Primary health care policy and vision for community pharmacy and pharmacists in Colombia

Keywords: Pharmacies, Primary Health Care, Delivery of Health Care, Integrated, Ambulatory Care, Community Health Services, Pharmacists, Community Pharmacy Services, Professional Practice, Colombia

Abstract

Colombia is a decentralized republic with a population of 50 million, constituted by 32 departments (territorial units) and 1,204 municipalities. The health system provides universal coverage and equal access to health care services to 95% of the population. Primary health care is seen as a practical approach that guarantees the health and well-being of whole-of-society. The National Pharmaceutical Policy (NPP, 2012) goal is "to develop strategies that enable the Colombian population equitable access to effective medicines, through quality pharmaceutical services (PS)”. There are 4,351 providers certified to deliver PS: 3,699 (85%) ambulatory and 652 (15%) hospital care. The goals for PS are: a) promoting healthy lifestyles; b) preventing risk factors arising from medication errors; c) promoting rational use of medicines; and d) implementing Pharmaceutical Care. There are a number of ways that ambulatory patients access medications: through intermediary private companies, public and private hospitals pharmacies, and retail establishments (drugstores and pharmacies). Intermediary private companies are similar to Pharmaceutical Benefits Management in the U.S. health system, and act as intermediaries between health insurers, pharmaceutical laboratories, and patients. Pharmacists are being employed by these companies and in health insurance companies managing, auditing and delivering rational use of medicines programs. In 2014 there were approximately 20,000 pharmacies and drugstores, (private establishments) where a significant number of prescription-only medicines are sold without medical prescription. Colombian laws allow personal without pharmacy education to be a “director” in these establishments, so the training and education of persons working in drugstores and pharmacies is an important challenge. There about 8,000 registered pharmaceutical chemists with 25% to 30% working in patient care. Since the 90´s, there are more favorable conditions for pharmacist’s participation and contribution to health system and patient’s health outcome. These environmental facilitators include: a) laws and regulations regarding pharmaceutical services (2005-2007), b) establishment of a NPP (2012), and c) opportunities associated with the consolidation of private health management companies providing health services with an interest in pharmaceutical services (since 1995). Finally, telepharmacy, comprehensive care routes for pharmaceutical services, and further strengthen of postgraduate training in pharmacy practice are future strategies to improve the pharmacy profession in Colombia. They provide an opportunity to influence the recognition and value of the pharmacist as the health care professional.

Downloads

Download data is not yet available.

Author Biography

Mauricio Ceballos

Department of Pharmacy

Research Group on Pharmaceutical Prevention and Promotion

References

Departamento Nacional de Planeación (DANE). Colombia: National Census population and housing 2018 results. Available at: https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/proyecciones-de-poblacion (accessed Jun 8, 2020).

República de Colombia. [Ley No 100, 23 December de 1993. To create the Unique Social Security System]. Bogotá: Diario Oficial del Congreso de la República de Colombia. 1993. Available at: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/ley-100-de-1993.pdf (accessed Jun 8, 2020).

Guerrero R, Gallego AI, Becerril-Montekio V, Vásquez J. [The health system of Colombia]. Salud Publica Mex. 2011;53(supl 2):S144-S155.

Inter-American Development Bank, IDB. From the Patient’s Perspective: Experiences with Primary Health Care in Latin America and the Caribbean. 2018. Available at: https://publications.iadb.org/en/patients-perspective-experiences-primary-health-care-latin-america-and-caribbean (accessed Jul 1, 2020).

Pérez-Valbuena GJ, Silva-Ureña A. A look at out-of-pocket health expenses for Colombia. Available at: https://www.banrep.gov.co/sites/default/files/publicaciones/archivos/dtser_218.pdf (accessed Jul 1, 2020).

Organización para la Cooperación y el Desarrollo Económico (OCDE). OECD Economic studies: Colombia 2019. Available at: https://doi.org/10.1787/805f2a79-es (accessed Jul 1, 2020).

International Monetary Fund. World Economic Outlook database, April 2020. Available at: https://www.imf.org/external/pubs/ft/weo/2020/01/weodata/download.aspx (accessed Jul 1, 2020).

