{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T01:34:48Z","timestamp":1769477688533,"version":"3.49.0"},"reference-count":33,"publisher":"FapUNIFESP (SciELO)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ci\u00eanc. sa\u00fade coletiva"],"abstract":"<jats:p>Abstract Little is known about the perception of healthcare professionals working in the management of the Specialized Component of Pharmaceutical Service (Componente Especializado da Assist\u00eancia Farmac\u00eautica - CEAF) regarding the clearness of the clinical practice guidelines (protocolos cl\u00ednicos e diretrizes terap\u00eauticas - PCDT) related to the inclusion and exclusion of patients and the discontinuation of medicines. Thus, the present study used a mixed-methods approach, with a quantitative phase to assess the objectivity of the criteria established in the PCDT, published from 2012 to 2022, and a qualitative phase through a focus group with healthcare professionals working in CEAF management. The 36 PCDTs analyzed in our study covered 1,972 criteria, of which 57.1% were objective. The thematic analysis of the focus group discourse indicated that the criteria, due to ambiguity and lack of clarity, have different interpretations, leading to inequality of access and compromising the principles of the SUS, especially equity. Improvements were suggested, including summarized versions of PCDTs, a version for pharmaceutical service management tasks, an additional document presenting the criteria clearly and objectively, exams, and information to verify the criteria.<\/jats:p>","DOI":"10.1590\/1413-81232026311.14282025en","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T15:12:42Z","timestamp":1769440362000},"source":"Crossref","is-referenced-by-count":0,"title":["Criteria used in clinical practice guidelines for the management of pharmaceutical service"],"prefix":"10.1590","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1314-1108","authenticated-orcid":false,"given":"Mariana Rosa","family":"Gomes","sequence":"first","affiliation":[{"name":"Universidade Federal do Paran\u00e1,  Brasil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8691-7359","authenticated-orcid":false,"given":"Paula","family":"Rossignoli","sequence":"additional","affiliation":[{"name":"Secretaria de Estado da Sa\u00fade do Paran\u00e1,  Brasil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8529-9595","authenticated-orcid":false,"given":"Fernando","family":"Fernandez-Llimos","sequence":"additional","affiliation":[{"name":"Universidade do Porto,  Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9723-584X","authenticated-orcid":false,"given":"Helena Hiemisch Lobo","family":"Borba","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1,  Brasil"}]}],"member":"530","published-online":{"date-parts":[[2026,1]]},"reference":[{"key":"ref1","series-title":"Clinical Practice Guidelines We Can Trust","author":"Graham R","year":"2011"},{"issue":"6","key":"ref2","article-title":"The quality of clinical practice guidelines over the last two decades a systematic review of guideline appraisal studies","volume":"19","author":"Alonso-Coello P","year":"2010","journal-title":"Qual Saf Health Care"},{"issue":"4","key":"ref3","first-page":"3275","article-title":"Protocolos cl\u00ednicos e diretrizes terap\u00eauticas no SUS hist\u00f3rico, desafios e perspectivas","volume":"6","author":"Mega TP","year":"2015","journal-title":"Rev Eletron Gest Saude"},{"key":"ref4","series-title":"Lei n\u00ba 12.401, de 28 de abril de 2011. Altera a Lei n\u00ba 8.080, de 19 de setembro de 1990, para dispor sobre a assist\u00eancia terap\u00eautica e a incorpora\u00e7\u00e3o de tecnologia em sa\u00fade no \u00e2mbito do Sistema \u00danico de Sa\u00fade - SUS","year":"2011"},{"key":"ref5","series-title":"Portaria de Consolida\u00e7\u00e3o n\u00ba 2 de 28 de setembro de 2017. T\u00edtulo IV Das regras de financiamento e execu\u00e7\u00e3o do Componente Especializado da Assist\u00eancia Farmac\u00eautica no \u00e2mbito do Sistema \u00danico de Sa\u00fade (SUS) [Internet]","year":"2017"},{"issue":"6","key":"ref6","first-page":"1157","article-title":"Evaluation of eight Clinical Protocols and Therapeutic