Papers by Simone de Araújo Medina Mendonça
International Journal of Innovative Research in Medical Science, 2016
The aim of the present study was to describe the process of implementation and systematization of... more The aim of the present study was to describe the process of implementation and systematization of a comprehensive medication management (CMM) service, from the perspective of the participants involved, in a high complexity service that cares for women with breast cancer in Brazil. Methods: A qualitative study that utilized action research that followed the procedures proposed by Kurt Lewin and the ethical and clinical principles of pharmaceutical care practice. Data collection techniques were participant observation between August 2014 and December 2016, semi-structured interviews with eight pharmacists and pharmacy residents, field notes, and analysis of documents. Results: Six major themes emerged in four cycles of the action research process: (1) Resistance is human; the management of conflict is necessary; (2) insecurity with being a clinician; (3) management of change supported by driving forces; (4) pharmaceutical care fostering professionals' selfefficacy; (5) documentation as the conducting wire of the practice; and (6) the advantages of a systematized practice. Conclusion: The study offered an understanding of the process of implementation of CMM services from the perspective of pharmacists. It produced knowledge on the experiences of pharmacists as they lived through the process of transformation of their professional practice to offer a patientcentered and systematized service. The framework of Lewin supported the introduction of a new work path for pharmacists, which could be operationalized as an innovative technology for the Brazilian health-care system: CMM services.
International Journal of Environmental Research and Public Health
Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) ... more Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pharmacotherapy and the stigma related to both diseases are complex. The patients’ subjective experiences with diseases and medications are of utmost importance in pharmaceutical care practice. This study aimed to understand the subjective medication experience of TB and HIV/AIDS coinfected patients. The study was based on descriptive research of a qualitative and quantitative nature using data collected during pharmaceutical care appointments and from medical records from September 2015 to December 2016 at a tertiary infectious diseases referral hospital in Southeastern Brazil. Data from 81 patients were analyzed. Regarding patient subjective medication experience, the following responses to the quantitative questionnaire were most frequent: preference for a route of administration (12.4%) and for non-pharmacological therapy (50.6%); concerns about price (11.1%) and adverse effects (18....
Research, Society and Development, Sep 23, 2022
Esta pesquisa visou identificar, descrever e analisar estudos que empregaram a etnografia na área... more Esta pesquisa visou identificar, descrever e analisar estudos que empregaram a etnografia na área de educação farmacêutica, utilizando o método de revisão narrativa da literatura. A busca foi realizada em revistas científicas especializadas e relevantes na área de educação farmacêutica e de educação de profissionais de saúde e em bases de dados secundárias. Foram selecionados cinco artigos que atenderam ao critério de inclusão, excluindo-se os artigos que apenas apresentavam discussões teóricas e metodológicas. Estes foram analisados quanto às características clássicas de um estudo etnográfico: processo de coleta de dados em longo prazo, uso de observação participante, realização nos ambientes naturais, múltiplos métodos de coletas de dados e aplicação do princípio da reflexividade. Os cincos artigos abrangeram a temática de educação farmacêutica no cuidado ao paciente; relação à metodologia, apenas dois apresentavam todas as características descritas acima. É sugerido, portanto, que estudos futuros sejam desenvolvidos no campo da educação farmacêutica com observância de tais características, aumentando o rigor e a qualidade dos resultados.
DOAJ: Directory of Open Access Journals - DOAJ, Mar 1, 2019
The aim of this study was to understand the essential elements of the systematization process of ... more The aim of this study was to understand the essential elements of the systematization process of the clinical practice of a pharmacist in primary health care. This systematization was based on the framework of pharmaceutical care practice, which provides the foundation for comprehensive medication management services. The methodology utilized was autoetnography, built collaboratively between the authors. The data have been produced through participant observation, field journals, reflections and semi structured interviews with pharmacists who are building clinical practices in primary health care. The results have demonstrated that the main elements associated with the systematization of clinical practices are ‘the construction of a new professional identity in a multiprofessional team’ as well as ‘the incorporation of new activities in the work routine’, that, combined, result in ‘Integration of comprehensive medication management services in the flow of the health unit’. In this w...
The Qualitative Report, 2017
The recent inclusion of pharmacists in primary healthcare in Brazil through the Family Health Sup... more The recent inclusion of pharmacists in primary healthcare in Brazil through the Family Health Support Team has encouraged them to reflect on the need to change from a professional focused on medications to one focused on individuals. This autoethnography allowed a pharmacist to confront her perspectives on clinical practice between 2014 and 2016, a period when she decided to challenge her traditional training as a pharmacist centered on medications. Using pharmaceutical care practice as the theoretical framework that prompted the profession of pharmacy to change its focus to the patient, the authors collaborated to construct a monologue that engages readers in the meanings of becoming patient centered. The research findings also support the versatility of application of the reflective process provided by autoethnography. Through fieldwork, reflective writing and interviews, the pharmacist discovered a new way to relate to "caring" and "patients" in her daily rout...
