A sacola de medicamentos: reflexões sobre as práticas de assistência farmacêutica em unidades de saúde da atenção básica

Introduction: the pharmacist's work in Primary Care has traditionally aimed more at the pharmacies logistics and supply issues in Health Units rather than the user needs regarding the use of their medicines. This gap was gradually noticed, not only by the pharmaceutical professionals, but also by other professionals of the health teams, as reports emerged of users with great difficulty in handling and understanding their drug treatment. There was a demand and a space that the pharmaceutical professional could occupy. The approach of this professional to the teams of Primary Care, as responsible for the shared care of these users, was facilitated in the Family Health Support Centers. Therefore, the Pharmaceutical Assistance actions have expanded to those related to Pharmaceutical Care, considered as a model of pharmaceutical practice and that is attentive to attitudes, ethical values, behaviors, skills, commitments and co-responsibilities in disease prevention, health promotion and recovery, in an integrated manner to the health teams. This requires a direct interaction with the user through qualified hearing, aiming at gaining users autonomy with regard to medication use. In addition to be a hearing space, the group experience can offer opportunities for the exchange of ideas and experiences in this direction. Objectives: To monitor a group experience, which uses the GAM strategy – Autonomous Medication Management in a Family Health Unit of the Municipality of Santos, with users who have chronic non communicable diseases, observing their effects on medication management. Identify barriers and facilitators in the medication use, the importance of the medication for these users and the effects of the group on their autonomy and prominent role. Method: a qualitative study using the intervention research with a group of users with chronic diseases who use polymedication with reference to the Brazilian Autonomous Medication Management Guide .Autonomous Medication Management Guide initially created in Canada with users of Mental Health services and subsequently adapted to the Brazilian context proposes a co-management of medication among teams, users, family and community. Results and Discussion: it was found the importance of ensuring spaces for discussion and learning among users with chronic diseases and workers, enabling a better understanding of drug treatment, which contributes to the pharmaceutical care process, generating increased possibility of negotiation and consequently autonomy for the user. The GAM themes are important triggers for these reflections. The "bag" of medicines points to the medication as a commodity and incentive to consumption, as well as a criticism of the way drugs are being dispensed, causing in many cases non-adherence to treatment. As barriers were encountered, difficulties arose in the formation of the groups and in the presence of a larger number of professionals from the teams to increase co-management. As a suggestion for new studies the topic of medicalization can be more discussed in the teams as a way of overcoming the assistance model, which has so far been established especially with regard to the use of medicines.

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