Fitoterapia no Brasil contemporâneo e no cuidado farmacêutico: situações-limite e educação como inédito-viável.

Abstract

Phytotherapy is a practice that is widely and increasingly used by the most diverse populations around the world. Its inclusion in official health systems has been recommended by the World Health Organization since the 1970s. However, considering the national potential, the expressiveness of this practice in the Brazilian healthcare system is still timid. Healthcare professionals do not feel qualified to deal with it. Pharmaceutical Care is a professional practice that aims to meet the social need for the optimized use of medicines, presenting a promising theoretical-methodological framework for advances in this field. This research aimed to critically understand the challenges and potential of phytotherapy in the broad context of contemporary Brazil and in the specific context of Pharmaceutical Care practice and education, promoting awareness and instrumentalization of pharmacy students and pharmacists. It was a qualitative research, coined in a subjectivist epistemology and in a critical paradigm. A combination of the Investigation of Generating Themes proposed in the “Pedagogy of the Oppressed” by Paulo Freire and Autoethnography was adopted. The research was conducted at the Center for Studies in Pharmaceutical Care at the Federal University of Minas Gerais. Data collection took place between December 2020 and July 2024 through immersion in the research community, collaborative interviews, and autoethnographic writing. Promoting recursion between reflection and implementation, 62 educational actions were carried out throughout its development. 12 autoethnographic vignettes were prepared, 13 interviews were conducted with pharmacists and pharmacy students, and 84 reflective activities were written by students. Data obtained through different methods were analyzed dialogically, adopting thematic analysis and also autoethnographic analysis. The results revealed two limit-situations. The first concerns the state of phytotherapy in contemporary Brazil, a reflection of colonization that can be overcome by valuing Traditional Brazilian Medicine and including knowledge produced in different logics in teaching, research, and healthcare services. The second highlighted limit-situation referred to the state of phytotherapy in Pharmaceutical Care. A critical full-blown problematization about Pharmaceutical Care indicated that one should seek to equalize the philosophy of professional practice and its operationalization in the biomedical and neoliberal context, in order to promote awareness and action to reduce the oppression often inherent in the formal healthcare system. It is urgent that the theoretical-methodological framework of Pharmaceutical Care is applied to meet the social need for an indicated, effective, safe and convenient use of phytotherapy, enabling the prevention, recognition and resolution of problems related to their use, which is the responsibility of every pharmacist who performs Medication Therapy Management, a practice centered on the patient. Thus, greater resolution in care, autonomy and appreciation of the professional are promoted. Phytotherapy needs to be appropriately included in undergraduate and graduate education, in professional practice and in research on Pharmaceutical Care. The denunciation of these limit-situations announced the untested feasibility, which began to be materialized through the education of the community involved throughout the research process. It is hoped that its developments will lead to the construction of other and necessary untested feasibilities, engendering a broad, ecological and socially fairer science and health project.