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DESIGN THINKING AS A PROJECTIVE ARCHITECTURE FOR THE IMPLEMENTATION OF PHARMACISTS’ CLINICAL SERVICES IN A RHEUMATOID ARTHRITIS AMBULATORY CLINIC
The Comprehensive medication management services (CMM) is a practice performed by clinical pharmacists to prevent and resolve drug therapy problem (DTP) in partnership with the doctors. So that the patient uses the most effective and safe medications possible, and that has good adherence to the use of them.This service has produced clinical, economic, and humanistic results. However, its implementation in the various health systems requires research and adjustments. Design thinking (DT) is an approach used to solve complex problems and places the human being at the center of the process. Thus, the objective of this work was to plan, implement and describe the implementation process of the CMM in the rheumatoid arthritis (RA) outpatient clinic in a public hospital in Belo Horizonte.
Materials and methods
This is a qualitative research that used the design thinking methodology to implement the CMM service in the RA outpatient clinic of a Brazilian public reference hospital during the period from 2018 to 2019. Throughout the stages proposed by the DT (insights, fieldwork tools, informal and semi-structured interviews, focal group, service blueprint and storyboard were used.
As a result, clinicians and ambulatory patients were found to be unaware of pharmaceutical clinical services. Medical practice initially focused on RA disease which often neglected patients' needs in relation to other health conditions. Clinical pharmacists found initial barriers to the resolution of DTPs connected to medications used to control conditions other than RA. The need to collect physical evidence that could give more materiality to the service of CMM to broaden their understanding by the other actors, and back-up processes. Over time, there was evolution in the integration of the different services in the ambulatory and in the resolution of DTP.
The design thinking methodology proved to be useful in the implementation of the CMM service since it promoted a systemic view of the project leading to a better integration of the CMM in the outpatient clinic and to better attend to the specific demands of the patients.
Hágabo Mathyell Silva, Carina Morais Neves, Isabela Viana Oliviera, Mariana Martins Gonzaga Nascimento, Carla Martins Cipolla, Djenane Ramalho Oliveira