This review aims to synthesize the available evidence related to interprofessional education acti... more This review aims to synthesize the available evidence related to interprofessional education activities and health student's evaluation in the context of drug therapy shared decision-making.
APRESENTACAO: O Gerenciamento da Terapia Medicamentosa (GTM) e um servico clinico baseado no refe... more APRESENTACAO: O Gerenciamento da Terapia Medicamentosa (GTM) e um servico clinico baseado no referencial teorico-metodologico da pratica da Atencao Farmaceutica. Trata-se de uma pratica generalista, centrada no paciente, na qual o profissional estabelece relacao terapeutica com o usuario, coresponsabilizando-se por sua farmacoterapia. Este servico tem apresentado resultados clinicos, economicos e humanisticos positivos, que justificam sua expansao e consolidacao nos sistemas de saude. O projeto de extensao “Gerenciamento da Terapia Medicamentosa na Atencao Primaria a Saude” tem como objetivo ofertar servicos de GTM em unidades de saude do Sistema Unico de Saude (SUS) em Belo Horizonte, Minas Gerais e contribuir para a formacao de estudantes extensionistas, levando ao desenvolvimento de habilidades e competencias necessarias para prover servicos de GTM na Atencao Primaria a Saude (APS). O objetivo deste trabalho foi descrever o perfil dos pacientes atendidos nas unidades de saude que...
11O Congresso Internacional Da Rede Unida, Apr 30, 2014
Introducao: O servico de Gerenciamento da Terapia Medicamentosa (GTM) e baseado no arcabouco teor... more Introducao: O servico de Gerenciamento da Terapia Medicamentosa (GTM) e baseado no arcabouco teorico da atencao farmaceutica (AF). Esta e uma pratica centrada no paciente que busca garantir a efetividade, a seguranca e a comodidade da farmacoterapia. Atraves da compreensao da experiencia subjetiva com medicamentos, o farmaceutico elabora planos de cuidados com o proposito de alcancar melhores resultados na farmacoterapia e na qualidade de vida do paciente (CIPOLLE, STRAND, MORLEY, 2012). Objetivo: Compreender a perspectiva de usuarios sobre servicos de GTM implantados em duas unidades de Saude da Familia em um municipio no centro-oeste de Minas Gerais como parceria entre o municipio e o curso de Farmacia da Universidade Federal de Sao Joao Del-Rei (UFSJ). Metodo: Utilizou-se a metodologia qualitativa. O metodo de coleta de dados foi a entrevista semiestruturada. Segundo o criterio de saturacao dos dados, foram incluidos no estudo 24 usuarios dos servicos de AF atendidos entre os anos de 2011 e 2012. Resultados: O desconhecimento previo sobre a pratica de AF surge de forma significativa nos relatos dos sujeitos da pesquisa. No entanto, os mesmos foram capazes de descrever, em seus relatos sobre os atendimentos recebidos, os pilares filosoficos e organizacionais dessa pratica profissional. Os usuarios entendem a AF como o acompanhamento relacionado ao tratamento medicamentoso com atencao voltada para o paciente e seus questionamentos. A disponibilidade de tempo que o farmaceutico do servico de GTM dedica para a avaliacao clinica e a orientacao faz com que o usuario comece a enxergar um novo profissional clinico. Os sujeitos da pesquisa relatam que a atencao que recebem, a confianca que possuem no profissional e as intervencoes realizadas nos seus tratamentos medicamentosos fazem com que eles sigam o tratamento corretamente. Esses fatores sao descritos pelos usuarios como criterios de satisfacao com o servico. Os pacientes relatam ainda, melhora em seu autocuidado e tambem maior controle de seu estado de saude em consequencia dos atendimentos farmaceuticos. Conclusao: A identificacao de caracteristicas chave da pratica da AF nos relatos dos sujeitos da pesquisa, aponta para uma avaliacao positiva dos servicos implantados. A equipe composta por farmaceutico, docentes e discentes da UFSJ parece ter oferecido um servico clinico condizente com o referencial teorico-metodologico da pratica profissional da AF.
