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Colaço RF, Onocko-Campos RT. [Shared decision-making of psychopharmaceutical treatment: survey with users of CAPS from four large Brazilian cities]. CIENCIA & SAUDE COLETIVA 2022; 27:2553-2562. [PMID: 35730827 DOI: 10.1590/1413-81232022277.17162021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 01/05/2022] [Indexed: 11/22/2022] Open
Abstract
In this article we describe the characteristics of the treatment negotiation process with medications at the Centros de Atenção Psicossocial (CAPS) in four major Brazilian municipalities. A structured questionnaire was applied to 1,630 CAPS users in the cities of Campinas, Fortaleza, Porto Alegre and São Paulo. Most users undergoing treatment at the CAPS did not start using medication at the CAPS, but already in the first contact with health services. Almost all users were medicated when starting treatment at CAPS and most of them were medicated at the first visit. Between 55.2% and 40.7% (depending on the municipality) reported not having received information on the time needed to use the medication. A very high proportion of users reported having changed the dose of the medication alone (40.5% to 28.7%) or having been medicated against their will (35.7% to 15.6%), which indicates limits on building consensus among staff, users and families on the use of medication. CAPS users participate little in the medication decision process. There are problems from the provision of information to problems in building consensus involving the introduction and continued use of the drug.
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Affiliation(s)
- Rafael Freitas Colaço
- Departamento de Saúde Coletiva, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
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Redigolo E, Pereira LRL, Santos VD, Troncon LEDA. Pharmacists’ Educational Training and Professional Activities at the Municipal Level of the Brazilian National Health System. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e21323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Damasceno LT, Mendes SJ, Aguiar PM. Interface entre a saúde mental de crianças e adolescentes e a atuação clínica do farmacêutico: um estudo qualitativo. INTERFACE - COMUNICAÇÃO, SAÚDE, EDUCAÇÃO 2022. [DOI: 10.1590/interface.210780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
O estudo objetivou analisar a percepção do farmacêutico sobre a sua atuação clínica em Centros de Atenção Psicossocial Infantojuvenil (CAPSi). Foi realizado estudo qualitativo, por meio de entrevistas on-line individuais e semiestruturadas com seis farmacêuticas de CAPSi. As entrevistas foram gravadas, transcritas, analisadas e categorizadas segundo o método de análise de conteúdo. As categorias temáticas foram “Equipe multidisciplinar e as diferentes formas de produção de cuidado”, “Inserção do farmacêutico no serviço”, “Aspectos que se relacionam ao uso de psicofármacos” e “Nuances do trabalho farmacêutico em rede na infância e adolescência”. Os resultados mostram uma gradual mudança de paradigma da atuação do farmacêutico em direção ao cuidado da pessoa em sofrimento mental, culminando em ampla atuação na equipe multidisciplinar. Apesar disso, foi apontada a necessidade de documentos que guiem a atuação clínica deste profissional com o público infantojuvenil.
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Campos RO, Santos DVDD, Diaz AV, Emerich B, Trape T, Gama CAPD, Amaral CEM, Poderoso RE, Ferrer AL, Miranda L, Pereira MB, Surjus LT. Mental Health Studies published in the last 25 years in the Journal Ciência & Saúde Coletiva. CIENCIA & SAUDE COLETIVA 2020; 25:4771-4790. [PMID: 33295500 DOI: 10.1590/1413-812320202512.27932020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 11/22/2022] Open
Abstract
A systematic review of the 25-year Mental Health production of Journal Ciência & Saúde Coletiva was performed to identify whether this production had changed over time. We investigated whether these changes would have any relationship with the implementation of a new regulatory and legal framework for this field and the expansion of public services and the promotion of public funding agencies' investigation on the subject. A total of 278 original papers were analyzed from the following categories: sociocultural transformations related to madness and its approach; legislative changes; implantation, coverage range and operation of the network of substitute services; clinic/care developed in substitute services; the role and possibilities of primary care; drug use-related problems; mental health of children and adolescents; epidemiological studies/psychiatric categories; and others - which included ethnic-racial issues, violence, about the elderly population, suicide, bullying, and migration. A chronological relationship can be observed between the increase in publications and research notices and the expansion of services, not seemingly in the same way concerning care for people with alcohol and other drug problems.
