Abstract

Dispensing is the process, performed exclusively by the pharmacist, during which medication is provided to the patient, along with counseling on how to use that medication. Within primary health care settings, this service can identify, prevent, and resolve problems related to medications, consequently improving the health of the population. Nevertheless, this task has been incipient in Brazil, possibly interfering with the rational use of medicines and the success of pharmacological treatment. The objective of this study was to analyze pharmacists’ perception of medications dispensing within a Primary Health Care setting. A descriptive exploratory study was conducted using a qualitative approach. Semi-structured interviews were carried out with seven pharmacists working in Primary Health Care. The interviews were conducted using scripted questions and were audio-recorded. The sample was defined by data saturation and the data was analyzed using content analysis. This study was approved by the Research Ethics Committee of the Federal University of Goiás. Seven interviews were conducted, with three thematic categories being identified: medication management, medication dispensing, and pharmaceutical education. Medication management was found to be the activity that generated greatest concern among the pharmacists. Medication dispensing was considered inconsistent, with the participants reporting difficulties that negatively affect this service, particularly the physical structure of the pharmacy, and issues involving pharmacy assistants and the multi-professional teamwork. These pharmacists also mentioned that the undergraduate pharmacy program is deficient insofar as medication dispensing is concerned. Most interviewees reported a need for continuing education, with emphasis on master’s degree courses. These results highlight the lack of proximity between the pharmacist and the patient, with the pharmacist’s routine activities being focused predominantly on medication management. Also, it is important to review the structure and processes established in primary health care to improve the pharmacy structure, the relationship between the pharmacist and the assistants, as well as the multi-professional teamwork. The pharmacists interviewed were interested in acquiring medication dispensing skills through continuing education. Therefore, developing continuing education in medication dispensing for pharmacists working in primary health care and encouraging them to take advantage of such programs could improve their performance and the health of patients.

Keywords: Primary Health Care; Medication Dispensing; Pharmaceutical Education; Continuing Education

