Cuidados Farmacêuticos Caminhos para o futuro. Fernando Fernandez-Llimos Universidade de Lisboa

Transcrição

1 Cuidados Farmacêuticos Caminhos para o futuro Fernando Fernandez-Llimos Universidade de Lisboa

2 sumário Futuro? Cuidados Farmacêuticos? Tem futuro os cuidados farmacêuticos? Conflicto de intereses: Sim, tenho.

3 de 1922 a 1969 O farmacêutico tinha proibido: to comment the therapeutical effects or the composition of a prescription with patients Código ético da American Pharmaceutical Association.

4 1970 Brodie DC. Drug utilization Public health probelm. Drug Intell Clin Pharm 1970;4:203.

5 1970 Brodie DC. Drug utilization Public health probelm. Drug Intell Clin Pharm 1970;4:203.

6 1967 Francke DE. The clinical pharmacist. Drug Intell 1967;1:243

7 1967 Francke DE. The clinical pharmacist. Drug Intell 1967;1:243

8 1950 Rudi FM. The future of pharmacy as a profession may lie in hospital and clinical practice. Mod Hosp. 1950;75(3):100-2.

9 1950 Rudi FM. The future of pharmacy as a profession may lie in hospital and clinical practice. Mod Hosp. 1950;75(3):100-2.

10 PubMed 4-Fev-2017

11 PubMed 4-Fev-2017

12 Leitura recomendada A leiteira. Everest Editora; ISBN:

13 Difussão das inovações Rogers EM. Diffusion of Innovations, 4 th ed. New York: The Free Press; 1995.

14 Difussão das inovações

15 Difussão das inovações Failed innovation Rogers EM. Diffusion of Innovations, 4 th ed. New York: The Free Press; 1995.

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17 Cuidados Farmacêuticos Caminhos para o futuro Fernando Fernandez-Llimos Universidade de Lisboa

18 O que são os Cuidados Farmacêuticos?

19 Linha histórica 1950

20 Linha histórica 1967

21 Cuidados Farmacêuticos Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):

22 Cuidados Farmacêuticos Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):

23 Linha histórica 1990 Farmácia clínica

24 J Am Pharm Assoc. 2005;45:

25 MTM definition (J Am Pharm Assoc. 2008;48(3): ) Medication therapy management (MTM) is a distinct service or group of services that optimize therapeutic outcomes for individual patients. MTM services are independent of, but can occur in conjunction with, the provision of a medication product. MTM encompasses a broad range of professional activities and responsibilities within the licensed pharmacist s or other qualified health care provider s scope of practice.

26 Linha histórica 2005

27 Linha histórica Farmácia clínica Pharmaceutical care

28 Comprehensive Medication Management Dvoracek JJ, Cook KM, Klepser DG. Student-run low-income family medicine clinic: controlling costs while providing comprehensive medication management. J Am Pharm Assoc (2003) May-Jun;50(3): Cobb CD. Optimizing medication use with a pharmacistprovided comprehensive medication management service for patients with psychiatric disorders. Pharmacotherapy. 2014;34(12):

29 Comprehensive Medication Management

30 Linha histórica

31 Linha histórica Farmácia clínica Pharmaceutical care MTM CMM

32 O.M.G.!!!

33 Diferenças? Dreischulte T, Fernandez-Llimos F. Current perceptions of the term Clinical Pharmacy and its relationship to Pharmaceutical Care: a survey of members of the European Society of Clinical Pharmacy. Int J Clin Pharm Dec;38(6):

34 Clinical Pharmacy & Pharmaceutical Care Dreischulte T, Fernandez-Llimos F. Current perceptions of the term Clinical Pharmacy and its relationship to Pharmaceutical Care: a survey of members of the European Society of Clinical Pharmacy. Int J Clin Pharm Dec;38(6):