World Health Organization (WHO). Global Health Expenditure Database. 2017 Available at: https://apps.who.int/nha/database (accessed Jul 1, 2020).

Ministerio de Salud y Protección Social. $31.8 billions for health in 2020. Available at: https://www.minsalud.gov.co/Paginas/31-8-billones-para-la-salud-en-2020.aspx (accessed Jul 1, 2020).

Ministerio de Salud. [Ley 1122 de 2007, to develop modify the General System of Social Security]. Available at: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/ley-1122-de-2007.pdf (accessed Jul 1, 2020).

Ministerio de Salud. Ley 1438 de 2011. Por medio de la cual se reforma el Sistema General de Seguridad Social en Salud y se dictan otras disposiciones. Available at: https://www.minsalud.gov.co/comunicadosprensa/lists/ley%201438/allitems.aspx (accessed Jul 1, 2020).

Ministerio de Salud y Protección Social. The Ten-year Public Health Plan 2012-2021: Health in Colombia is contructed by your Ministru of Health and Social Protection]. Available at: https://www.minsalud.gov.co/Normatividad_Nuevo/LEY%201438%20DE%202011.pdf (accessed Jun 8, 2020).

Organización Panamericana de la Salud OPS. [Andes region drug policy]. Available at: http://www.orasconhu.org (accessed Jun 8, 2020).

Organización Panamericana de la Salud OPS. [National Pharmaceutical policy]. Available at: http://www.med-informatica.com/CID-MED/PoliticaFarmaceuticaNal.html (accessed Jun 8, 2020).

Consejo Nacional de Política Económica y Social. National Pharmaceutical policy, document from CONPES Social 155]. Available at: https://www.minsalud.gov.co/Documentos y Publicaciones/Politica Farmaceutica Nacional.pdf (accessed Jun 8, 2020).

República de Colombia. [Decreto 780 de 2016, to promulgue A Unique Regulatory Decree of health and social protection sector]. Available at: https://www.minsalud.gov.co/Normatividad_Nuevo/Decreto%200780%20de%202016.pdf (accessed Jun 8, 2020).

República de Colombia. [Resolución 1403 de 2007, to determine the managemt model for the pharmaceutica service, adopt the Manual of essential conditions and procedures]. Available at: https://www.invima.gov.co/documents/20143/453029/Resoluci%C3%B3n+1403+de+2007.pdf/6b2e1ce1-bb34-e17f-03ef-34e35c126949 (accessed Jun 8, 2020).

República de Colombia. [Resolución 1043 de 2006, to establish the conditions that must fulfil health services providers ti habilitate their pharmaceutical services]. Available at: https://www.ins.gov.co/TyS/programas-de-calidad/Documentos%20Programa%20EEDDCARIO/resolucion%201043%202006.pdf (accessed Jun 8, 2020).

República de Colombia. Resolución 2003 de 2014. [To define procedures and conditions to register health services providers and to habilitate health services]. Available at: https://www.minsalud.gov.co/Normatividad_Nuevo/Resoluci%C3%B3n%202003%20de%202014.pdf (accessed Jun 8, 2020).

República de Colombia. [Resolución 3100 de 2019 to define procedures and conditions to register health services providers and to habilitate health services]. Available at: https://www.minsalud.gov.co/Normatividad_Nuevo/Resoluci%C3%B3n%20No.%203100%20de%202019.pdf (accessed Jun 8, 2020).

República de Colombia. [Resolución 0444 de 2008, to adopt the instrument to check the compliance of good compounding practices]. Available at: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/Resoluci%C3%B3n_0444_de_2008.pdf (accessed Jun 8, 2020).

República de Colombia. [Decreto 1011 de 2006, to tsablish the Healthcare and Social Security System mandatory quality assurance system]. Available at: https://www.minsalud.gov.co/Normatividad_Nuevo/DECRETO%201011%20DE%202006.pdf (accessed October 13, 2020).

