Model for the evaluation of drug-dispensing services in
					primary health care

Sartor, Vanessa de Bona; Freitas, Sergio Fernando Torres de

doi:10.1590/S0034-8910.2014048005135

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Public Health Practice • Rev. Saúde Pública 48 (5) • Oct 2014 • https://doi.org/10.1590/S0034-8910.2014048005135 linkcopy

Model for the evaluation of drug-dispensing services in primary health care

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE To develop a model for evaluating the efficacy of drug-dispensing service in primary health care.

METHODS An efficacy criterion was adopted to determine the level of achievement of the service objectives. The evaluation model was developed on the basis of a literature search and discussions with experts. The applicability test of the model was conducted in 15 primary health care units in the city of Florianópolis, state of Santa Catarina, in 2010, and data were recorded in structured and pretested questionnaires.

RESULTS The model developed was evaluated using five dimensions of analysis for analysis. The model was suitable for evaluating service efficacy and helped to identify the critical points of each service dimension.

CONCLUSIONS Adaptations to the data collection technique may be required to adjust for the reality and needs of each situation. The evaluation of the drug-dispensing service should promote adequate access to medications supplied through the public health system.

Pharmaceutical Preparations, supply & distribution; Good Dispensing Practices; Primary Health Care; Health Services Evaluation

Dimension	Indicator	Measurement	Parameter
User embracement	Beneficiary approach	Was a friendly approach adopted? (a) Were the beneficiaries welcomed? (b) Were attempts made to identify the beneficiaries? (c) Were professionals at the disposal of the beneficiaries?	Yes = when beneficiaries were identified in ≥ 50.0% of the services provided and were welcomed, or when professionals were at the disposal of beneficiaries in ≥ 50.0% of the services. No = when beneficiaries were identified in < 50.0% of the services.
Evaluation of prescription	Analysis of prescription	Were prescriptions analyzed? (a) Were legal nonconformities identified? (b) Were technical nonconformities identified?	Yes = nonconformities were identified in some prescriptions among the health services provided (a perceived event). No = no nonconformities were identified (no perceived event).
	Evaluation of drug therapy	Was drug therapy evaluated? (a) Were therapy nonconformities identified? (b) Was the health status assessed during drug therapy?	Yes = when the health status of beneficiaries was identified in ≥ 50.0% of the services provided or when nonconformities were identified in any of the therapies among the health care services provided (a perceived event). No = when the health status of beneficiaries was identified in < 50.0% of the services provided and no nonconformities of therapy were observed.
Separation and preparation of mediciness	Assessment of the quantity and quality of mediciness	Was drug quantity and expiration date assessed? (a) Were nonconformities in quantity and expiration date identified? Were these aspects verified?	Yes = when nonconformities in quantity or quality were identified or when the verifications were confirmed (a perceived event). No = when nonconformities in quantity or quality of the medicines supplied were not observed and when the verifications were not confirmed.
	Compliance with the preparation techniques	Were the medications prepared? (a) Were the medications accompanied by drug description leaflets with data on the active ingredient, batch number, expiration date, and drug concentration (criteria for product fractionation)?	Yes = it meets the fractionation criteria in ≥ 50.0% of the services provided. No = it meets the fractionation criteria in < 50.0% of the services provided.
Beneficiary guidance upon medicines delivery	Guidance on medicines use	Was any guidance on medicines use provided? (a) Was any guidance on the method of use (amount, when, how, and for how long) provided? (b) Was any guidance on drug access during periods of unavailability provided?	Yes = the method of use was informed in ≥ 50.0% of the services provided and guidance on drug access during periods of unavailability was provided. No = the method of use was informed in < 50% of the services provided.
	Guidance on the outcomes of drug therapy	Was any guidance on the outcomes of drug therapy provided? (a) Was the purpose of the medication informed? (b) Was product safety informed? (c) Was product efficacy informed?	Yes = the medication purpose, efficacy, or safety were informed in ≥ 50.0% of the services provided. No = the purpose, efficacy, or safety were informed in < 50.0% of the services provided.
Data recording	Record of medicines outflow/supply	Was medicines outflow/supply recorded? (a) Was the outflow of all products recorded?	Yes = product outflow/supply was recorded in the inventory control system in ≥ 50.0% of the services provided. No = product outflow/supply was recorded in the inventory control system in < 50.0% of the services provided.
	Record of care rendered to the beneficiary	Was the care provided to the beneficiary recorded? (a) Were interventions or nonconformities recorded? (b) Were prescription drugs recorded?	Yes = when prescription drugs were recorded in ≥ 50.0% of the services provided or the medical interventions or nonconformities observed were recorded (a perceived event). No = when prescription drugs were recorded in < 50.0% of the services provided or when no medical interventions or nonconformities were recorded.

Dimension	Indicator and measure	Rating of variable efficacy	Rating of service efficacy	Rating of municipality efficacy
User embracement	Beneficiary approach Was a friendly approach adopted?	Yes = Acceptable No = Unacceptable	ACCEPTABLE Predominance of acceptable ratings, presence of acceptable rating in the dimensions “evaluation of prescription”, and “beneficiary guidance upon medicines delivery”, and absence of unacceptable ratings	ACCEPTABLE Predominance of acceptable ratings; ≤ 20.0% of unacceptable ratings
Evaluation of prescription	Analysis of prescription Was the analysis of prescription performed?	Yes + Yes = Acceptable Yes + No = Regular No + No = Unacceptable
Evaluation of prescription	Evaluation of drug therapy Was the evaluation of drug therapy performed?
Separation and preparation of medicines	Assessment of the quantity and quality of medicines Was the verification of drug quantity and expiration date performed?	Yes + Yes = Acceptable Yes + No = Regular No + No = Unacceptable	REGULAR Maximum of two unacceptable ratings and absence of unacceptable ratings in the dimensions “evaluation of prescription” and “beneficiary guidance upon medicines delivery”	REGULAR ≤ 40.0% of unacceptable ratings
Separation and preparation of medicines	Compliance with the preparation techniques Were the medications prepared?			REGULAR ≤ 40.0% of unacceptable ratings
Beneficiary guidance upon medicines delivery	Guidance on medicines use Was any guidance of medication use provided?	Yes + Yes = Acceptable Yes + No = Regular No + No = Unacceptable	UNACCEPTABLE Predominance of unacceptable ratings or presence of unacceptable ratings in the dimensions “evaluation of prescription” and “beneficiary guidance upon medicines delivery”	UNACCEPTABLE > 40.0% of unacceptable ratings
Beneficiary guidance upon medicines delivery	Guidance on the outcomes of drug therapy Was any guidance on the results of drug therapy provided?			UNACCEPTABLE > 40.0% of unacceptable ratings
Data recording	Record of medicines outflow/supply Was product outflow/supply recorded?	Yes + Yes = Acceptable Yes + No = Regular No + No = Unacceptable
Data recording	Record of care rendered to the beneficiary Was the care provided to the beneficiary recorded?

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