences between the averages were analyzed in generalized linear models with F-test with Bonferroni correction for multiple comparisons. The analyses considered significant had p≤0.05. RESULTS The professionals responsible for pharmaceutical services reported non-existence of a formally constituted Pharmacy and Therapeutics Committee (PTC) (12.5%). They claimed to have an updated (80.4%) list of Essential Medicines (85.3%) and being active participants of this process (88.2%). However, in the perception of respondents, the list only partially (70.1%) meets the health demands. Of the interviewed professionals responsible for the dispensing of medicines, only 16.6% were pharmacists; even so, 47.8% reported to know the procedures to change the list. From the perspective of most of these professionals (70.9%), the list meets the health demands of the city. Among physicians, only 27.2% reported to know the procedures to change the list, but 76.5% would have some claim to change it. Most of them reported to base their claims in clinical experiences (80.0%). For 13.0% of them, the list meets the health demands. CONCLUSIONS As this is the first national survey of characterization of the process of selection of medicines within primary health care, it brings unpublished data for the assessment of policies related to medicines in Brazil.

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