Escasez de medicamentos y otros productos en los servicios de salud brasileños en el escenario impuesto por la COVID-19

Autores/as

DOI:

https://doi.org/10.33448/rsd-v11i5.27928

Palabras clave:

COVID-19; Servicios de salud; Servicios farmacéuticos; Encuestas y cuestionarios.

Resumen

Objetivo: Nuestro objetivo fue investigar y describir los medicamentos y recursos materiales en escasez de salud en los servicios brasileños durante la pandemia de COVID-19. Métodos: Realizamos un estudio transversal en formato de encuesta online con preguntas cerradas. Se buscó información sobre el perfil institucional y asistencial, organización del servicio farmacéutico, incumplimiento en el stock o falta de medicamentos y otros productos sanitarios entre abril y octubre de 2020. Se realizaron análisis estadísticos descriptivos, univariados y multivariados, como la t de Fisher. -test, chi-square test, y los análisis de Correspondencia Múltiple y Cluster Jerárquico. Se consideró un valor de p por debajo de 0,05 y un nivel de significancia del 95%. Resultados: 228 instituciones brasileñas, la mayoría ubicadas en las capitales, con camas específicas para COVID-19 y administración pública, fueron incluidas en el estudio. La agrupación por similitud separó la muestra del estudio en cinco grupos heterogéneos. El 84% de los servicios indicó desabastecimiento de medicamentos, en especial bloqueadores neuromusculares (64,9%), hipnóticos y sedantes (52,9%), fármacos vasoactivos (37,3%) y antiinfecciosos (30%). Conclusión: En todos los conglomerados, hubo relatos de escasez de artículos considerados esenciales en el manejo de pacientes críticos, lo que corrobora la percepción de que ese fue un desafío importante para la asistencia farmacéutica en varios servicios brasileños durante la pandemia de COVID-19.

Citas

Abdi, H., & Valentin, D. (2007). Multiple Correspondence Analysis. Encyclopedia of Measurement and Statistics.

Acosta, A., Vanegas, E. P., Rovira, J., Godman, B., & Bochenek, T. (2019). Medicine Shortages: Gaps Between Countries and Global Perspectives. Frontiers in Pharmacology, 10, 763. https://doi.org/10.3389/fphar.2019.00763

African COVID-19 Critical Care Outcomes Study (ACCCOS) Investigators. (2021). Patient care and clinical outcomes for patients with COVID-19 infection admitted to African high-care or intensive care units (ACCCOS): A multicentre, prospective, observational cohort study. Lancet (London, England), 397(10288), 1885–1894. https://doi.org/10.1016/S0140-6736(21)00441-4

Agência Nacional de Vigilância Sanitária. (2021, janeiro 18). Painel mostra dados sobre medicamentos para Covid-19. Agência Nacional de Vigilância Sanitária - Anvisa. https://www.gov.br/anvisa/pt-br/assuntos/noticias-anvisa/2020/painel-mostra-dados-sobre-medicamentos-para-covid-19

Aljadeed, R., AlRuthia, Y., Balkhi, B., Sales, I., Alwhaibi, M., Almohammed, O., Alotaibi, A. J., Alrumaih, A. M., & Asiri, Y. (2021). The Impact of COVID-19 on Essential Medicines and Personal Protective Equipment Availability and Prices in Saudi Arabia. Healthcare, 9(3), 290. https://doi.org/10.3390/healthcare9030290

AlRuthia, Y. S., AlKofide, H., AlAjmi, R., Balkhi, B., Alghamdi, A., AlNasser, A., Alayed, A., Alshammari, M., Alsuhaibani, D., & Alathbah, A. (2017). Drug shortages in large hospitals in Riyadh: A cross-sectional study. Annals of Saudi Medicine, 37(5), 375–385. https://doi.org/10.5144/0256-4947.2017.375

American Society of Health-System Pharmacists. (2021). Drug Shortages Statistics—ASHP. https://www.ashp.org/Drug-Shortages/Shortage-Resources/Drug-Shortages-Statistics

