巴西初级卫生保健用药选择的特征描述
Characterization of the selection of medicines for the Brazilian primary health care.
作者信息
Karnikowski Margô Gomes de Oliveira, Galato Dayani, Meiners Micheline Marie Milward de Azevedo, Silva Emília Vitória da, Gerlack Letícia Farias, Bós Ângelo José Gonçalves, Leite Silvana Nair, Álvares Juliana, Guibu Ione Aquemi, Soeiro Orlando Mario, Costa Karen Sarmento, Costa Ediná Alves, Guerra Augusto Afonso, Acurcio Francisco de Assis
机构信息
Curso de Farmácia. Faculdade de Ceilândia. Universidade de Brasília. Brasília, DF, Brasil.
Programa de Pós-graduação em Ciências e Tecnologias em Saúde. Faculdade de Ceilândia. Universidade de Brasília. Brasília, DF, Brasil.
出版信息
Rev Saude Publica. 2017 Nov 13;51(suppl 2):9s. doi: 10.11606/S1518-8787.2017051007065.
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.
目的
描述巴西各地区基层医疗保健用药选择过程的特征。
方法
本文是2015年全国药品获取、使用及合理用药促进情况调查——服务（PNAUM——全国药品获取、使用及合理用药促进情况调查——服务，2015年）的一部分，这是一项横断面研究，包括在巴西五个地区的城市样本中收集信息。所使用的数据通过对负责药学服务（PS）的人员（n = 506）、负责药品调配的专业人员（n = 1,139）和医生（n = 1,558）进行访谈收集。为评估比率之间的差异，我们采用了复杂样本的卡方检验。在具有F检验并经Bonferroni校正用于多重比较的广义线性模型中分析平均值之间的差异。分析认为有显著差异的p值≤0.05。
结果
负责药学服务的专业人员报告称不存在正式组建的药学与治疗学委员会（PTC）（12.5%）。他们声称拥有最新的（80.4%）基本药物清单（85.3%），并且是这一过程的积极参与者（88.2%）。然而，在受访者看来，该清单仅部分（70.1%）满足健康需求。在接受访谈的负责药品调配的专业人员中，只有16.6%是药剂师；即便如此，47.8%的人报告了解更改清单的程序。从这些专业人员中的大多数（70.9%）的角度来看，该清单满足城市的健康需求。在医生中，只有27.2%的人报告了解更改清单的程序，但76.5%的人会要求更改它。他们中的大多数人报告称其要求基于临床经验（80.0%）。对其中13.0%的人来说，该清单满足健康需求。
结论
由于这是首次对基层医疗保健用药选择过程特征进行的全国性调查，它为评估巴西与药品相关的政策带来了未公布的数据。
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