Amariles Pedro, Ceballos Mauricio, González-Giraldo Cesar
PhD, MPharm, BPharm. Professor. University of Antioquia. Medellín (Colombia).
MSc, BPharm. Professor. University of Antioquia. Medellín (Colombia).
Pharm Pract (Granada). 2020 Oct-Dec;18(4):2159. doi: 10.18549/PharmPract.2020.4.2159. Epub 2020 Nov 23.
Colombia is a decentralized republic with a population of 50 million, constituted by 32 departments (territorial units) and 1,204 municipalities. The health system provides universal coverage and equal access to health care services to 95% of the population. Primary health care is seen as a practical approach that guarantees the health and well-being of whole-of-society. The National Pharmaceutical Policy (NPP, 2012) goal is "to develop strategies that enable the Colombian population equitable access to effective medicines, through quality pharmaceutical services (PS)". There are 4,351 providers certified to deliver PS: 3,699 (85%) ambulatory and 652 (15%) hospital care. The goals for PS are: a) promoting healthy lifestyles; b) preventing risk factors arising from medication errors; c) promoting rational use of medicines; and d) implementing Pharmaceutical Care. There are a number of ways that ambulatory patients access medications: through intermediary private companies, public and private hospitals pharmacies, and retail establishments (drugstores and pharmacies). Intermediary private companies are similar to Pharmaceutical Benefits Management in the U.S. health system, and act as intermediaries between health insurers, pharmaceutical laboratories, and patients. Pharmacists are being employed by these companies and in health insurance companies managing, auditing and delivering rational use of medicines programs. In 2014 there were approximately 20,000 pharmacies and drugstores, (private establishments) where a significant number of prescription-only medicines are sold without medical prescription. Colombian laws allow personal without pharmacy education to be a "director" in these establishments, so the training and education of persons working in drugstores and pharmacies is an important challenge. There about 8,000 registered pharmaceutical chemists with 25% to 30% working in patient care. Since the 90´s, there are more favorable conditions for pharmacist's participation and contribution to health system and patient's health outcome. These environmental facilitators include: a) laws and regulations regarding pharmaceutical services (2005-2007), b) establishment of a NPP (2012), and c) opportunities associated with the consolidation of private health management companies providing health services with an interest in pharmaceutical services (since 1995). Finally, telepharmacy, comprehensive care routes for pharmaceutical services, and further strengthen of postgraduate training in pharmacy practice are future strategies to improve the pharmacy profession in Colombia. They provide an opportunity to influence the recognition and value of the pharmacist as the health care professional.
哥伦比亚是一个实行地方分权的共和国，人口5000万，由32个省（领土单位）和1204个市组成。其卫生系统为95%的人口提供全民覆盖和平等的医疗服务。初级卫生保健被视为保障全社会健康和福祉的切实途径。《国家药品政策》（2012年）的目标是“制定战略，使哥伦比亚民众能够通过优质的药学服务公平地获得有效药品”。有4351家机构获得提供药学服务的认证：3699家（85%）为门诊服务机构，652家（15%）为医院服务机构。药学服务的目标是：a）促进健康的生活方式；b）预防用药错误产生的风险因素；c）促进合理用药；d）实施药学保健。门诊患者获取药品有多种途径：通过中介私营公司、公立和私立医院药房以及零售机构（药店）。中介私营公司类似于美国卫生系统中的药品福利管理机构，在健康保险公司、制药企业和患者之间充当中间人。这些公司以及健康保险公司雇佣药剂师来管理、审核并实施合理用药项目。2014年，大约有2万间药店（私营机构），大量处方药在这些地方无需医生处方就得以出售。哥伦比亚法律允许没有药学教育背景的人员担任这些机构的“负责人”，因此药店和药房工作人员的培训与教育成为一项重大挑战。约有8000名注册药剂师，其中25%至30%从事患者护理工作。自20世纪90年代以来，药剂师参与卫生系统并对患者健康结果做出贡献的条件更为有利。这些环境促进因素包括：a）关于药学服务的法律法规（2005 - 2007年），b）《国家药品政策》的制定（2012年），以及c）与整合提供对药学服务感兴趣的健康服务的私营健康管理公司相关的机遇（自1995年起）。最后，远程药学服务（远程药房）、药学服务综合护理途径以及进一步加强药学实践研究生培训是哥伦比亚提升药学专业水平的未来战略。它们为提升药剂师作为医疗保健专业人员的认可度和价值提供了契机。