Ayati, N., Saiyarsarai, P., & Nikfar, S. (2020). Short and long term impacts of COVID-19 on the pharmaceutical sector. DARU Journal of Pharmaceutical Sciences, 28(2), 799–805. https://doi.org/10.1007/s40199-020-00358-5

Badreldin, H. A., & Atallah, B. (2021). Global drug shortages due to COVID-19: Impact on patient care and mitigation strategies. Research in Social & Administrative Pharmacy, 17(1), 1946–1949. https://doi.org/10.1016/j.sapharm.2020.05.017

Bohand, X., Jordan, D., & Dubois, F. (2021). Managing the risk of shortages and medication errors with curares during the COVID-19 pandemic: A hospital pharmacy experience. European Journal of Hospital Pharmacy, ejhpharm-2020-002605. https://doi.org/10.1136/ejhpharm-2020-002605

Botega, L. de A., Andrade, M. V., Guedes, G. R., Botega, L. de A., Andrade, M. V., & Guedes, G. R. (2020). Perfil dos hospitais gerais do Sistema Único de Saúde. Revista de Saúde Pública, 54. https://doi.org/10.11606/s1518-8787.2020054001982

Cadastro Nacional de Estabelecimentos de Saúde. (2021, abril 10). http://cnes.datasus.gov.br/

Cameron, E. E., & Bushell, M.-J. A. (2021). Analysis of drug shortages across two countries during pre-pandemic and pandemic times. Research in Social and Administrative Pharmacy, 17(9), 1570–1573. https://doi.org/10.1016/j.sapharm.2020.12.001

Carvalho, M. S., & Struchiner, C. J. (1992). Análise de correspondência: Uma aplicação do método à avaliação de serviços de vacinação. Cadernos de Saúde Pública, 8(3), 287–301. https://doi.org/10.1590/S0102-311X1992000300008

Castro, M. C., Kim, S., Barberia, L., Ribeiro, A. F., Gurzenda, S., Ribeiro, K. B., Abbott, E., Blossom, J., Rache, B., & Singer, B. H. (2021). Spatiotemporal pattern of COVID-19 spread in Brazil. Science. https://doi.org/10.1126/science.abh1558

Castro, M. C., Massuda, A., Almeida, G., Menezes-Filho, N. A., Andrade, M. V., Noronha, K. V. M. de S., Rocha, R., Macinko, J., Hone, T., Tasca, R., Giovanella, L., Malik, A. M., Werneck, H., Fachini, L. A., & Atun, R. (2019). Brazil’s unified health system: The first 30 years and prospects for the future. The Lancet, 394(10195), 345–356. https://doi.org/10.1016/S0140-6736(19)31243-7

Chaves, G. C., Moraes, E. L., & Osorio-de-Castro, C. G. S. (2021). Estratégias de produção e aquisição de produtos farmacêuticos em contexto de dependência. Cadernos de Saúde Pública, 37(3), e00036821. https://doi.org/10.1590/0102-311x00036821

Clews, G. (2021, março 27). Manufacturing problems cause 60% of medicines shortages, say European wholesalers. The Pharmaceutical Journal. https://pharmaceutical-journal.com/article/news/manufacturing-problems-cause-60-of-medicines-shortages-say-european-wholesalers

Commissioner, O. of the. (2020, setembro 9). Food and Drug Administration. FDA; FDA. https://www.fda.gov/consumers/consumer-updates/combating-antibiotic-resistance

Cundell, T., Guilfoyle, D., Kreil, T. R., & Sawant, A. (2020). Controls to Minimize Disruption of the Pharmaceutical Supply Chain During the COVID-19 Pandemic. PDA Journal of Pharmaceutical Science and Technology, 74(4), 468–494. https://doi.org/10.5731/pdajpst.2020.012021

Don Eliseo Lucero-Prisno, I. I. I., Elhadi, Y. A. M., Modber, M. A. A., Musa, M. B., Mohammed, S. E. E., Hassan, K. F., Dafallah, A., Lin, X., Ahmadi, A., Adeyemi, S., Ekpenyong, A., & Adebisi, Y. A. (2020). Drug shortage crisis in Sudan in times of COVID-19. Public Health in Practice, 1, 100060.

