Telefarmácia: construção e validação de um guia com script para o acompanhamento de pessoas com diabetes na atenção primária

Abstract

Diabetes Mellitus (DM) is a chronic condition that requires continuous medical monitoring. The lack of adequate care is associated with increased morbidity and mortality. In the context of the Unified Health System (SUS), the integration of person-centered practices with the use of telehealth tools has emerged as a fundamental strategy for promoting the humanization of care, especially in cases of chronic diseases such as DM. Telepharmacy, in this scenario, represents an important complementary strategy, enabling the provision of specialized pharmaceutical care. The objective of this thesis was to structure and validate a scripted guide focused on person-centered communication for people with diabetes. This is a methodological, qualitative, and quantitative study developed in three successive stages: Stage 1 – Integrative review: The question was structured using the PICO strategy, and the implementation followed methodological guidelines based on the items of the PRISMA 2020 protocol. Stage 2 – Structuring and pilot application of the guide: This stage occurred in two phases. The first stage involved structuring the guide, based on service design principles and tools, as well as national and international clinical guidelines, with a focus on practical applicability in the Primary Health Care (PHC) context. The second stage involved applying the structured guide in a pilot study. Stage 3 – Validation by expert judges and testing in a Primary Health Care Unit (PHCU). Content validation was conducted using the Delphi method and with the participation of expert judges. The I-CVI Content Validity Index (I-CVI) was used to assess the guide's content validity. The S-CVI was then obtained by averaging the I-CVI scores. Finally, the test was conducted in a PHCU, assessing patients' perceptions of the telepharmacy service and pharmacist comprehension, perception, and readiness to use the scripted guide as a support tool. The result was a telepharmacy guide validated by 14 experts. It contained 52 points, including 11 scripts and 41 items. The guide aimed to standardize the approach of healthcare professionals, especially pharmacists, in telepharmacy consultations, promoting comprehensive care for people with diabetes. Thus, the scripted guide, called GST, can facilitate communication between professionals and patients and organize the care process. Continued research and expanded application in different contexts are essential to consolidate its effectiveness and promote the inclusion of GST as a support tool in healthcare services.