Top Banner
Cuidados Farmacêuticos – Caminhos para o futuro Fernando Fernandez-Llimos Universidade de Lisboa
60

Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Jul 28, 2020

Download

Documents

dariahiddleston
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Page 1: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Cuidados Farmacêuticos –Caminhos para o futuro

Fernando Fernandez-Llimos

Universidade de Lisboa

Page 2: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

sumário

• Futuro ?

• Cuidados Farmacêuticos ?

• Tem futuro os cuidados farmacêuticos ?

Conflicto de intereses:

• Sim, tenho.

Page 3: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

de 1922 a 1969

O farmacêutico tinha proibido:

“to comment the therapeutical effects or thecomposition of a prescription with patients”

Código ético da American Pharmaceutical Association.

Page 4: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

1970

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

Page 5: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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

1970

Page 6: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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

1967

Page 7: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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

1967

Page 8: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

1950

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

Page 9: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

1950

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

Page 10: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

PubMed 4-Fev-2017

Page 11: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

PubMed 4-Fev-2017

Page 12: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Leitura recomendada

A leiteira. Everest Editora; 2005. ISBN: 9789895002757

Page 13: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Difussão das inovações

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

Page 14: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Difussão das inovações

Page 15: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Difussão das inovações

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

Failed innovation

Page 16: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services
Page 17: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Cuidados Farmacêuticos –Caminhos para o futuro

Fernando Fernandez-Llimos

Universidade de Lisboa

Page 18: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

O que são os

Cuidados Farmacêuticos?

Page 19: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Linha histórica

1950

Page 20: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Linha histórica

1967

Page 21: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533-43.

Cuidados Farmacêuticos

Page 22: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533-43.

Cuidados Farmacêuticos

Page 23: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Linha histórica

Farmácia clínica

1990

Page 24: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

J Am Pharm Assoc. 2005;45:566–572

Page 25: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

MTM definition(J Am Pharm Assoc. 2008;48(3):341-353)

• 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.

Page 26: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Linha histórica

2005

Page 27: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Linha histórica

Farmácia clínica Pharmaceuticalcare

Page 28: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Comprehensive Medication Management

Cobb CD. Optimizing medication use with a pharmacist-provided comprehensive medication management service forpatients with psychiatric disorders. Pharmacotherapy. 2014;34(12):1336-40.

Dvoracek JJ, Cook KM, Klepser DG. Student-run low-incomefamily medicine clinic: controlling costs while providingcomprehensive medication management. J Am Pharm Assoc(2003). 2010 May-Jun;50(3):384-7.

Page 29: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Comprehensive Medication Management

https://www.accp.com/docs/positions/misc/CMM%20Brief.pdf

Page 30: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Linha histórica

Page 31: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Linha histórica

Farmácia clínica Pharmaceuticalcare MTM

CMM

Page 32: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

O.M.G.!!!

Page 33: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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. 2016 Dec;38(6):1445-1456.

Page 34: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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. 2016 Dec;38(6):1445-1456.

Page 35: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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. 2016 Dec;38(6):1445-1456.

Page 36: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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. 2016 Dec;38(6):1445-1456.

Page 37: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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. 2016 Dec;38(6):1445-1456.

Page 38: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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. 2016 Dec;38(6):1445-1456.

Page 39: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Cuidados Farmacêuticos –Caminhos para o futuro

Fernando Fernandez-Llimos

Universidade de Lisboa

Page 40: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Barreiras? Quais?

Brazinha I, Fernandez-Llimos F. Barriers to the implementation of advanced clinical pharmacy services at Portuguese hospitals. Int J Clin Pharm. 2014 Oct;36(5):1031-8.

Page 41: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services
Page 42: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Barreiras? Quais?

ConclusionSeveral 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 organisationof 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. 2014 Oct;36(5):1031-8.

Page 43: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Management by objectives

Page 44: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services
Page 45: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services
Page 46: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

eu:

Fernando Fernandez-Llimos

Universidade de Lisboa

Page 47: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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. 2017 Jan - Feb;13(1):201-208.

Page 48: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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. 2016 Jun;22(6):699-713.

Page 49: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services
Page 50: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services
Page 51: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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.

Page 52: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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.

Page 53: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

2011

Page 54: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services
Page 55: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services
Page 56: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services
Page 57: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

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%

Page 58: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services
Page 59: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Como mudar?

Kotter JP. Leading Change. Boston, MA: Harvard Business School Press; 1996. ISBN 9780875847474.

http://www.kotterinternational.com/8-steps-process-for-leading-change/

Page 60: Cuidados Farmacêuticos Caminhos para o futuro · MTM definition (J Am Pharm Assoc. 2008;48(3):341-353) • Medication therapy management (MTM) is a distinct service or group of services

Teremos futuro, se mudarmos o presente