European Medicines Agency. (2018, setembro 17). Availability of medicines [Text]. European Medicines Agency. https://www.ema.europa.eu/en/human-regulatory/post-authorisation/availability-medicines

Everitt, B., & Dunn, G. (2001). Applied multivariate data analysis. Arnold ; Oxford University Press.

FenaSaúde. (2021). Covid-19 causa aumento de até de 5.275% nos custos dos planos de saúde com medicamentos de intubação | FenaSaude. https://fenasaude.org.br/noticias/covid-19-causa-aumento-de-ate-de-5-275-nos-custos-dos-planos-de-saude-com-medicamentos-de-intubacao.html

Fernandes, D. R. A., Gadelha, C. A. G., & Maldonado, J. M. S. de V. (2021). Vulnerabilidades das indústrias nacionais de medicamentos e produtos biotecnológicos no contexto da pandemia de COVID-19. Cadernos de Saúde Pública, 37(4), e00254720. https://doi.org/10.1590/0102-311x00254720

Ferrando, C., Suarez-Sipmann, F., Mellado-Artigas, R., Hernández, M., Gea, A., Arruti, E., Aldecoa, C., Martínez-Pallí, G., Martínez-González, M. A., Slutsky, A. S., & Villar, J. (2020). Clinical features, ventilatory management, and outcome of ARDS caused by COVID-19 are similar to other causes of ARDS. Intensive Care Medicine, 1–12. https://doi.org/10.1007/s00134-020-06192-2

Food and Drug Administration, O. of the. (2021, outubro 25). U.S. Food and Drug Administration. FDA; FDA. https://www.fda.gov/home

Fox, E. R., Birt, A., James, K. B., Kokko, H., Salverson, S., Soflin, D. L., & Soflin, D. L. (2009). ASHP Guidelines on Managing Drug Product Shortages in Hospitals and Health Systems. American Journal of Health-System Pharmacy: AJHP: Official Journal of the American Society of Health-System Pharmacists, 66(15), 1399–1406. https://doi.org/10.2146/ajhp090026

Greenacre, M., & Hastie, T. (1987). The Geometric Interpretation of Correspondence Analysis. 12.

Hoss, M., & Caten, C. S. ten. (2010). Processo de Validação Interna de um Questionário em uma Survey Research Sobre ISO 9001:2000. Produto & Produção, 11(2), Article 2. https://doi.org/10.22456/1983-8026.7240

IBGE | Biblioteca | Detalhes | L’Analyse des donnees / rediges et publies sous la direction du Professeur J. P. Benzecri. -. (2021, janeiro 18). https://biblioteca.ibge.gov.br/biblioteca-catalogo.html?id=222708&view=detalhes

Jager, J., Putnick, D. L., & Bornstein, M. H. (2017). More than Just Convenient: The Scientific Merits of Homogeneous Convenience Samples. Monographs of the Society for Research in Child Development, 82(2), 13–30. https://doi.org/10.1111/mono.12296

Martinez, E. Z., Aragon, D. C., Nunes, A. A., Martinez, E. Z., Aragon, D. C., & Nunes, A. A. (2020). Long-term forecasts of the COVID-19 epidemic: A dangerous idea. Revista Da Sociedade Brasileira de Medicina Tropical, 53. https://doi.org/10.1590/0037-8682-0481-2020

Melo, A. C., Galato, D., Maniero, H. K., Frade, J. C. Q. P., Palhano, T. J., Silva, W. B. da, & João, W. da S. J. (2017). Pharmacy in Brazil: Progress and Challenges on the Road to Expanding Clinical Practice. Canadian Journal of Hospital Pharmacy, 70(5), Article 5. https://doi.org/10.4212/cjhp.v70i5.1700

Merchan, C., Soliman, J., Ahuja, T., Arnouk, S., Keeley, K., Tracy, J., Guerra, G., DaCosta, K., Papadopoulos, J., & Dabestani, A. (2020). COVID-19 pandemic preparedness: A practical guide from an operational pharmacy perspective. American Journal of Health-System Pharmacy: AJHP. https://doi.org/10.1093/ajhp/zxaa212

