Cuidado farmacêutico na Atenção Primária à Saúde em Belo Horizonte: um processo em construção

Abstract

This thesis portrays the experience of the pharmacist insertion in Primary Health Care, which is a process under construction. It is a case study with a qualitative approach, whose objective was to describe Pharmaceutical Care in the context of Primary Health Care in the city of Belo Horizonte, from the perspective of pharmacists and patients. Pharmacists and patients of the Belo Horizonte Health Centers made up the study sample, carried out between May 2016 and April 2017. The research was developed in three stages: in the first 50 pharmacists working in Primary Health Care answered a semi-structured questionnaire addressing aspects related to their socio-demographic, professional and training profile, and about the activities developed. From these data, six pharmacists were identified who performed pharmacotherapeutic follow-up using a method validated in the literature. These six were asked to refer patients, who twelve were interviewed individually to understand their experience with pharmaceutical care. In the third, the nine pharmacists who reported developing pharmacotherapeutic follow-up in the first stage were interviewed individually about the work process in Primary Health Care. It was observed that pharmaceutical care is still a challenge to be faced, mainly due to the demand for managerial activities and the deficiency in training for care, needing to reorganize the work processes and institutional guidelines for expanding access to pharmaceutical services focused on the patient. Patients reported recognizing the pharmacist as a guide and encourager in the treatment process, showing satisfaction and desire for the service continuity. It is important to highlight aspects related to the training of pharmacists, noting that the professional identifies his deficiencies in training for care and seeks to supply them with complementary learning and with his own practice. The professional transformation process stands out when assimilating the assumptions of pharmaceutical practice. When talking about their practice, pharmacists stressed that by improving clinical reasoning with practice, it is possible to perceive / recognize their role as a caregiver in identifying the patient's needs. The results allow us to infer that the unfamiliarity and, sometimes, the perception of other professionals, changes as the pharmacists perform the service and give feedback to the team, clarifying their contribution to patient care. When performing pharmacotherapeutic follow-up, the pharmacist approached patients and other team members, expanding their role in care, legitimizing their competence, being recognized for their work. This thesis is expected to be a subsidy for the systematization and implementation of the practice of Pharmaceutical Care in the Unified Health System, for the rescue of the social role and the identity of the pharmacist with the professionals of the teams and the population. Furthermore, it can sensitize managers and contribute to the curricular adjustments necessary for pharmaceutical teaching related to Pharmaceutical Care, from the perspective of patient-centered care.