Propuesta de modelo de atención farmacéutica para centros de atención secundaria en el sistema de salud de Guatemala

Abstract

Este trabajo de investigación analiza la viabilidad de implementar un modelo de atención farmacéutica en establecimientos de segundo nivel de atención del sistema de salud de Guatemala. Se fundamenta en la necesidad de integrar al farmacéutico en servicios asistenciales públicos, promoviendo un enfoque centrado en el paciente para identificar, prevenir y resolver problemas relacionados con medicamentos (PRM). Se desarrolló un modelo teórico adaptado al contexto guatemalteco, basándose en metodologías internacionales como el método Dáder y modelos hospitalarios de farmacia clínica. La metodología fue descriptiva con enfoque mixto, combinando revisión bibliográfica y una encuesta piloto exploratoria. El modelo teórico define el rol del farmacéutico en el entorno hospitalario de segundo nivel, incluyendo revisión farmacoterapéutica, seguimiento, intervención clínica y farmacovigilancia. Se propone una integración interdisciplinaria para optimizar el uso de medicamentos, mejorar resultados terapéuticos y fortalecer la seguridad del paciente, adaptándose a las limitaciones del sistema público guatemalteco. Se concluye que la aplicación del modelo es teóricamente viable y beneficiosa para la calidad asistencial y la racionalidad del uso de medicamentos, visibilizando al farmacéutico como profesional sanitario activo y agente clave. A pesar de las limitaciones, la implementación progresiva es posible con estrategias adecuadas. Se recomienda validar el modelo mediante aplicación piloto, evaluar su impacto y desarrollar estrategias para la incorporación formal del farmacéutico, considerando la integración de inteligencia artificial.

This research project consisted of a literature review and a perception assessment with the purpose of analyzing the feasibility of implementing a pharmaceutical care model in secondary healthcare facilities within the Guatemalan health system. The research was based on the need to integrate pharmaceutical professionals into public healthcare services, promoting a patient-centered approach aimed at the identification, prevention, and resolution of drug-related problems (DRPs). To this end, a theoretical pharmaceutical care model adapted to the Guatemalan context was developed, based on internationally recognized methodologies, including the Dáder method and hospital clinical pharmacy models implemented in consolidated healthcare systems.

The methodology employed was descriptive with a mixed-methods approach, based on an extensive literature review and the application of a non-experimental exploratory pilot survey. The literature review established the conceptual foundation of the proposed model, while the survey aimed to gather perceptions from pharmaceutical professionals regarding the feasibility, relevance, and applicability of the model within the national context. The measurement instrument consisted of a brief perception questionnaire. The collected data were analyzed using descriptive statistics in order to strengthen the validity of the proposed model and contextualize its feasibility within the country’s public healthcare system.

The proposed theoretical model established a functional structure for the role of pharmacists within the secondary-level hospital environment, defining processes related to pharmacotherapeutic review, pharmacotherapy follow-up, clinical intervention, and active pharmacovigilance. In addition, an interdisciplinary integration framework was proposed to optimize medication use, improve therapeutic outcomes, and strengthen patient safety, while adapting to the logistical and structural limitations of the Guatemalan public healthcare system.

Overall, it was concluded that the implementation of the pharmaceutical care model in secondary healthcare centers is theoretically feasible and potentially beneficial for improving healthcare quality and promoting the rational use of medications. The proposal highlighted the importance of pharmacists as active healthcare professionals within multidisciplinary teams and as key agents in strengthening pharmacotherapy, pharmacovigilance, and health education. Despite the structural and resource limitations observed in secondary-level facilities, it was identified that the gradual implementation of the model could be possible through appropriate management and training strategies.

Among the main recommendations, it was proposed that future research should validate the model through pilot implementation in secondary healthcare centers, evaluating its clinical, economic, and organizational impact. Likewise, the development of strategies to support the formal integration of pharmaceutical professionals into these institutions was suggested, promoting public policies aimed at strengthening hospital pharmaceutical services. Finally, it was recommended to consider the integration of artificial intelligence–based tools to support pharmacotherapeutic information management, optimize the detection of DRPs, and facilitate the sustainability of the model through collaboration between pharmaceutical personnel and automated data analysis systems.