Serviço de gerenciamento da terapia medicamentosa: processo de implementação em uma farmácia universitária ambulatorial por meio do active implementation framework.

Abstract

Implementation Sciences deals with the insertion of services and this process promotes changes and transformations in the work routine, promoting challenges for the functioning of services, among these, the Comprehensive Medication Management (CMM). With this study aims to structure a process of implementation of CMM services in a University Pharmacy. The methodology applied was the Active Implementation Framework, organized into three steps: I - a systematic review exploring barriers and facilitators influencing the implementation of CMM in outpatient settings; II - a mixed-methods study approaching the development of a course on the emergency remote teaching environment to capacitate human resources to operate in CMM services; III - a qualitative study developing a guide for the implementation of CMM. The results from the systematic review indicated that the most cited barrier was the lack of knowledge from patients about the existence of the pharmaceutical service, whilst the appropriate communication between the pharmacist offering CMM and other health care workers was the most frequent facilitator. In the mixed-methods study, students have shown improvements in the development of clinical competencies to the offering of CMM, even with the challenges of emergency remote teaching. As for the Guide to Implementation, 15 critical steps were identified, highlighting the following: an Implementation Plan to guide all the efforts of the implementation team; prospecting for financial resources from the beginning of the process so as not to cause avoidable delays; compilation of data for the formation of indicators in order to diagnose points of improvement of the implemented service. Thus, to increase the chances of success of the implementation process, the responsible team must concentrate their efforts to previously guarantee human, financial, and material resources, and to establish how CMM will interact with the other existing services and with patients, considering that all actions regarding the implementation should be guided by a validated methodology.