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巴西依赖处方的概念层面、影响及现状:叙述性综述

Conceptual aspects, impact, and state of the art of dependent prescription in Brazil: narrative review.

作者信息

Andrade Heuler S, Guimarães Eliete A A, Obreli Neto Paulo R, Pereira Mariana L, Zanetti Maria O B, Reis Tiago M, Baldoni André O

机构信息

Universidade Federal de São João Del-Rei (UFSJ) - CCO - Divinópolis, Minas Gerais, Brazil.

出版信息

Porto Biomed J. 2020 Jun 4;5(3):e66. doi: 10.1097/j.pbj.0000000000000066. eCollection 2020 May-Jun.

DOI:10.1097/j.pbj.0000000000000066
PMID:33299947
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7722403/
Abstract

BACKGROUND

Nonmedical prescription is recognized in several countries as an excellent strategy in facing emerging demands that put a strain on the health system. It is a practice carried out by professionals who are not doctors and who, after obtaining specific qualifications and legal authorization, can prescribe medication and curatives. In Brazil, although there is already a legal subsidy for prescription in some professions, it is still an underdeveloped activity with few studies.

OBJECTIVE

This study aimed to describe the conceptual aspects and state of the art of this type of prescription in Brazil.

METHODS

It is a narrative review of the literature that included national and international regulations related to the subject, as well as available articles, published in electronic journals in different databases. Key terms used were nonmedical prescription, nursing prescription, and pharmaceutical prescription.

RESULTS

It was evidenced that nonmedical prescription has ample potential for improving the quality of care and the health conditions of patients. One can highlight as positive results the improvement of work satisfaction and self-confidence of those who have developed this practice; improvement of teamwork reported by other professionals due to the reduction of work overload; greater patient satisfaction in relation to access; and care provided by prescribers.

CONCLUSIONS

It is understood that there are many challenges for the consolidation of this activity in Brazil and that its success depends on a joint effort of health and educational institutions, health professionals, and patients.

摘要

背景

在一些国家,非医疗处方被视为应对给卫生系统带来压力的新出现需求的一项出色策略。这是由非医生专业人员开展的一种做法,这些人员在获得特定资质和法律授权后,可以开具药物和治疗剂。在巴西,尽管某些职业的处方已有法律补贴,但这仍是一项发展不完善的活动,相关研究较少。

目的

本研究旨在描述巴西这类处方的概念性方面和现状。

方法

这是一项文献叙述性综述,纳入了与该主题相关的国家和国际法规以及在不同数据库的电子期刊上发表的现有文章。使用的关键词为非医疗处方、护理处方和药物处方。

结果

有证据表明,非医疗处方在改善护理质量和患者健康状况方面具有巨大潜力。可以突出的积极成果包括:开展这种做法的人员工作满意度和自信心提高;其他专业人员报告称,由于工作负担减轻,团队合作得到改善;患者在就医机会和处方者提供的护理方面满意度更高。

结论

据了解,在巴西巩固这项活动面临诸多挑战,其成功取决于卫生和教育机构、卫生专业人员及患者的共同努力。

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本文引用的文献

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Independent prescribing in primary care: A survey of patients', prescribers' and colleagues' perceptions and experiences.初级保健中的独立处方:对患者、处方者和同事的看法和经验的调查。
Health Soc Care Community. 2019 Jul;27(4):e459-e470. doi: 10.1111/hsc.12746. Epub 2019 Mar 18.
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Facilitators and barriers to non-medical prescribing - A systematic review and thematic synthesis.非医疗处方的促进因素和障碍 - 系统评价和主题综合分析。
PLoS One. 2018 Apr 30;13(4):e0196471. doi: 10.1371/journal.pone.0196471. eCollection 2018.
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Rational use of medicines, pharmaceuticalization and uses of methylphenidate.药品的合理使用、药物化及哌甲酯的用途
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Pharmacist prescribing: a cross-sectional survey of the views of pharmacists in Nigeria.药剂师开处方:尼日利亚药剂师观点的横断面调查
Int J Pharm Pract. 2018 Apr;26(2):111-119. doi: 10.1111/ijpp.12381. Epub 2017 May 12.
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Repeat prescribing of medications: A system-centred risk management model for primary care organisations.药物重复开具:基层医疗组织以系统为中心的风险管理模型
J Eval Clin Pract. 2017 Aug;23(4):779-796. doi: 10.1111/jep.12718. Epub 2017 Mar 31.
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Survey of pharmacist prescribing practices in Alberta.艾伯塔省药剂师处方行为调查。
Am J Health Syst Pharm. 2017 Jan 15;74(2):62-69. doi: 10.2146/ajhp150349.
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Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care.基层医疗和二级医疗中急性和慢性疾病管理的非医学处方与医学处方对比
Cochrane Database Syst Rev. 2016 Nov 22;11(11):CD011227. doi: 10.1002/14651858.CD011227.pub2.
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An evaluation of elderly people's understanding of pharmacotherapy among those treated in the Primary Healthcare System in Belo Horizonte, Brazil.
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Nonmedical prescribing: where are we now?非医学处方:我们现在处于什么状况?
Ther Adv Drug Saf. 2016 Aug;7(4):165-72. doi: 10.1177/2042098616646726. Epub 2016 Apr 29.
10
Predictive Factors of Patient Satisfaction with Pharmacy Services in South Korea: A Cross-Sectional Study of National Level Data.韩国患者对药房服务满意度的预测因素:一项基于国家级数据的横断面研究。
PLoS One. 2015 Nov 5;10(11):e0142269. doi: 10.1371/journal.pone.0142269. eCollection 2015.