Research in Social and Administrative Pharmacy, 2022
BACKGROUND Pharmaceutical care in outpatient settings is a type of health service that has been s... more BACKGROUND Pharmaceutical care in outpatient settings is a type of health service that has been shown to contribute to decreasing drug-related morbidity and mortality rates. However, every process of implementing a new service brings about changes and transformations in the work routine, thus posing challenges. OBJECTIVES This systematic review aims to identify barriers to and facilitators for the implementation of pharmaceutical care in outpatient settings by applying the CFIR method, a framework based on the theory of health services, used to analyze and synthesize research data, which can direct strategies for the service to work as planned. METHODS A systematic review was conducted exploring the barriers to and facilitators for the implementation of pharmaceutical care in outpatient settings. The MEDLINE, EMBASE, CINAHL, COCHRANE, and LILACS databases were consulted. RESULTS Eight studies were included: five qualitative ones, two mixed-method ones, and a quantitative one. The most frequent CFIR constructs identified were Patient Needs and Resources (n = 30, 10.75%), Knowledge and Beliefs about the Intervention (n = 31, 11.11%), Networks and Communications (n = 34, 12.19%), and Available Resources (n = 56, 20.07%). The most cited barriers were: insufficient human resources, patients' unawareness of the existence of the pharmaceutical care service, and pharmacists' resistance to changes. Facilitators included: the opportune presentation of the service to the healthcare team; the use of electronic devices for specific guidance; and the assessment of patient satisfaction. CONCLUSIONS This systematic review allowed detecting key guidelines to improve the implementation process, including (1) defining an implementation method and exploring it extensively during the pre-implementation phase, (2) ensuring human and financial resources, (3) determining how the new service will interact with other existing services. More research is needed to understand how these factors can affect the implementation of clinical services.
Journal of Interprofessional Care, 2022
Revista de APS, 2021
A Assistência Farmacêutica se volta à promoção, proteção e recuperação da saúde por meio de ativi... more A Assistência Farmacêutica se volta à promoção, proteção e recuperação da saúde por meio de atividades técnico-gerenciais e clínico-assistenciais. A atuação do farmacêutico nas unidades básicas de saúde parece favorecer esse processo, embora alguns municípios optem por não inclui-lo no quadro de recursos humanos das farmácias básicas. Nesse contexto, ao realizar uma pesquisa para avaliar o acesso aos medicamentos em municípios de Minas Gerais, nosso grupo de pesquisa verificou se a presença do farmacêutico nas farmácias básicas tem influenciado sobre a qualidade dos produtos e serviços oferecidos nesses estabelecimentos. Um instrumento padronizado foi utilizado na coleta de dados e indicadores foram selecionados para avaliar qualidade no âmbito técnico-gerencial e clínico-assistencial. Como resultado, observou-se que a presença do farmacêutico nesses estabelecimentos não influenciou sobre a qualidade da Assistência Farmacêutica. Lacunas na formação desses profissionais podem estar c...
Pharmacy Practice, 2020
Objective: Considering the curriculum reform process taking place in pharmacy undergraduate progr... more Objective: Considering the curriculum reform process taking place in pharmacy undergraduate programs in Brazil and the importance of practical experience to students throughout their learning process in university, this study aims to provide an overview of pharmacy undergraduate programs in Brazil and their respective internships. Methods: An observational, descriptive, cross-sectional study. A documentary analysis of pharmacy undergraduate programs in the face-to-face modality was carried out, with data obtained from the Political Pedagogical Projects of the programs, the curricula, and course descriptions containing information on internships, all provided by the Brazilian Ministry of Education. The data collected concerned higher education institutions (HEIs), pharmacy programs and internships. Results: Pharmacy undergraduate programs in Brazil have a median duration of 10 semesters, requiring from students a median of 6 internships, from the 6 th semester on, totalizing 826 hours. The programs lack uniformity among their internships, mainly regarding total hours and the semester in which internships start. The pharmacy internships cover, in greater number, the areas of outpatient and community pharmacy, clinical analysis, and pharmaceutical technology, respectively, being clinical analysis the area with more hours. Public and private HEIs have different internship proceedings in their curricula, hence no homogeneity among them in the different regions of Brazil. Conclusions: This study demonstrates the diversity of pharmacy programs in Brazil in the context of internships, reflecting on the training and the activity of pharmacists in recent decades. Further studies are needed to deepen the understanding of this theme.
