O presente estudo buscou compreender aspectos assistenciais presentes na base da utilização indiscriminada de benzodiazepínicos. Com base numa parceria entre uma universidade brasileira e uma cubana, buscou-se o entendimento das práticas relacionadas ao uso desses medicamentos na atenção primária e dos sentidos que profissionais de saúde atribuem a elas. A investigação integrou um estudo de casos múltiplos realizado nos municípios de São Paulo e Diadema (Brasil) e Santiago de Cuba (Cuba). O trabalho de campo adotou como estratégias de coleta de dados entrevistas individuais e grupos focais. Os dados, analisados tematicamente, revelaram cinco temas: (i) terra de ninguém: a ausência de gestão sobre o uso dos benzodiazepínicos pelos profissionais da atenção básica; (ii) indicação inadequada: o benzodiazepínico prescrito psra situações injustificáveis; (iii) salvação e perdição: o medicamento como atenuante da dificuldade de atuação na saúde mental pelos profissionais da atenção primária; (iv) pouco empoderamento dos profissionais da atenção primária para atuação na saúde mental; e (v) cuidado fragmentado: a desarticulação da rede de atenção psicossocial. A pouca apropriação das questões da saúde mental pelos profissionais da atenção primária, a fragmentação do cuidado, a sobrecarga de trabalho com temas considerados prioritários, as deficiências na disponibilidade de recursos terapêuticos e o pouco investimento em formação específica contribuem para o uso não adequado de benzodiazepínicos. Independentemente dos contextos sanitários estudados, os desafios são semelhantes para os sistemas de saúde e só podem ser enfrentados se convertidos em prioridade para a gestão das organizações e para o conjunto dos profissionais.

Background: Medication review is a multifaceted service aimed at optimizing the use of medicines and enhancing the health outcomes of patients. Due to its complexity, it is crucial to clearly describe the service, its variants, and its components to avoid confusion and ensure a better understanding of medication review among healthcare providers. Aim: This study aims to bring clarity to the origins, definitions, abbreviations, and types of medication reviews, together with the primary criteria that delineate key features of this service. Method: A narrative review approach was employed to clarify the diverse terminology associated with “medication review” services. Relevant references were initially identified through searches on PubMed and Google Scholar, complementing the existing literature known to the authors. Results: The study uncovers a complicated and sometimes convoluted history of “medication review” in different regions around the world. The initial optimization of medicine use had an economic purpose before evolving subsequently into a more patient-oriented approach. A selection of abbreviations, definitions, and types were outlined to enhance the understanding of the service. Conclusions: The study underscores the urgent need for comprehensive information and standardization regarding the content and quality of the services, collectively referred to as “medication review”.

Background: Over the past decades, the qualitative research approach has played a crucial role in supporting the adoption of Pharmaceutical Care (PhC) and offers a valuable approach to explore health issues from a social and cultural perspective. It delves into attitudes, perceptions, behaviours, beliefs, and social representations related to health phenomena.Objective: To explore the experiences, insights and outlook of pharmacists regarding the development of PhC in daily practice in Belgium and Cuba. Methods: A qualitative study was conducted using a semi-structured interview guide. Thematic content analysis was used. Themes emerged by examining key phrases in the interviewees' responses. Results: Fifteen interviews with 18 professionals in Belgium and 10 interviews from Cuba were conducted. In total, 18 themes emerged from the Belgian and Cubans interviewees, 12 common themes and six non-overlapping themes. Common issues addressed in both countries include: access to patient records, lack of time, pharmacy staff and private spaces, legal framework, and non-systematic practice of PhC, pharmacists' attitudes, interaction with physicians, the need for collaborative practice, insufficient recording of PhC activity, and continuity of care between levels of care. Themes specific to Belgium include the need for remuneration, patient loyalty to a single pharmacy, and quality control of PhC services. Meanwhile, Cuba faces particular challenges such as a lack of materials and technological resources, shortages of medicines, and inadequate administrative support.Conclusion: Both Belgium and Cuba face challenges in implementing pharmaceutical care (PhC). Despite their differences, both countries need to enhance PhC by improving resources, tools, and monitoring. Belgium has made progress in PhC, while Cuba faces resource limitations. The holistic approach to pharmacists' professional perception and practice is still limited.

Context: Infections by multiresistant bacteria increase the risk of therapeutic failure, increasing hospital stay, costs and mortality. This determines the use of more expensive antibacterials with a broader spectrum, which leads to a high consumption at the hospital level, which increases bacterial resistance. Aims: To characterize the consumption of antibacterials in three hospitals in Santiago de Cuba. Methods: A descriptive and cross-sectional study of consumption was carried out. The consumed units, anatomical, therapeutic, and chemical classification, route of administration and price were analyzed for each antimicrobial. The defined daily dose (DDD)/100 beds/day and the cost of antibacterials for systemic use were determined. Descriptive statistics were used. Results: The most used antibacterial in both years (2019 and 2020) was ceftriaxone (12.6% and 26.9%). The most used group was J01D (39.5% and 44.8%), mainly parenteral via. In 2019 they presented higher DDD/100 beds/day: gentamicin (38.74 in the General Hospital and 20.20 in the Maternal Hospital) and ciprofloxacin (31.51 in the General Hospital and 15.00 in the Oncology Hospital); and in 2020 it was cefazolin (41.42 in General Hospital), ciprofloxacin (17.73 in Oncology) and gentamicin (26.99 in Maternal). The highest total costs were for ciprofloxacin and ceftriaxone. Conclusions: The increase in consumption evidenced the need to update therapeutic policies and validation of prescriptions for this group of drugs.

Context: Comprehensive medication management service provides comprehensive pharmaceutical care to patients to meet their pharmacotherapeutic needs and improve their quality of life in terms of health. Aims: To describe the results of the pilot implementation of the comprehensive medication management service provided to inpatients with cardiovascular diseases. Methods: Longitudinal, prospective and intervention study was carried out, with qualitative research elements. The sample included patients with cardiovascular diseases and more than five days from the Cardiology Service of the “Saturnino Lora” Provincial Hospital in Santiago de Cuba. The care process was developed according to the OFIL's Guide for the implementation of Comprehensive Medication Management. The patients’ medication experiences were evaluated according to Ramalho de Oliveira et al. The evaluation of drug-related problems and the clinical outcomes was carried out according to the Pharmacotherapy Work-up Method. Results: Twenty patients were included, 65% male. The mean age was 66.2 ± 13.1 years. Eighty percent of the patients had hypertension. One hundred percent received antihypertensive and antithrombotic drugs. Forty percent reported body as a pharmacotherapeutic experience. One hundred and thirty-three drug-related problems were detected and 45.1% corresponded to safety problems. One hundred and fifty-five pharmaceutical interventions were performed and 89% were accepted. Ninety percent of the patients achieved positive clinical outcomes. Conclusions: The pilot implementation of the comprehensive medication management service contributed to the resolution of drug-related problems and showed positive clinical outcomes in patients with cardiovascular diseases.