Machado Fernanda Lacerda da Silva, Dos Santos Danielle Maria de Souza Serio, Lopes Luciane Cruz
Federal University of Rio de Janeiro, UFRJ, Macaé, Brazil.
Pharmaceutical Sciences Graduate Course, University of Sorocaba, UNISO, Sorocaba, Brazil.
Front Pharmacol. 2021 Apr 22;12:612426. doi: 10.3389/fphar.2021.612426. eCollection 2021.
In the last decades, litigation has been increasingly used to access medicines in Brazil. This phenomenon has led to the development of diverse strategies to reduce its negative impact on the organization of pharmaceutical services. In spite of that, managers still face difficulties dealing with lawsuits. This study aims to report the planning and implementation of strategies to approach medicines litigation in a municipality located in the southeast region of Brazil. Mixed methods were employed through an action research cycle. A network coordination team included researchers from university and municipal managers. The scenario analysis comprised the characterization of pharmaceutical services and the profile of medicines lawsuits. Afterward, strategies were planned to deal with the central problem identified. The action plan involved educational outreach visits and distribution of printed materials for health professionals, evaluated through opinion survey. Group conversations were conducted with the users of the public health system, followed by thematic analysis of reports. The characterization of pharmaceutical services in the municipality revealed that treatments supplied were in accordance with the National Medicines Policy. In addition, a sector was implemented to attend demands for non-incorporated medicines. In spite of the services available, the characterization of lawsuits indicated that the main claimants were users of the public health system, requiring non-incorporated medicines, with therapeutic alternatives available. Thus, educational outreach visits were held in 14 health units (23 physicians in total). Everyone who answered the evaluation declared that they were very satisfied with the approach. Group conversations with the users of the health system reached 227 participants in total. In regard to users' perception about pharmaceutical services, thematic analysis of reports identified three main categories including aspects related to medicines provided, users assisted, and quality of service. The study described the first cycle of an action research project to develop strategies to approach medicines litigation at the municipal level. The application of educational outreach visits for health professionals and group conversations with health system users is a promising approach to improve access to information about pharmaceutical services in Brazil.
在过去几十年里，诉讼在巴西越来越多地被用于获取药品。这一现象促使人们制定了各种策略，以减少其对药品服务组织的负面影响。尽管如此，管理人员在处理诉讼时仍面临困难。本研究旨在报告在巴西东南部一个城市应对药品诉讼的策略规划与实施情况。通过行动研究循环采用了混合方法。一个网络协调团队包括来自大学的研究人员和市政管理人员。情景分析包括药品服务的特征描述和药品诉讼的概况。之后，针对所确定的核心问题制定了应对策略。行动计划包括对卫生专业人员进行教育外展访问并分发印刷材料，并通过意见调查进行评估。与公共卫生系统的用户进行了小组对话，随后对报告进行了主题分析。该市药品服务的特征描述显示，所提供的治疗符合国家药品政策。此外，还设立了一个部门来处理对未纳入医保的药品的需求。尽管有这些可用服务，但诉讼的特征表明，主要索赔人是公共卫生系统的用户，他们需要未纳入医保的药品，且有可用的治疗替代方案。因此，在14个卫生单位进行了教育外展访问（共有23名医生）。所有回答评估的人都表示对这种方式非常满意。与卫生系统用户的小组对话共有227名参与者。关于用户对药品服务的看法，报告的主题分析确定了三个主要类别，包括与所提供药品、所服务用户以及服务质量相关的方面。该研究描述了一个行动研究项目的第一个周期，该项目旨在制定市级应对药品诉讼的策略。对卫生专业人员进行教育外展访问以及与卫生系统用户进行小组对话，是改善巴西药品服务信息获取情况的一种有前景的方法。