IFARMA. [Development of pharmaceutical services in Colombia: Companies for pharmaceutical sertivces management]. Available at: https://www.ifarma.org/uploads/8/2/9/4/82946470/servicios.pdf (accessed Jun 10, 2020).

Herrera-Marín R, Estrada-Acevedo JI, Restrepo-Jimenez AM. [Association between the evaluation by a patient care team and compliance with the claim of drugs in pharmacy]. Farm Hosp. 2015;39:6-12.

Machado-Alba JE, Moncada JC, Moreno-Gutiérrez PA. Medication errors in outpatient care in Colombia, 2005-2013. Biomedica. 2016;36:251-257.

Colegio Nacional de Químicos Farmacéuticos (CNQF). [Ocupational characterization of pharmaceutical sector in Colombia]. Available at: https://repositorio.sena.edu.co/bitstream/11404/2142/1/3065.pdf (accessed Jun 10, 2020).

Colegio nacional de Químicos Farmacéuticos (CNQF). Working observatory for the Chemical-pharmaceutical profession in Colombia]. Available at: http://web.cnqfcolombia.org/wp-content/uploads/2014/12/Observatorio-Laboral-Profesion-Quimica-Farmaceutica-de-Colombia.pdf (accessed Jun 10, 2020).

Vacca CP, Niño CY, Reveiz L. Restriction of antibiotic sales in pharmacies in Bogotá, Colombia: a descriptive study. Rev Panam Salud Pública. 2011;30(6):586-591.

Ceballos M, Giraldo JA, Marín VH, Amariles P. Characterization of aspects related to the use of controlled drugs in Drugstores and pharmacies-drugstores in Medellin and the Metropolitan Area. Rev Univ Ind Santander Salud. 2018;50(1):27-36.

Buxton JA, Babbitt R, Clegg CA, Durley SF, Epplen KT, Marsden LM, Thomas BA, Thompson NS. ASHP guidelines: Minimum standard for ambulatory care pharmacy practice [published correction appears in Am J Health Syst Pharm. 2015 Sep 1;72(17):1432]. Am J Health Syst Pharm. 2015;72(14):1221-1236. https://doi.org/10.2146/sp150005

Scahill SL, Atif M, Babar ZU. Defining pharmacy and its practice: a conceptual model for an international audience. Integr Pharm Res Pract. 2017;6:121-129. https://doi.org/10.2147/IPRP.S124866

Giraldo-Rojas JJ, Ocampo-Saldarriaga ZA, Sánchez-Rojo LC, Ospina-Marulanda EA. Economic impact of a dispensing analog insulin strategy to diabetic patients. J Pharm Pharmacol. 2017;5:531-535 https://doi.org/10.17265/2328-2150/2017.08.008

Arroyave OL, Álvarez WA, Amariles P, Vásquez MG, Cardona BE. Pertinencia laboral y social del programa de Tecnología en Regencia de Farmacia en la región de Urabá. Rev Univ Ind Santnader Salud. 2016;48(4):526-534.

República de Colombia. [Ley 1122 de 1995, to regulate the profession of Chemical Pharmacist]. Available at: http://www.secretariasenado.gov.co/senado/basedoc/ley_0212_1995.html (accessed Oct 22, 2020).

República de Colombia. [Decreto 1945 de 1996, to partially regulate Laws 23 of 1962 and 212 of 1995]. Available at: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/Decreto-1945-de-1996.pdf (accessed Oct 22, 2020).

República de Colombia. [Resolución 1964 de 2006, to define the specific characteristics of the quality for the suply and development of the professional curriculum of Pharmacy]. Available at: https://www.mineducacion.gov.co/1759/articles-98663_archivo_pdf.pdf (accessed Jun 10, 2020).

República de Colombia. [Resolución 1963 de 2006, to define the specific characteristics of the quality for the suply and development of the professional curriculum of Pharmacy Technician]. Available at: https://www.mineducacion.gov.co/1759/articles-98662_archivo_pdf.pdf (accessed Jun 10, 2020).