35 Clinical Pharmacy & Pharmaceutical Care Dreischulte T, Fernandez-Llimos F. Current perceptions of the term Clinical Pharmacy and its relationship to Pharmaceutical Care: a survey of members of the European Society of Clinical Pharmacy. Int J Clin Pharm Dec;38(6):

36 Clinical Pharmacy & Pharmaceutical Care Dreischulte T, Fernandez-Llimos F. Current perceptions of the term Clinical Pharmacy and its relationship to Pharmaceutical Care: a survey of members of the European Society of Clinical Pharmacy. Int J Clin Pharm Dec;38(6):

37 Clinical Pharmacy & Pharmaceutical Care Dreischulte T, Fernandez-Llimos F. Current perceptions of the term Clinical Pharmacy and its relationship to Pharmaceutical Care: a survey of members of the European Society of Clinical Pharmacy. Int J Clin Pharm Dec;38(6):

38 Clinical Pharmacy & Pharmaceutical Care Dreischulte T, Fernandez-Llimos F. Current perceptions of the term Clinical Pharmacy and its relationship to Pharmaceutical Care: a survey of members of the European Society of Clinical Pharmacy. Int J Clin Pharm Dec;38(6):

39 Cuidados Farmacêuticos Caminhos para o futuro Fernando Fernandez-Llimos Universidade de Lisboa

40 Barreiras? Quais? Brazinha I, Fernandez-Llimos F. Barriers to the implementation of advanced clinical pharmacy services at Portuguese hospitals. Int J Clin Pharm Oct;36(5):

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42 Barreiras? Quais? Conclusion Several barriers to the implementation of advanced clinical services in hospital pharmacies in Portugal were identified. These barriers comprised hospital pharmacists mind-set, environmental factors, access to information and technology, and particularities regarding the structure and organisation of the pharmacy service within the hospital. Of these barriers, the pharmacists mind-set appears to be a major barrier that limits the implementation of advanced clinical pharmacy services in Portuguese hospitals and influences the perception of all the other barriers. Brazinha I, Fernandez-Llimos F. Barriers to the implementation of advanced clinical pharmacy services at Portuguese hospitals. Int J Clin Pharm Oct;36(5):

43 Management by objectives

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46 eu: Fernando Fernandez-Llimos Universidade de Lisboa

47 Rotta I, Souza TT, Salgado TM, Correr CJ, Fernandez-Llimos F. Characterization of published randomized controlled trials assessing clinical pharmacy services around the world. Res Social Adm Pharm Jan - Feb;13(1):

48 Sabater-Hernández D, Sabater-Galindo M, Fernandez-Llimos F, Rotta I, Hossain LN, Durks D, Franco-Trigo L, Lopes LA, Correr CJ, Benrimoj SI. A Systematic Review of Evidence-Based Community Pharmacy Services Aimed at the Prevention of Cardiovascular Disease. J Manag Care Spec Pharm Jun;22(6):

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51 Carga horária de ciencias básicas Nunes-da-Cunha I, Arguello B, Martinez F, Fernandez-Llimos F. A comparison of patient-centered care in pharmacy curricula in the United States and Europe. Am J Pharm Educ. 2016;80(5):83.

52 Carga horária de matérias clínicas Nunes-da-Cunha I, Arguello B, Martinez F, Fernandez-Llimos F. A comparison of patient-centered care in pharmacy curricula in the United States and Europe. Am J Pharm Educ. 2016;80(5):83.

53 2011

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57 Autonomia Alterar uma dose 15,8% Alterar um intervalo de administração 15,8% Alterar a duração de uma terapêutica 26,3% Introduzir um novo medicamento 5,3% Suspender um medicamento 10,5% Substituir por uma alternativa terapêutica 15,8% Alterar a forma farmacêutica 36,8% Alterar a via/método de administração 100,0%

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59 Como mudar? Kotter JP. Leading Change. Boston, MA: Harvard Business School Press; ISBN

60 Teremos futuro, se mudarmos o presente