Necessidades reais de implementação de novos serviços farmacêuticos centrados no doente

Abstract

While new more potent and complex pharmaceutical agents are becoming available, increasing demands on doctors and the health care system, the increase of drug related morbidity and mortality throughout the world and rising costs related with the incorrect use of medicines make it clear that the identification of a practitioner who is available to focus on the management of all of a patient’s medicines would be an important asset to the future of human health. Medicines are precious, but patients need to learn how to use them. It is possible that this will be one of the advantages that the pharmacist, as a medicine specialist, will bring to the health system, i.e. the promotion of the rational use of medicines as laid down in legislation. The correct use of medicines will significantly decrease the negative outcomes of phar- macotherapy, namely untreated health problems, ineffective treatment and unsafe treatment.

Pharmaceutical care is a patient-centered philosophy of assistential practice in which the pharmacist, as a health care team member, has responsibilities in patient medication. There are pharmaceutical services that monitor the process of the use of medicines from a preventive standpoint, identifying risk factors and acting within their constraints – dispensing, preventable morbidity indicators, medication review – and there are pharmaceutical services that monitor the outcomes from a reactive standpoint, identifying negative clinical outcomes and acting on their causes – pharmacotherapy follow-up, disease management.

The clinical pharmacist will have to develop new competencies in communication, information retrieval, critical analysis, ethical behavior, teamwork and leadership. And, more than ever, the clinical pharmacist will have to be technically competent, which requires solid training in cellular biology, biochemistry, anatomophysiology, physiopathology, pharmacology and pharmacotherapy. The assistential pharmacist will have to learn to systematize and to register its action in each type of service carried out. The main barrier that he will have to overcome will be his own mind.

This will not only provide new ways of boosting the professional satisfaction of the clinical pharmacist but will also provide concrete answers to the real situations of patients, who will ultimately receive better care.