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Affiliation(s)
- Rosana Onocko Campos
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp). R. Tessália Vieira de Camargo 126, Barão Geraldo. 13084-971 Campinas SP Brasil.
| | | | - Alberto Velzi Diaz
- Consejo de Investigadores, Universidad Nacional de Rosario. Rosario Santa Fé Argentina
| | - Bruno Emerich
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp). R. Tessália Vieira de Camargo 126, Barão Geraldo. 13084-971 Campinas SP Brasil.
| | - Thiago Trape
- Faculdade São Leopoldo Mandic. Rio de Janeiro RJ Brasil
| | | | | | - Rosana Evangelista Poderoso
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp). R. Tessália Vieira de Camargo 126, Barão Geraldo. 13084-971 Campinas SP Brasil.
| | | | - Lilian Miranda
- Universidade Federal Rural do Rio de Janeiro. Rio de Janeiro RJ Brasil
| | - Mariana Barbosa Pereira
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp). R. Tessália Vieira de Camargo 126, Barão Geraldo. 13084-971 Campinas SP Brasil.
| | - Luciana Togni Surjus
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp). R. Tessália Vieira de Camargo 126, Barão Geraldo. 13084-971 Campinas SP Brasil.
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Silva SN, Lima MG, Ruas CM. Brazilian Mental Health Services Assessment: user satisfaction and associated factors. CIENCIA & SAUDE COLETIVA 2018; 23:3799-3810. [PMID: 30427450 DOI: 10.1590/1413-812320182311.25722016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 11/11/2016] [Indexed: 11/21/2022] Open
Abstract
Patient satisfaction is an important criterion for assessing the quality of Brazilian mental health services at Psychosocial Care Centers (CAPS - from the Portuguese 'Centro de Atenção Psicossocial'). The aim of this study was to evaluate the satisfaction of users at the main CAPS in a region of Minas Gerais state, Brazil, as well as associated factors. This was a cross-sectional study with 11 CAPS. Patients were interviewed using the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and a semi-structured questionnaire containing sociodemographic and clinical variables. The users were satisfied with the CAPS, particularly in terms of staff competence and the welcome received and care provided. The physical facilities and comfort at the centers obtained the lowest satisfaction scores on the scale. Almost half of the users were unfamiliar with basic aspects of their drug therapy, such as the name of medicines, and one-third reported inappropriate use of medications. Users of midsize CAPS and those providing treatment for alcohol and drug addiction were more satisfied than patients at mental health or 24-hour CAPS. Although this study identified a need for improvement in physical facilities, mechanisms of participation and patient empowerment, the users were satisfied with the CAPS care model.
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Affiliation(s)
- Sarah Nascimento Silva
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Departamento de Farmácia Social, Faculdade de Farmácia, Universidade Federal de Minas Gerais (UFMG). Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
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Ramos SF, Santos Júnior GAD, Pereira AM, Dosea AS, Rocha KSS, Pimentel DMM, Lyra-Jr DPD. Facilitators and strategies to implement clinical pharmacy services in a metropolis in Northeast Brazil: a qualitative approach. BMC Health Serv Res 2018; 18:632. [PMID: 30103749 PMCID: PMC6090582 DOI: 10.1186/s12913-018-3403-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 07/17/2018] [Indexed: 12/17/2022] Open
Abstract
Background Clinical Pharmacy Services (CPS) are a reality in many health systems around the world. However, there are few studies that discuss the facilitators and the strategies to implement CPS in healthcare systems. In this way, the objective of this study was to identify the facilitators and strategies involved in the CPS implementation process in some public health units in a metropolis in the Northeast Brazil. Methods A qualitative study was carried out with health-system pharmacists and managers who experienced the implementation of CPS. Therefore, focus groups were conducted with pharmacists, and the interviews with the managers. The discussions were carried out through semi-structured scripts and were recorded in audio and videos, after the signature of the consent form. The recordings were transcribed and analyzed independently through content analysis, followed by consensus meetings between researchers. Results Two focus groups were conducted, with an average of seven pharmacists per group, and five interviews with local health managers. Participants reported 39 facilitators who were related to the categories: local healthcare network, healthcare team, pharmacists and implementation process of the CPS. And 21 strategies attributed to the following categories: local healthcare network, pharmacists and implementation process of the CPS. Conclusions This study identified facilitators and strategies of the implementation of CPS. Most of the positive experiences were related to the clinical skills and proactive attitudes of pharmacists. These findings may support pharmacists and health managers to implement CPS in health systems. Electronic supplementary material The online version of this article (10.1186/s12913-018-3403-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sheila Feitosa Ramos
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - Genival Araujo Dos Santos Júnior
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - André Mascarenhas Pereira
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - Aline Santana Dosea
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - Kérilin Stancine Santos Rocha
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - Déborah Mônica Machado Pimentel
- Department of Medicine, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - Divaldo Pereira de Lyra-Jr
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil.
