Quality indicators of pharmacists

http://dx.doi.org/10.1590/s2175-97902017000116021 Quality indicators of pharmacists’ services in community pharmacies in Paraná State, Brazil Edson Hipólito Júnior1,*, Gerusa Clazer Halila3, Walleri Christini Torelli Reis2, Matheus Murmel Guimarães2, Laís Danciguer Guanaes2, Roberto Pontarolo2, Cassyano Januário Correr2 Department of Biochemistry, Federal University of Paraná, PR, Brazil, 2Department of Pharmacy, Federal University of Paraná, Curitiba, PR, Brazil, 3Department of Pharmacy, State University of Ponta Grossa, Ponta Grossa, PR, Brazil 1 Pharmacists and their pharmacies have been evolving in their roles as health promoters in Brazil. Some examples are the recent legislation reaffirming the role of Brazilian pharmacies as health institutions, rather than having only a commercial profile, giving greater clarity to pharmacists about their roles as health care providers. This evolution came with the recognition that is already seen in other developed countries, confirming the need for the pharmacist as a health promoter, and not simply a dispenser of drugs in society. This study has obtained the profile and activities of community pharmacists, as well as the quality indicators of private community pharmacies throughout the State of Paraná through the application of an online survey sent to pharmacists in the state. Out of all pharmacists surveyed, 533 were part of the final analysis, being the pharmacists to complete the survey in full. Participants were mostly female (69.4%) and were, on average, 35.2 ± 9.2 years old. Of these, 60% worked in pharmacy chains and just 37% of all pharmacist respondents were issuing the Declaration of Pharmaceutical Services. The current study showed that many pharmaceutical services are not adopted by pharmacies as these services bring no significant financial reward. Regarding the structure, the Paraná State showed that pharmacies present a good overall structure. The kind of pharmacy (chain or independent) influenced the pharmaceutical services provided and the available structure, where the independent pharmacies provide a wider range of services and have better structure. This study was able to identify the profile and behaviors of pharmacists and also the quality indicators of pharmacies in Paraná State. Uniterms: Pharmaceutical care. Pharmacists/professional practice. Community pharmacy/structure indicators/Paraná State, Brazil. INTRODUCTION The pharmaceutical profession has undergone important changes in the last few decades in Brazil, especially in relation to community pharmacies, with changing roles and a focus on providing clinical services to patients. The pharmacy, as commercial establishment, has evolved significantly (França Filho et al., 2008; Silva, Vieira, 2004), with regulatory advancements such as the publication of law 13.021/14, which inverts the profit *Correspondence: E. Hipólito Júnior. Universidade Federal do Paraná. Av. Pref. Lothário Meissner, 632 – Jardim botânico – 80210-170 – Curitiba - PR, Brasil. Tel.: (41) 9775-0495. E-mail: Braz. J. Pharm. Sci. 2017;53(1):e16021 oriented logic, by defining the pharmacy as a health care entity geared toward providing a pharmaceutical service, and technical and clinical assistance, to promote the best health care for the patients (Brasil, 2014; Souza, 2012). The term service refers to a set of activities organized in a work process. In a broad definition, pharmaceutical services represent any particular service provided by pharmacists and they may be clinical or not. The pharmaceutical care includes a wide range of clinical services, ranging from the benchmarks to pharmacotherapeutic monitoring itself. Recently, in order to clarify definitions and guide professional activity, the Federal Council of Pharmacy (CFF) – National Pharmacy Council – in 2013 published the resolutions 585 and 586, Page 1 / 9 Article Brazilian Journal of Pharmaceutical Sciences E. Hipólito Júnior, G. C. Halila, W. C. T. Reis, M. M. Guimarães, L. D. Guanaes, R. Pontarolo, C. J. Correr which regulate the attributions of clinical pharmacists and of pharmaceutical prescription. The importance of pharmaceutical services has been recognized by various studies (Blenkinsopp, Bond, Raynor, 2012; Castelino, Bajorek, Chen, 2010; Krska et al., 2001), which indicate improvements in the profile of medication usage (Castelino, Bajorek, Chen, 2010; Cobb, 2014; Cramer, 2004; Gellad, Grenard, Mcglynn, 2009; Hatah et al., 2014; Machado et al., 2007b), clinical outcomes (Charrois et al., 2009; Machado et al., 2007a; Santschi et al., 2012; Sookaneknun et al., 2004; Wubben, Vivian, 2008), humanistic outcomes (Garrett, Bluml, 2005; Singhal et al., 1999) and economical outcomes (Altowaijri, Phillips, Fitzsimmons, 2013; Cranor, Christensen, 2003; Desborough et al., 2012; Gallagher et al., 2015; Garrett, Bluml, 2005; Riley, 2013), in numerous chronic conditions, besides the level of evident patient satisfaction. As such, many countries, including the United States, Canada and the United Kingdom, have added clinical pharmaceutical services to their healthcare systems. These services have allowed polymedicated patients, patients with chronic conditions and patients with comprehension or cognitive difficulties to have access to individual appointments for pharmacotherapy revision and pharmacotherapeutic follow up. These systems present well defined financial precepts, in which the professionals and establishments are remunerated according to the health care activities they provide (Blake, Madhavan, 2010; Latif, Pollock, Boardman, 2011; NHS, 2008,2009; Riley, 2013). Quality is a determining factor for the success of any clinical service and, as such, a good general structure, accompanied by a good work process, increases the success chances of a pharmaceutical care service. A structure comprised of a good human resources team, good facilities and material and financial resources paired together with a good process, in which the professional is enabled and confident and interacts appropriately with their patient, tends to produce more positive health care outcomes (Donabedian, 2005; Vuori, 1991). In Brazil, despite recent advancements, it is still under development in terms of pharmaceutical care, the initiatives are independent and uncoordinated, and there are numerous discrepancies among different regions, in terms of the profile of professionals and of the work processes that are adopted. Whereas overviews of the pharmaceutical activity in Paraná State are few and short, the objective of this study is to characterize the profiles and activities of community pharmacists, as well as the quality indicators of private community pharmacies in Paraná State - Brazil. Page 2 / 9 METHODS In order to conduct this transversal study, email addresses from all active pharmacists in the State of Paraná were obtained from the Conselho Regional de Farmácia do Paraná (CRF-PR), and these professionals were surveyed in the pe (...truncated)