• J Eval Clin Pract · Apr 2021

    Implementation of clinical pharmacy services using problematization with Maguerez Arc: A quasi-experimental before-after study.

    • Genival Araujo Dos Santos Júnior, Rafaella Oliveira Santos Silva, Thelma Onozato, Carina Carvalho Silvestre, Kérilin Stancine Santos Rocha, Elton Matos Araújo, and Divaldo Pereira de Lyra-Jr.
    • Department of Pharmacy and Nutrition, Federal University of Espírito Santo, Espírito Santo, Brazil.
    • J Eval Clin Pract. 2021 Apr 1; 27 (2): 391-403.

    Rationale, Aims, And ObjectivesThe growth of clinical pharmacy services (CPS) has positively impacted clinical, economic, and humanistic health outcomes. However, detailed studies on the process of implementing CPS in healthcare systems are incipient. Thus, the present study aimed to evaluate the CPS implementation in certain public health units in a metropolis in northeast Brazil.MethodsA quasi-experimental before-and-after study was carried out in Recife City, from July 2015 to March 2016. The study was carried out using the Methodology of Problematization with Maguerez Arc and was divided into: initial evaluation (before), planning, interventions, and preliminary evaluation (after). The participants were pharmacists, patients, health professionals, and local health managers. Descriptive statistics were used to report data. The statistical significance of the comparison between variables was evaluated using the Wilcoxon test (95% CI; P ≤ .05).ResultsInitial evaluation: Identified incipient CPS, a lack of structure and work process of pharmacists. Planning: Sixteen brainstorming meetings were held with the different actors resulting in a strategic plan.InterventionTwenty-two political-administrative meetings were held with managers and health teams and 768 hours of theoretical and practical training with mentoring for pharmacists. Preliminary evaluation: Structure indicators presented a statistically significant difference, differently from the process indicators. Pharmacists attended 842 patients and performed 1465 pharmaceutical consultations in 6 months. Regarding the outcome indicators, it was possible to identify changes in the clinical status of the most prevalent diseases among those patients who attended three pharmaceutical consultations.ConclusionsIt was possible to evaluate the CPS implementation in certain public health units in a metropolis in Brazil, through the Methodology of Problematization with Maguerez Arc. This methodology may be part of models for future implementations of CPS in health systems.© 2020 John Wiley & Sons Ltd.

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