Clinical Pharmacists in Primary Care: A Real-World Experience From São Paulo, Brazil

This study aimed to describe the development of pharmacist-led clinical services in primary health care (PHC) in a region of São Paulo, Brazil, comparing the profile of patients served, the types of care provided, and the clinical outcomes achieved in the provision of these services in two distinct periods.

This quantitative, descriptive, retrospective, observational study analyzed data from pharmaceutical consultations conducted in 12 PHC units in São Paulo, Brazil. Data were extracted from the service database and included patient characteristics and lifestyle habits, control of prevalent chronic conditions based on clinical and laboratory parameters, medication use history, identified drug-related problems, and pharmaceutical interventions.

A total of 3626 pharmacist-led clinical appointments were analyzed, involving 2442 patients, conducted between May and November 2016 and 2022 in Community Health Centers and patients' homes. Most patients were referred by other health care professionals and were predominantly women aged ≥ 60 years using five or more medicines. Overall, 7849 drug-related problems were identified, with a mean of 2.9 problems per patient in 2016 and 3.5 in 2022, mainly related to treatment adherence and clinical monitoring. A total of 17 304 pharmaceutical interventions were performed, with a mean of 7.0 per patient, predominantly involving pharmacotherapeutic counseling. An increase in the number of consultations was associated with higher rates of resolved drug-related problems and improved control of chronic conditions.

These findings demonstrate the sustainability of pharmacist-led clinical services in a large Brazilian municipality, with measurable benefits for medication management and chronic disease control, supporting the expansion of integrated clinical pharmacy services in PHC.