Challenges in Pharmaceutical Practice in Brazil ( FEBRAF, Brazil

CHALLENGES IN PHARMACEUTICAL PRACTICE IN BRAZIL AMBASSADOR: GIOVANNA SOUSA SILVA AND LAURA TREVISAN FECHNER FEBRAF, BRAZIL

According to the Federal Council of Pharmacy, responsible for regulating Pharmacist profession and advocating for its valorization and following Brazilian Law, 72 areas are described as Pharmacist attributions including Clinical Pharmacy, Public Health, Hospital Administration, Molecular Biology, Clinical Biochemistry, Community Pharmacy, Pharmacoepidemiology, Industrial Pharmacy, among others(1).

In 2020, around 234 300 Pharmacists were registered in regional class councils subordinated to the Federal Council(2). The Pharmaceutical profession evolved alongside society which led Pharmacists to assume a technicist role. However, there have been a rescuing of the role of the Pharmacist as a Health professional, including the adherence to the current legislation and, the growing practice of Pharmaceutical prescription, the insertion of Pharmacists in multidisciplinary teams aiming to provide care, security and proper orientation of patients in a daily basis. This has shown the complexity of the role of Pharmacists in the Brazilian Health Care System, Industry, Health Surveillance and society(3).

Health Care Systems around the world are facing challenges concerning budget constraints, the high prevalence of chronic non-communicable diseases, and the increase in problems related to pharmacotherapy that lead to morbidity and mortality related to medicines. Such challenges affected the Pharmaceutical profession as well. According to World Health Organisation, Pharmacists should be more involved in solving problems starting from a product-centred approach to care, carrying out activities aimed at promoting rational use of medicines and other health technologies, having its practice redefined based on the needs of people, family, caregivers, and community, e.g. pharmacotherapeutic follow-up, health education, health screening, medication reconciliation and pharmacotherapy review(4).

According to Martins-de-Freitas et al. (2016), the main difficulties Pharmacists face are lack of professional recognition considering low wages and little recognition by society, non-acceptance by the team in which the Pharmacists perform their activities, high range of attributions or activities, and technicist and mechanised view of the profession missing a humanised and holistic approach.

Nonetheless, the Pharmaceutical professional in the Brazilian context plays a vital role in Drug Therapy Management, contributing to the patient's health condition improvement. That said, Pharmacists are a gateway to the health system due to the easy access citizens have to pharmacies both in terms of free counselling and by geographic distribution(4). Brazilian Unified Health System (SUS), universal access to health as an expression of citizenship. I.e.,2021

The role of a Pharmacist is to ensure the essential medicines aimed at tackling priority diseases such as non-communicable diseases are accessible and to ensure their quality, efficacy and safety, as well as promoting the rational use of medicines in order to reintegrate Pharmaceutical Care into SUS(5).

Another challenge concerns the dispensing of medication on Health Care facilities such as a primary care facility, a hospital or a pharmacy or drugstore participating in the Popular Pharmacy Program, where the computerised program for drug dispensing is being implemented poses an obstacle to a therapeutic support system which incorporates a proper set of automated evaluation of prescriptions, e.g., screening for therapeutic duplicity, adverse reactions, drug interactions, adequate dose ranges, alerts for similar names and so on(6).

According to Freire et al. (2019), the environment used for the storage and dispensing of medication is another obstacle due to it being considered inadequate for assuring staff and patient safety and being insufficient for the purpose of administration, receipt, and storage of health products such as medication on account of lacking physical space, and controlled humidity and temperature. Ultimately, the number of Pharmacists in the SUS is insufficient to build a Systemic Pharmaceutical Care from the logistical aspect to the provision of Pharmaceutical Assistance. Nonetheless, the efforts performed by Pharmacists are gaining recognition and achieving the goal of reinserting this professional as a Healthcare Provider(7).

References

1. Brasil - Áreas de atuação - Conselho Federal de Farmácia. Available on <https://www.cff.org.br/pagina.php?id=87>. 2. Brasil - Dados 2020 - Conselho Federal de Farmácia. Available on <https://www.cff.org.br/pagina.php? id=801&titulo=Dados+2016>. 3. Serafin, C., Correia-Junior, D., & Vargas, M.(2015) Perfil do farmacêutico no Brasil: relatório. Brasília: Conselho Federal de Farmácia. Available on <https://www.cff.org.br/userfiles/file/Perfil%20do%20farmac%C3%AAutico%20no% 20Brasil%20 _ web.pdf>. 4. Martins-de-Freitas, G. R. Pinto, R. S., Luna-Leite, M. A. Silveira-de-Castro, M., Heineck, I. (2016) Principais dificuldades enfrentadas por farmacêuticos para exercerem suas atribuições clínicas no Brasil. Rev. Bras. Farm. Hosp. Serv. Saúde São Paulo v.7 n.3 35-41. Available on <http://www.v1.sbrafh.org.br/public/artigos/2016070306000982BR.pdf>. 5. Bermudez, J. A. Z. Santos-da-Costa, J. C. Carvalho-de-Noronha, J. C. (2020) Desafios do acesso aos medicamentos no Brasil. Rio de Janeiro: Edições Livres. Available on 2021 <https://www.arca.fiocruz.br/bitstream/icict/41803/2/Desafios _ do _ Acesso _ a _ Medica mentos _ 2020.pdf>. 6. Freire, I., I. L. S., dosSantos, F. R., dosSantos-Barbosa, J., Oliveira-da-Silva, B. C., Souza-da-Silva, I., Lessa-de-Freitas, A. A. (2019). Conhecimento e atuação dos profissionais da farmácia sobre a dispensação dos medicamentos. Arquivos de Ciências da Saúde, v. 26 n.2 p. 141-145. Available on <https://www.cienciasdasaude.famerp.br/index.php/racs/article/view/1372>. Doi: https://doi.org/10.17696/2318-3691.26.2.2019.1372. 7. Oliveira-de-Melo, D. Cardozo-de-Castro, L. L. (2017) A contribuição do farmacêutico para a promoção do acesso e uso racional de medicamentos essenciais no SUS. Ciênc. Saúde coletiva. 22 (1). Available on <https://scielosp.org/article/csc/2017.v22n1/235-244/>. doi: https://doi.org/10.1590/141381232017221.