Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM): avaliação dos serviços de atenção farmacêutica primária

Abstract

The rational use of medicines is a goal that should not be attributed only to the meeting between health professional and user, because it goes beyond the limits of mere interaction between prescription and use that takes place in the doctor-patient relationship. This alleged rationality in the use of medicines would require a difficult alignment between distinct rationalities of the various actors that interact in the field of pharmaceutical services: federal, state, and municipal governments; universities and technical courses; health professionals; public and private health services; pharmaceutical industry and providers of supplies; patients and media. In this sense, the proposition "I think, therefore I am, " which would indicate the prominence of the Empire of reason, might fail, because "we think where we do not exist, or exist where we do not think" 23. However, this cannot move us away from the pursuit of a common vision that articulates the different actors of the field around a set of principles and agreements that can promote a quality use of medicines, namely: (1) strengthening the right to health care by universal health systems; (2) providing care with solutions in line with the needs of the population; (3) encouraging effective procedures; (4) promoting health and preventing diseases; and (5) setting in a transparent way the roles of the actors in the field. Thus, we seek to reverse the logic that the medicine is only one "input" in the health care network, so that it can be seen as element of an interconnected chain that produces quality "outcomes" 8. To do so, we need: (1) easy access to essential medicines at costs that society can endure; (2) medicines that meet criteria of quality, safety, and efficacy; (3) quality use of medicines; (4) stimulus to industry segments that are viable and responsible 8. In this context, governments and universities gathered around the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM-National Survey on Access, Use and Promotion of Rational Use of Medicines) to produce a comprehensive scenario of the situation of access and use of medicines in Brazil 12. Revista de Saúde Pública has published, in previous supplement 6 , results of the comprehensive household survey of PNAUM, which collected important information regarding several