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Silva SN, Lima MG, Ruas CM. Pharmaceutical interventions in mental health: A review of the literature to support evidence-informed policymaking. Res Social Adm Pharm 2017; 14:891-900. [PMID: 29195731 DOI: 10.1016/j.sapharm.2017.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 11/23/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pharmaceutical interventions may have an impact on different treatment aspects, such as therapy adherence, reducing the number of different medications in use and lowering treatment costs. OBJECTIVE Identify pharmaceutical interventions in the mental health field and their possible application in Brazilian public mental health services, considering the evidence-based model to establish implementation options. METHODS A structured search of the literature was performed in the Pubmed (Medline), Cochrane, PsycINFO and Lilacs databases to identify the main pharmaceutical intervention studies conducted in the mental health area. The articles selected were evaluated according to the quality of the evidence. The current laws and public database were researched to collect information on services and procedures provided by the Brazilian units, known as CAPS, and the number the pharmacists allocated to them. The proposal to synthesize the results of pharmaceutical interventions in Brazil was based on SUPPORT methodology items to prepare evidence-based policies. RESULTS A total of 1442 studies were identified, 18 of which were included. Several interventions are reported in the literature, educational interventions being frequently cited. However, there is a need for further studies with more methodological rigor. The number of pharmacists working in the CAPS is insufficient to cover all the services, since only 26.5% of CAPS employ pharmacists, who work an average of 29 (±11.1) hours a week. Three options were formulated to implement interventions in the Brazilian context that consider including pharmacists on the basic team of CAPS professionals and educational interventions through pharmacist training. CONCLUSIONS The present study could support the establishment of health policies, based on a synthesis of the evidence, contextualization of the current situation, given the absence of local evidence, and a discussion of the options available to implement pharmaceutical interventions in the Brazilian health system. Organizational changes in CAPS are needed to broaden pharmacist participation on the multidisciplinary team.
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Affiliation(s)
- Sarah Nascimento Silva
- Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Marina Guimarães Lima
- Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Cristina Mariano Ruas
- Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Silva SN, Lima MG. [Pharmaceutical Assistance in Mental Health: a diagnosis of Psychosocial Care Centers]. CIENCIA & SAUDE COLETIVA 2017; 22:2025-2036. [PMID: 28614521 DOI: 10.1590/1413-81232017226.25722016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 11/13/2016] [Indexed: 11/22/2022] Open
Abstract
The study evaluated the conditions of Pharmaceutical Assistance (PA) in Psychosocial Care Centers (CAPS) through a cross-sectional study in 15 CAPS located in the Médio Paraopeba region of the State of Minas Gerais. Data collection was conducted through direct observation of CAPS and interviews with pharmacists and managers of PA. The instruments were based on indicators proposed by the WHO, technical documents for the organization of PA, from legislation and recommendations seeking pharmaceutical Best Practices. There were 13 dispensing units, nine of them within the CAPS. The services presented updated lists of essential medicines with high availability of the main drugs used in mental health treatment. All of the cities participated in an inter-municipal consortium for the purchase of medicines. The complete identification of drugs was present in only seven services and all had failings in traceability of medicines dispensed. In the CAPS there is only one pharmacist during part of the operating period. The need for greater participation of the pharmacist was observed in the control and standardization of the activities of CAPS and especially in care activities comprising the benchmark team in Mental Health.
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Affiliation(s)
- Sarah Nascimento Silva
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Departamento de Farmácia Social, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Marina Guimarães Lima
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Departamento de Farmácia Social, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
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