Ceballos M, Salazar-Ospina A, Sabater-Hernández D, Amariles P. Evaluation of the effects of a drug with fiscalized substance dispensation, health education, and pharmacovigilance continuing education program in Colombia drugstores and drugstores/pharmacies: study protocol of a multicenter, cluster-randomized controlled trial. Trials. 2020;21(1):545. https://doi.org/10.1186/s13063-020-04481-1

Amariles, P. [Advances in pharmacuetical care in Colomnbia in 1994-2012]. Vitae. 2012;19(Suppl. 2):71-73.

Agudelo N, Cifuentes J, Amariles P. Impacto de la intervención del químico farmacéutico en el proceso de atención ambulatoria en una institución de salud en Medellín - Colombia. Pharm Care Esp. 2003;5:1-12.

Amariles P, Giraldo N. Dader method for drug therapy follow-up and Drug Therapy Use Problems in the Colombia’s situation. Seguim Farmacoter. 2003;1(3):99-104.

Amariles P, Giraldo AN, Toro PV, Restrepo GM, Galvis PD, Pérez MJ. Método Dáder de seguimiento farmacoterapéutico y farmacovigilancia en instituciones de salud de Colombia. Vitae. 2005;12(1):29-38.

Salazar-Ospina A, Amariles P, Hincapié-García JA, González-Avendaño S, Benjumea DM, Faus MJ, Rodriguez LF. Effectiveness of the Dader Method for Pharmaceutical Care on Patients with Bipolar I Disorder: Results from the EMDADER-TAB Study. J Manag Care Spec Pharm. 2017;23(1):74-84. https://doi.org/10.18553/jmcp.2017.23.1.74

Monsalve David M, Hincapié García JA, Salazar Ospina A, Amariles P. Cost-effectiveness of pharmaceutical care in patients with bipolar I disorder: The EMDADER-TAB randomized clinical trial. Pharmacoeconomics - Spanish Res Artic. 2017;14(2):31-38. https://doi.org/10.1007/s40277-017-0068-z

Amariles P. Primer Congreso Colombiano de Atención Farmacéutica. Tecnología en salud, clave para el uso adecuado de los medicamentos. Vitae. 2011;18(Suppl. 1):13-14.

Amariles P. Segundo congreso colombiano de Atención Farmacéutica: Generando y divulgando resultados clínicos y económicos de la Atención Farmacéutica. Vitae. 2013;19(Suppl. 1):13-14.

Amariles P. Tercer congreso colombiano de Atención Farmacéutica: Generando y articulando estrategias para la farmacoseguridad del paciente. Vitae. 2015;22(Suppl. 1):13-14.

Amariles P. Cuarto congreso colombiano de Atención Farmacéutica: Visibilizando los beneficios para los pacientes y sistemas de salud. Vitae. 2017;24(Suppl. 1):15-16.

Hincapié-García J, Amariles P. Quinto congreso colombiano de atención farmacéutica: Incorporando la revolución digital para mejorar los procesos y resultados de la atención farmacéutica. Vitae. 2019;26(suppl. 1):11-13.

Ministerios de Salud y Protección Social. [Resolución 2654. 2019, to establish regulations for telehealth and telemedicine in the country]. Available at: https://www.minsalud.gov.co/Normatividad_Nuevo/Resoluci%C3%B3n%20No.%202654%20del%202019.pdf (accessed Jun 10, 2020).

Ministerios de Salud y Protección Social. [Methodologuical manual to produce and implement RIAS]. Available at: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/Manual-metodologico-rias.pdf (accessed Jun 10, 2020).

Amariles P, Sorio-Bedoya EJ, Cardona D. Teaching of pharmaceutical care in Latin America: a structured review. Enseñanza de la atención farmacéutica en América Latina: una revisión estructurada. Farm Hosp. 2019;43(2):66-73. https://doi.org/10.7399/fh.11193

Published
2020-11-23
How to Cite
1.
Amariles P, Ceballos M, Gonzalez-Giraldo C. Primary health care policy and vision for community pharmacy and pharmacists in Colombia. Pharm Pract (Granada) [Internet]. 2020Nov.23 [cited 2021Jan.24];18(4):2159. Available from: https://pharmacypractice.org/journal/index.php/pp/article/view/2159
Section
International Series