Miljković, N., Godman, B., Kovačević, M., Polidori, P., Tzimis, L., Hoppe-Tichy, T., Saar, M., Antofie, I., Horvath, L., De Rijdt, T., Vida, R. G., Kkolou, E., Preece, D., Tubić, B., Peppard, J., Martinez, A., Yubero, C. G., Haddad, R., Rajinac, D., … Miljković, B. (2020). Prospective Risk Assessment of Medicine Shortages in Europe and Israel: Findings and Implications. Frontiers in Pharmacology, 11. https://doi.org/10.3389/fphar.2020.00357

Ministério da Saúde. (2018). Assistência Farmacêutica no SUS: 20 anos de políticas e propostas para desenvolvimento e qualificação: Relatório com análise e recomendações de gestores, especialistas e representantes da sociedade civil organizada [recurso eletrônico] (p. 127).

Nascimento, A. do, Almeida, R. M. V. R., Castilho, S. R. de, & Infantosi, A. F. C. (2013). Análise de correspondência múltipla na avaliação de serviços de farmácia hospitalar no Brasil. Cadernos de Saúde Pública, 29(6), 1161–1172. https://doi.org/10.1590/S0102-311X2013000600013

Oliveira, Ely Francina Tannuri; Grácio, Maria Claudia Cabrini. (2022). Análise a respeito do tamanho de amostras aleatórias simples: Uma aplicação na área de Ciência da Informação. https://brapci.inf.br/index.php/res/v/6591

Omer, S., Pan, M., Ali, S., Shukar, S., Fang, Y., & Yang, C. (2021). Perceptions of pharmacists towards drug shortages in the healthcare system of Pakistan and its impact on patient care: Findings from a cross-sectional survey. BMJ Open, 11(12), e050196. https://doi.org/10.1136/bmjopen-2021-050196

Palomar-Fernández, C., & Álvarez-Díaz, A. (2020). Hospital Pharmacy Service: Facing the logistics of medicines procurement. Farmacia Hospitalaria: Organo Oficial De Expresion Cientifica De La Sociedad Espanola De Farmacia Hospitalaria, 44(7), 17–20. https://doi.org/10.7399/fh.11489

Passos, M. M. B. dos, Castoldi, V. de M., & Soler, O. (2021). O papel do farmacêutico na pandemia de COVID-19: Revisão integrativa. Research, Society and Development, 10(6), Article 6. https://doi.org/10.33448/rsd-v10i6.15809

Paumgartten, F. J. R., & Oliveira, A. C. A. X. de. (2020). Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues. Ciência & Saúde Coletiva, 25(9), 3413–3419. https://doi.org/10.1590/1413-81232020259.16792020

Pauwels, K., Huys, I., Casteels, M., & Simoens, S. (2014). Drug shortages in European countries: A trade-off between market attractiveness and cost containment? BMC Health Services Research, 14(1), 438. https://doi.org/10.1186/1472-6963-14-438

Pauwels, K., Simoens, S., Casteels, M., & Huys, I. (2015). Insights into European Drug Shortages: A Survey of Hospital Pharmacists. PLOS ONE, 10(3), e0119322. https://doi.org/10.1371/journal.pone.0119322

Pulk, R. A., Leber, M., Tran, L., Ammar, M., Amin, N., Miller, L., & Yazdi, M. (2020). Dynamic pharmacy leadership during the COVID-19 crisis: Optimizing patient care through formulary and drug shortage management. Am J Health Syst Pharm, 1874–1884.

Reis, A. M. M., & Perini, E. (2008). Desabastecimento de medicamentos: Determinantes, conseqüências e gerenciamento. Ciência & Saúde Coletiva, 13(suppl), 603–610. https://doi.org/10.1590/S1413-81232008000700009

Rosa, M. B., Reis, A. M. M., & Perini, E. (2016). Drug shortage: A public health problem. Cadernos de Saúde Pública, 32(10). https://doi.org/10.1590/0102-311X00086916

Schweitzer, S. O. (2013). How the US Food and Drug Administration Can Solve the Prescription Drug Shortage Problem. American Journal of Public Health, 103(5), e10–e14. https://doi.org/10.2105/AJPH.2013.301239