References

1. Ministério da Saúde. Portaria nº 3.916. “Aprova a Política Nacional de Medicamentos.” Diário Oficial da União, Brasília. DF (1998).
2. World Health Organization. “The rational use of drugs: report of the conference of experts”. Nairobi (1985): 25-29.
3. Organización Pan-Americana de la Salud (OPAS)/ Organización Mundial de la Salud (OMS). “El papel del farmacéutico en la atencíon a salud”. Informe de la reunión de la OMS, Tokio, Japon, 31 ago. Washington: PAHO (1995).
4. Pan american organization. “Guidelines for the Development of Pharmaceutical Services in Primary Health Care”. 1° ed. Washington: OPAS (2011).
5. Cazarim MDS., et al. “Impact Assessment of Pharmaceutical Care in the Management of Hypertension and Coronary Risk Factors after Discharge”. PLOS ONE6 (2016). e0155204.
6. Nicolas A., et al. “Drug-related problems in prescribed medicines in Germany at the time of dispensing”. International Journal of Clinical Pharmacy 3 (2013): 476-482.
7. Laliberté MC., et al. “Ideal and actual involvement of community pharmacists in health promotion and prevention:a cross-sectional study in Quebec, Canada”. BMC Public Health 12 (2012): 192.
8. Carvalho MN., et al. “Workforce in the pharmaceutical services of the primary health care of SUS, Brazil”. Revista de Saude Publica 2 (2017): 16s.
9. Leite SN., et al. “Medicine dispensing service in primary health care of SUS”. Revista de Saude Publica 2 (2017): 11s.
10. Reis TM., et al. “Knowledge and conduct of pharmacists for dispensing of drugs in community pharmacies: a cross-sectional study”. Brazilian Journal of Pharmaceutical Sciences 51 (2015): 3.
11. Roque F. “Educational interventions to improve prescription and dispensing of antibiotics: a systematic review”. BMC Public Health (2014).
12. Mcdowell J., et al. “A Simulated Learning Environment for Teaching Medicine Dispensing Skills”. American Journal of Pharmaceutical Education 80 (2016): 1-11.
13. Alaqeel S and Abanmy NO. “Counselling practices in community pharmacies in Riyadh, Saudi Arabia: a cross-sectional study”. BMC Health Services Research (2015): 557.
14. Gregório J., et al. “A scenario-planning approach to human resources for health: the case of community pharmacists in Portugal”. Human Resources for Health (2014): 58.
15. Tong A., et al. “Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups”. International Journal for Quality in Health Care 19 (2007): 349-357.
16. Instituto Brasileiro de Geografia e Estatística. “IBGE divulga estimativa da população dos municípios (2020).
17. Bardin L. “Análise de conteúdo. São Paulo: Edições 70 (2011).
18. Twigg MJ., et al. “The current and future roles of community pharmacists: views and experiences of patients with type 2 diabetes”. Research in Social and Administrative Pharmacy: RSAP (2013): 777-789.
19. Costa AF., et al. “Provision of pharmaceutical care by community pharmacists across Europe: Is it developing and spreading?” Journal of Evalition in Clinical Practice (2017): 1336-1347.
20. Sartor VDB And Freitas SFT. “Model for the evaluation of drug-dispensing services in primary health care”. Revista de Saúde Pública5 (2014): 827-836.
21. Angonesi D and Rennó MUP. “Dispensation of pharmaceuticals: proposal of a model for dispensation”. Ciência e Saúde Coletiva (2011).
22. World Health Organization. “Developing pharmacy practice a focus on patient care”. (2006).
23. Al-Arifi MN. “Community pharmacists’ attitudes toward dispensing errors at community pharmacy setting in Central Saudi Arabia”. Saudi Pharmaceutical Journal3 (2014): 195-202.
24. Inoue Y., et al. “Future expectations for Japanese pharmacists as compared to the rest of the world”. Research in Social and Administrative Pharmacy: RSAP3 (2014): 448-458.
25. Elliott RA., et al. “Prevalence and economic burden of medication errors in the NHS in England”. Policy Research Unit in Economic Evaluation of Health and Care Interventions (2018).
26. Medeiros CDSO. “The Process of (re) Building Multiprofessionalism in PrimaryCare: Limits and Challenges for Effective Teamwork in FamilyHealth Strategy in Joao Pessoa – PB”. Revista Brasileira de Ciências da Saúde3 (2011): 319-328.
27. Araújo ALA and Freitas O. “Conceptions of the pharmaceutical professional about the pharmaceutical assistance in basic health care units: difficulties and elements for change”. The Brazilian Journal of Pharmaceutical Sciences/Revista 1 (2006): 137-146.
28. Saramunee K., et al. “How to enchance public health service ultilization in community pharmacy? General public and health providers’perspectives”. Research in Social and Admisntrative Pharmacy (2014): 272-284.
29. Hamrosi KK., et al. “Enhancing provision of written medicine information in Australia: pharmacist, general practitioner and consumer perceptions of the barriers and facilitators”. BMC Health Services Research 183 (2014): 656-668.
30. Hamrosi KK., et al. “Pharmacist and general practitioner ambivalence about providing written medicine information to patients a qualitative study”. Research in Social and Administrative Pharmacy: RSAP5 (2013): 517-530.
31. World Health Organization. “The role of the pharmacist in the health care system preparing the future pharmacist: curricular development”. Vancouver, Canada 27-29 (1997).
32. , et al. “The invisible pharmacist”. American Journal of Pharmaceutical Education 73.4 (2009): 74.
33. Ministério da Educação (BR). Conselho Nacional de Educação. Resolução CNE/ CES 6/2017. “Diretrizes Curriculares Nacionais do Curso de Graduação em Farmácia”. Diário Oficial da União 1 (2017): 30.
34. Pitka K., et al. “Integrating internships with professional study in pharmacy education in Finland”. American Journal of Pharmaceutical Education 9 (2014): 1-9.
35. Rezende VLM., et al. “Documentary analysis of the pedagogical project of a Medicine course and teaching in Primary Care”. Interface1 (2019).
36. Mattos LB., et al. “Contribution of the specialization course in primary health care to the practice of health professionals”. ABCS Health Sciences 3 (2015): 184-189.
37. Bush CT and Lowery B. “Postgraduate Nurse Practitioner Education: Impact on Job Satisfaction”. The Journal for Nurse Practitioners4 (2016): 226-234.
38. Moraes KG and Dytz J LG. “Permanent Education in Health Policy: analysis of its implementation”. ABCS Health Sciences 3 (2015): 263-269.
39. Tofade T., et al. “The Responsibility of Advancing Continuing Professional Development and Continuing Education Globally”. American Journal of Pharmaceutical Education 2 (2015): 1-2.