No abstract

Objective: The aim of the present study was to describe the process of implementation and systematization of a comprehensive medication management (CMM) service, from the perspective of the participants involved, in a high complexity service that cares for women with breast cancer in Brazil.Methods: A qualitative study that utilized action research that followed the procedures proposed by Kurt Lewin and the ethical and clinical principles of pharmaceutical care practice. Data collection techniques were participant observation between August 2014 and December 2016, semi-structured interviews with eight pharmacists and pharmacy residents, field notes, and analysis of documents.Results: Six major themes emerged in four cycles of the action research process: (1) Resistance is human; the management of conflict is necessary; (2) insecurity with being a clinician; (3) management of change supported by driving forces; (4) pharmaceutical care fostering professionals’ self-efficacy; (5) documentation as the conducting wire of the practice; and (6) the advantages of a systematized practice.Conclusion: The study offered an understanding of the process of implementation of CMM services from the perspective of pharmacists. It produced knowledge on the experiences of pharmacists as they lived through the process of transformation of their professional practice to offer a patient-centered and systematized service. The framework of Lewin supported the introduction of a new work path for pharmacists, which could be operationalized as an innovative technology for the Brazilian health-care system: CMM services.

Objective: Considering the curriculum reform process taking place in pharmacy undergraduate programs in Brazil and the importance of practical experience to students throughout their learning process in university, this study aims to provide an overview of pharmacy undergraduate programs in Brazil and their respective internships. Methods: An observational, descriptive, cross-sectional study. A documentary analysis of pharmacy undergraduate programs in the face-to-face modality was carried out, with data obtained from the Political Pedagogical Projects of the programs, the curricula, and course descriptions containing information on internships, all provided by the Brazilian Ministry of Education. The data collected concerned higher education institutions (HEIs), pharmacy programs and internships. Results: Pharmacy undergraduate programs in Brazil have a median duration of 10 semesters, requiring from students a median of 6 internships, from the 6 th semester on, totalizing 826 hours. The programs lack uniformity among their internships, mainly regarding total hours and the semester in which internships start. The pharmacy internships cover, in greater number, the areas of outpatient and community pharmacy, clinical analysis, and pharmaceutical technology, respectively, being clinical analysis the area with more hours. Public and private HEIs have different internship proceedings in their curricula, hence no homogeneity among them in the different regions of Brazil. Conclusions: This study demonstrates the diversity of pharmacy programs in Brazil in the context of internships, reflecting on the training and the activity of pharmacists in recent decades. Further studies are needed to deepen the understanding of this theme.

Objective: The aim of the present study was to describe the process of implementation and systematization of a comprehensive medication management (CMM) service, from the perspective of the participants involved, in a high complexity service that cares for women with breast cancer in Brazil. Methods:A qualitative study that utilized action research that followed the procedures proposed by Kurt Lewin and the ethical and clinical principles of pharmaceutical care practice. Data collection techniques were participant observation between August 2014 and December 2016, semi-structured interviews with eight pharmacists and pharmacy residents, field notes, and analysis of documents.Results: Six major themes emerged in four cycles of the action research process: (1) Resistance is human; the management of conflict is necessary; (2) insecurity with being a clinician; (3) management of change supported by driving forces; (4) pharmaceutical care fostering professionals' selfefficacy; (5) documentation as the conducting wire of the practice; and (6) the advantages of a systematized practice. Conclusion:The study offered an understanding of the process of implementation of CMM services from the perspective of pharmacists. It produced knowledge on the experiences of pharmacists as they lived through the process of transformation of their professional practice to offer a patientcentered and systematized service. The framework of Lewin supported the introduction of a new work path for pharmacists, which could be operationalized as an innovative technology for the Brazilian health-care system: CMM services.

A Assistência Farmacêutica se volta à promoção, proteção e recuperação da saúde por meio de atividades técnico-gerenciais e clínico-assistenciais. A atuação do farmacêutico nas unidades básicas de saúde parece favorecer esse processo, embora alguns municípios optem por não inclui-lo no quadro de recursos humanos das farmácias básicas. Nesse contexto, ao realizar uma pesquisa para avaliar o acesso aos medicamentos em municípios de Minas Gerais, nosso grupo de pesquisa verificou se a presença do farmacêutico nas farmácias básicas tem influenciado sobre a qualidade dos produtos e serviços oferecidos nesses estabelecimentos. Um instrumento padronizado foi utilizado na coleta de dados e indicadores foram selecionados para avaliar qualidade no âmbito técnico-gerencial e clínico-assistencial. Como resultado, observou-se que a presença do farmacêutico nesses estabelecimentos não influenciou sobre a qualidade da Assistência Farmacêutica. Lacunas na formação desses profissionais podem estar comprometendo a atuação do farmacêutico em consonância com as necessidades do Sistema Único de Saúde.