Secretaria de Governo. (2021). Financiamento na Saúde. Secretaria de Governo. https://www.gov.br/secretariadegoverno/pt-br/portalfederativo/agenda-do-prefeito-brasil/guia-prefeito-200-dias/conteudos-e-orientacoes/saude

Sen-Crowe, B., Sutherland, M., McKenney, M., & Elkbuli, A. (2021). A Closer Look Into Global Hospital Beds Capacity and Resource Shortages During the COVID-19 Pandemic. The Journal of Surgical Research, 260, 56–63. https://doi.org/10.1016/j.jss.2020.11.062

Shortages catalogue | European Medicines Agency. (2021). https://www.ema.europa.eu/en/human-regulatory/post-authorisation/availability-medicines/shortages-catalogue

Shukar, S., Zahoor, F., Hayat, K., Saeed, A., Gillani, A. H., Omer, S., Hu, S., Babar, Z.-U.-D., Fang, Y., & Yang, C. (2021). Drug Shortage: Causes, Impact, and Mitigation Strategies. Frontiers in Pharmacology, 12, 1772. https://doi.org/10.3389/fphar.2021.693426

Silva, L. M. C. da, & Araújo, J. L. (2020). Atuação do farmacêutico clínico e comunitário frente a pandemia da COVID-19. Research, Society and Development, 9(7), e684974856–e684974856. https://doi.org/10.33448/rsd-v9i7.4856

Sociedade Brasileira de Farmácia Hospitalar. (2021, abril 21). Levantamento nacional sobre o abastecimento de medicamentos e produtos para a saúde durante o enfrentamento da pandemia pela Covid-19. http://www.sbrafh.org.br/inicial/levantamento-nacional-referente-ao-abastecimento-de-medicamentos-e-produtos-para-a-saude-durante-o-enfrentamento-da-pandemia-pela-covid-19-anexo-do-oficio-no-037-2020-enviado-ao-ministro-da-saude-em/

Ventola, C. L. (2011). The Drug Shortage Crisis in the United States. Pharmacy and Therapeutics, 36(11), 740–757.

Videau, M., Chemali, L., Stucki, C., Saavedra-Mitjans, M., Largana, S., Guerin, A., Bonnabry, P., Delhauteur, B., Hees, T. V., Lebel, D., & Bussières, J.-F. (2019). Drug Shortages in Canada and Selected European Countries: A Cross-Sectional, Institution-Level Comparison. Canadian Journal of Hospital Pharmacy, 72(1), Article 1. https://doi.org/10.4212/cjhp.v72i1.2863

Vogler, S., & Fischer, S. (2020). How to address medicines shortages: Findings from a cross-sectional study of 24 countries. Health Policy (Amsterdam, Netherlands), 124(12), 1287–1296. https://doi.org/10.1016/j.healthpol.2020.09.001

Wallis, N., Gust, C., Porter, E., Gilchrist, N., & Amaral, A. (2020). Implementation of field hospital pharmacy services during the COVID-19 pandemic. American Journal of Health-System Pharmacy: AJHP. https://doi.org/10.1093/ajhp/zxaa211

World Health Organization. (2016). Meeting Report: Technical Definitions of Shortages and Stockouts of Medicines and Vaccines.

World Health Organization. (2021, abril 10). WHO Coronavirus (COVID-19) Dashboard. https://covid19.who.int

Ying, W., Qian, Y., & Kun, Z. (2020). Drugs supply and pharmaceutical care management practices at a designated hospital during the COVID-19 epidemic. Research in Social & Administrative Pharmacy. https://doi.org/10.1016/j.sapharm.2020.04.001

Descargas

Publicado

06/04/2022

Cómo citar

MARTINS, M. R. .; BEZERRA, V. S. .; OLIVEIRA , F. N. M. de; SILVA, A. R. O.; LIMA, E. da C. Escasez de medicamentos y otros productos en los servicios de salud brasileños en el escenario impuesto por la COVID-19. Research, Society and Development, [S. l.], v. 11, n. 5, p. e26711527928, 2022. DOI: 10.33448/rsd-v11i5.27928. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/27928. Acesso em: 21 nov. 2024.

Número

Sección

Ciencias de la salud