Overview of the CUIDAR+ Project, the development of Telepharmacy (FEBRAF, Brazil

OVERVIEW OF THE CUIDAR+ PROJECT, THE DEVELOPMENT OF TELEPHARMACY WITH DR. AGNES AMBASSADOR: LAURA TREVISAN FECHNER FEBRAF, BRAZIL

The telepharmacy practice has been expanding due to Covid-19. The state of Rio Grande do Sul (RS) in partnership with some Pharmacists organised the CUIDAR+ program, and one of the branches of this project is the Tele-pharmaceutical care service, and as the first strategy: complementary follow-up mostly with patients with chronic respiratory diseases who use special medicines. The objective of the program is to provide clinical services remotely, avoiding the need of displacement, and increasing the access to monitoring services.

Willing to know more about the Project, we talked with Dr. Agnes Gossenheimer, Coordinator of the program CUIDAR+. From the very beginning of our conversation, she seemed very excited to share her collaboration in the Program CUIDAR+ with pharmacy students from all over the world!

During our conversation, Dr. Agnes explained how the project CUIDAR+ and the Telepharmaceutical care work.

Could you give a brief overview regarding this initiative? Perhaps this could be written as " .... overview of this initiative"

The telepharmacy program started with users with ASTHMA and COPD and is now moving towards the treatment of diabetic patients as well. It takes place in three meetings: the first is to collect information about the use of medications, how the disease is controlled; the second addresses more adherence to treatment and whether there are problems related to pharmacotherapy, also performing necessary interventions; in the third meeting, the monitoring of the patient's care plan begins. The focus of the program, as in every pharmaceutical activity, is the patient.

How does the pharmacist's patient follow-up process work?

The pharmacotherapeutic follow-up carried out by the pharmacist is a clinical service, which aims to carry out a review of the pharmacotherapy, following the patient regarding the correct use of medication. We assess correct use, necessity, use, safety, effectiveness, adherence, aiming to check and have positive clinical results.

Is it always the same pharmacist responsible for that patient's case or are there several other pharmacists?

Usually yes, because it facilitates the bond between patient and pharmacist. The pharmacist who started the treatment will carry out the subsequent appointments.

The project CUIDAR+ is a program of the government of the Rio Grande do Sul state that aims to promote pharmaceutical care in the state and municipalities, mainly in the pharmacy of special medications (FME), under state management. The Pharmaceutical Telecare is part of the CUIDAR+, and works as a service provided by the state, aimed at special/specialised medicines, with remote monitoring of patients. This telepharmacy program started with users

with ASTHMA and COPD and is now moving towards the treatment of diabetic patients as well. It takes place in three meetings: the first is to collect information about the use of medications, how the disease is controlled; the second addresses more adherence to treatment and whether there are problems related to pharmacotherapy, also performing necessary interventions; in the third meeting, the monitoring of the patient's care plan begins.

What was the most challenging part of the entire project construction? A: I think the most challenging part was how to innovate and how to overcome lack of confidence and fear with innovative practises. There is no history in the RS of having any group responsible for pharmaceutical care. Telecare is something that is not in Resolution, nor recommended within the Regional Council of Pharmacy. We saw that there was a need to develop this project. People first need to know the new and adapt to the new models.

Any advice for future pharmacy students here in Brazil, or maybe from other parts of the world who would like to start projects in this area?

My tip is: keep studying, and studying patterns that work well in certain places, so that we can check what we can adapt to each reality. Study what is most innovative, study what is happening in the world, what has already been done and think about people's needs. Always focusing on who the service is aimed at. Special Thanks goes to Dr. Agnes Gossenheimer, André Koga Salles, Diana Rosa Benitez Machado, Francisco Matheus Ferreira Dias, and Gabrielle Gimenes Lima