A assistência farmacêutica no cuidado a saúde na atenção básica : tão perto, tão longe
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Data
2017-06-30
Tipo
Dissertação de mestrado
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Introdução: A distribuição de medicamentos é parte integrante do SUS, sendo a alternativa terapêutica mais utilizada na rede de assistência aos pacientes. Entretanto, é preciso uma visão ampliada quanto à forma de utilização dos insumos farmacêuticos pelos usuários, uma vez que a racionalidade do uso de medicamentos está diretamente relacionada à qualidade do serviço de saúde e constitui um elemento importante para a avaliação do mesmo. Objetivo: É diante deste cenário, que o objetivo desse trabalho, foi caracterizar elementos da assistência farmacêutica no cuidado à saúde na ABS. Método: Do ponto de vista metodológico, optou-se por analisar o material de uma investigação de natureza cartográfica, realizada no ano de 2014 em sete UBS, e a partir deste empírico identificar cenas do cotidiano, que conectadas umas às outras, produziram planos de visibilidade para a questão do uso de medicamentos e da assistência farmacêutica. Além disso, foi realizado um seminário compartilhado junto aos atores institucionais das UBS estudadas, onde novos e marcantes elementos da assistência farmacêutica surgiram, abrindo a possibilidade de novas perspectivas sobre o material empírico e representando um novo momento de produção/ampliação do campo. Resultados: A partir dos planos de visibilidade foi possível identificar o hiato que existe, entre as diretrizes políticas relacionadas à assistência farmacêutica e o cotidiano na atenção básica: o uso (ir)racional de medicamentos e o papel que o profissional farmacêutico vem desempenhando. O estudo permitiu constatar também o quanto a farmácia é um observatório privilegiado da gestão e produção do cuidado, sendo um poderoso analisador deste cuidado: a conturbada relação entre a autonomia médica e a assistência farmacêutica; o agir do usuário e seu protagonismo; o isolamento do setor e equipe de farmácia. Conclusão: Ao contrastar aquilo que é prescrito na política com o material empírico, foi possível dissipar algo como uma cortina de fumaça, que se faz presente no cotidiano do trabalho na atenção básica e omite uma realidade muito distante daquilo que se considera como desejável, quando pensamos em termos da assistência farmacêutica. O que acontece depois que o usuário deixa a UBS com sua sacola cheia de medicamentos retirados na farmácia, parece ainda ficar oculto aos olhos dos profissionais de saúde. Ainda existe um longo caminho a ser percorrido até que de fato os serviços clínicos farmacêuticos incorporem os serviços básicos de saúde.
Introduction: The distribution of medicines is a integrant part of the SUS, being the most used therapeutic alternative in the network of patient care. However, it is necessary to have an expanded view on the use of pharmaceutical inputs by users, since the rational use of medicines is directly related to the quality of the health service and constitutes an important element for the evaluation of the same. Objective: It is against this background, that the objective of this work was to characterize elements of pharmaceutical assistance in health care in Basic Attention to Health. Method: From the methodological point of view, it was opted to analyze the material of an investigation of cartographic nature, carried out in 2014 in seven Primary Care Unit Health, and from this empirical one to identify daily scenes, that connected to each other, produced plans of visibility to the issue of medicines use and pharmaceutical assistance. In addition, a shared seminar was perfomed together with institutional actors of the Primary Care Unit Health studied, where new and important elements of pharmaceutical assistance emerged, opening up the possibility of new perspectives on the empirical material and representing a new moment of production / expansion of the field. Results: From the visibility plans, it was possible to identify the gap that exists between the political guidelines related to pharmaceutical assistance and daily life in basic attention: the rational use of medications and the role that the pharmaceutical professional has been playing. The study also showed how the pharmacy is a privileged observatory of the management and production of care, being a powerful analyzer of this care: the troubled relationship between medical autonomy and pharmaceutical assistance; The user's action and its protagonism; The isolation of the pharmacy sector and staff. Conclusion: By contrasting what is prescribed in politics with the empirical material, it was possible to dissipate something like a smokescreen, which is present in the daily work of basic attention and omits a reality far removed from what is considered desirable, when we think in terms of pharmaceutical assistance. What happens after the user leaves Primary Care Unit Health with his bag full of medicines withdrawn at the pharmacy, still seems to be hidden from the eyes of health professionals. There is still a long way to go until in fact pharmaceutical clinical services incorporate basic health services.
Introduction: The distribution of medicines is a integrant part of the SUS, being the most used therapeutic alternative in the network of patient care. However, it is necessary to have an expanded view on the use of pharmaceutical inputs by users, since the rational use of medicines is directly related to the quality of the health service and constitutes an important element for the evaluation of the same. Objective: It is against this background, that the objective of this work was to characterize elements of pharmaceutical assistance in health care in Basic Attention to Health. Method: From the methodological point of view, it was opted to analyze the material of an investigation of cartographic nature, carried out in 2014 in seven Primary Care Unit Health, and from this empirical one to identify daily scenes, that connected to each other, produced plans of visibility to the issue of medicines use and pharmaceutical assistance. In addition, a shared seminar was perfomed together with institutional actors of the Primary Care Unit Health studied, where new and important elements of pharmaceutical assistance emerged, opening up the possibility of new perspectives on the empirical material and representing a new moment of production / expansion of the field. Results: From the visibility plans, it was possible to identify the gap that exists between the political guidelines related to pharmaceutical assistance and daily life in basic attention: the rational use of medications and the role that the pharmaceutical professional has been playing. The study also showed how the pharmacy is a privileged observatory of the management and production of care, being a powerful analyzer of this care: the troubled relationship between medical autonomy and pharmaceutical assistance; The user's action and its protagonism; The isolation of the pharmacy sector and staff. Conclusion: By contrasting what is prescribed in politics with the empirical material, it was possible to dissipate something like a smokescreen, which is present in the daily work of basic attention and omits a reality far removed from what is considered desirable, when we think in terms of pharmaceutical assistance. What happens after the user leaves Primary Care Unit Health with his bag full of medicines withdrawn at the pharmacy, still seems to be hidden from the eyes of health professionals. There is still a long way to go until in fact pharmaceutical clinical services incorporate basic health services.
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Citação
MAXIMO, Samuel Amano. A assistência farmacêutica no cuidado a saúde na atenção básica : tão perto, tão longe. São Paulo, 2017. [114] p. Dissertação (Mestrado em Saúde coletiva) - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, 2017.