Brazilian Journal of Pharmaceutical Sciences, 2016
This study evaluates whether the integration of pharmacists into health-care teams through the de... more This study evaluates whether the integration of pharmacists into health-care teams through the delivery of pharmaceutical care-based medication therapy management (MTM) services can improve the clinical outcomes of patients with chronic health conditions in the primary health-care setting. A retrospective descriptive study of 92 outpatients assisted by MTM pharmacists in primary health-care units was carried out over 28 months (median follow-up: 05 months). Patients were followed up by MTM pharmacists, with a total of 359 encounters and a ratio of 3.9 encounters per patient. The prevalence of hypertension, diabetes mellitus and dyslipidaemia was 29.5%, 22.0% and 19.4%, respectively. There was a high prevalence of drug-related problems with a ratio of 3.4 per patient. Pharmacists performed a total of 307 interventions to prevent or resolve drug-related problems. With regard to control of the most prevalent chronic medical conditions, a high percentage of patients reached their therapy goals by the last encounter with the pharmacist: 90.0% for hypertension, 72.3% for diabetes mellitus and 90.3% for dyslipidaemia. MTM services provided by pharmacists resolved drug therapy problems and improved patients' clinical outcomes. This study provides evidence for health-care managers of the need to expand the clinical role of pharmacists within the Brazilian public health-care system.
International Journal of Pharmacy and Pharmaceutical Sciences, 2016
Objective: To analyze a product illegally sold as herbal medicine acquired and used by a patient ... more Objective: To analyze a product illegally sold as herbal medicine acquired and used by a patient and to understand the reasons that led the patient to use this product. Methods: The chemical analysis was performed by thin layer chromatography (TLC) and mass spectrometry (MS) analysis with a direct infusion with a Bruker Daltonics UltroTOF-Q, in positive mode. A qualitative interview was conducted with the patient. The data obtained were submitted to thematic analysis. Results: Chemical analysis confirmed the presence of piroxicam and orphenadrine, and the complete absence of a natural product. The qualitative study revealed three themes: previous experience with the disease and the use of medicines, feelings about the care provided by health professionals, and the patient's solution. Conclusion: The commercial availability of this kind of product raises concerns about safety and demonstrates the necessity for more intensive surveillance by health authorities. In addition, the present study showed the need for a patient-centered practice and the understanding of medication experience to provide effective care to patients who use medicines to preserve them from unsafe products.
Research, Society and Development, 2021
This study aims to assess the performance of pharmacy students in the provision of a comprehensiv... more This study aims to assess the performance of pharmacy students in the provision of a comprehensive medication management (CMM) service in a primary health care setting. Methods: A retrospective, descriptive, observational study spanning one academic semester of the provision of the CMM service by pharmacy students was conducted. The data on the profile of patients attended, drug therapy-related problems (DRPs) identified, and the interventions proposed to resolve the DRPs were collected from electronic medical records held by the service. Key findings: A total of 20 patients were attended, predominantly women (65%), with a mean age of 69.2 years. The mean number of health problems per patient was 4.8 and mean medications per patient was 6.8. Of the total 35 DRPs identified, the most common were those related to indication (40%) and effectiveness (22.9%) of the drug therapy. The two most frequent interventions to resolve the DRPs involved starting new therapy and changing dosage, res...
The community health agents are an important element in the management of medication information ... more The community health agents are an important element in the management of medication information in primary healthcare setting, improving healthcare team interaction with the community. The aim of this study was to reveal how the use of medicines is present in the routine of agentes and understand the relationships established between agents, users and healthcare team. This is a quantitative and qualitative study, using participant observation, semi-structured interview and focus group. This study was conducted at three basic health units in a municipality of Minas Gerais, Brazil, between March, 2013 and February, 2015. The results show that agents constantly relate with patients who experience drug therapy problems and have doubts about the indication, effects, adverse drug reactions, among other. They perform some interventions directly with the patient, but usually they prefer to refer cases to the healthcare team. Some agents said recognizing the pharmacist as a reference on med...
APRESENTACAO: Nas ultimas decadas, a demanda pela atuacao clinica de farmaceuticos nos sistemas d... more APRESENTACAO: Nas ultimas decadas, a demanda pela atuacao clinica de farmaceuticos nos sistemas de saude em diversos paises tem aumentado. Consequentemente, evidencia-se a necessidade de mudancas na formacao deste profissional, ate entao mais tecnologica e voltado para o produto. Paralelo a isto, as outras profissoes da area da saude tambem vem experimentando mudancas em seus processos de formacao. Tais mudancas visam o desenvolvimento de profissionais capazes de contribuir para a consolidacao de sistemas de saude organizados em redes baseadas na atencao primaria a saude (APS). E, especificamente no Brasil, pautado nos principios da integralidade, equidade e universalidade do Sistema Unico de Saude (SUS). Assim, a Farmacia tem a oportunidade de iniciar sua trajetoria de formacao clinica se beneficiando do conhecimento gerado neste campo pelas outras profissoes e contando com seu apoio neste desafio. Este trabalho tem como objetivo descrever a experiencia de realizacao de inovacoes p...
Uploads
Papers by Simone de Araújo Medina Mendonça