Guidelines under the Brazilian Ministry of Health using the AGREE II instrument a pilot study","volume":"31","author":"Ronsoni RM","year":"2015","journal-title":"Cad Saude Publica"},{"issue":"11","key":"ref7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0166367","article-title":"Non-Communicable Disease Clinical Practice Guidelines in Brazil A Systematic Assessment of Methodological Quality and Transparency","volume":"11","author":"Molino CG","year":"2016","journal-title":"PLoS One"},{"issue":"10","key":"ref8","doi-asserted-by":"crossref","first-page":"3947","DOI":"10.1590\/1413-812320182410.24352017","article-title":"Comparison of the methodological quality and transparency of Brazilian practice guidelines","volume":"24","author":"Molino C","year":"2019","journal-title":"Cien Saude Colet"},{"issue":"10","key":"ref9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0204723","article-title":"The different clinical guideline standards in Brazil high cost treatment diseases versus poverty-related diseases","volume":"13","author":"Santana RS","year":"2018","journal-title":"PLoS One"},{"issue":"8","key":"ref10","first-page":"2487","article-title":"An evaluation of governance capacity of the specialized component of pharmaceutical services in Brazil","volume":"22","author":"Rover MRM","year":"2017","journal-title":"Cien Saude Colet"},{"issue":"11","key":"ref11","first-page":"5481","article-title":"Challenges in the management of high-priced drugs in the SUS evaluation of Pharmaceutical Policy in Sao Paulo, Brazil","volume":"26","author":"Fatel KO","year":"2021","journal-title":"Cien Saude Colet"},{"issue":"1","key":"ref12","first-page":"197","article-title":"Clinical Protocol of the Brazilian Ministry of Health on Parkinson's Disease adherence and perception of the prescribing physician","volume":"26","author":"Rigo AP","year":"2021","journal-title":"Cien Saude Colet"},{"issue":"2","key":"ref13","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1590\/S0103-73312016000200017","article-title":"Da organiza\u00e7\u00e3o do sistema \u00e0 fragmenta\u00e7\u00e3o do cuidado a percep\u00e7\u00e3o de usu\u00e1rios, m\u00e9dicos e farmac\u00eauticos sobre o Componente Especializado da Assist\u00eancia Farmac\u00eautica","volume":"26","author":"Rover MRM","year":"2016","journal-title":"Physis"},{"issue":"2","key":"ref14","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun V","year":"2006","journal-title":"Qual Res Psychol"},{"key":"ref15","series-title":"Minist\u00e9rio da Sa\u00fade (MS). Da excepcionalidade \u00e0s linhas de cuidado: o Componente Especializado da Assist\u00eancia Farmac\u00eautica","year":"2010"},{"key":"ref16","series-title":"Minist\u00e9rio da Sa\u00fade (MS). Componente especializado da assist\u00eancia farmac\u00eautica: inova\u00e7\u00e3o para a garantia do acesso a medicamentos no SUS","year":"2014"},{"issue":"6","key":"ref17","first-page":"2471","article-title":"Incorporation of medicines in the Unified Health System (SUS) comparison between oncology and the specialized component of pharmaceutical care","volume":"27","author":"Capucho HC","year":"2022","journal-title":"Cien Saude Colet"},{"issue":"2","key":"ref18","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1590\/S1020-49892010000200010","article-title":"Assist\u00eancia farmac\u00eautica no sistema p\u00fablico de sa\u00fade no Brasil","volume":"27","author":"Vieira FS","year":"2010","journal-title":"Rev Panam Salud Publica"},{"issue":"2","key":"ref19","first-page":"920","article-title":"Analyses of the pharmacotherapeutic profile and treatment costs of patients treated by the specialized component of pharmaceutical care in the city of Cariria\u00e7u, Cear\u00e1","volume":"14","author":"Borges KD","year":"2023","journal-title":"Rev Bras Farmacia Hosp Serv Saude"},{"key":"ref20","series-title":"Portaria n\u00ba 375, de 10 de novembro de 2009. Aprova, na forma do anexo desta Portaria, o roteiro a ser 92 utilizado na elabora\u00e7\u00e3o de Protocolos Cl\u00ednicos e Diretrizes Terap\u00eauticas (PCDT), no \u00e2mbito da Secretaria de Aten\u00e7\u00e3o \u00e0 Sa\u00fade - SAS\/MS","year":"2009"},{"key":"ref21","series-title":"Decreto n\u00ba 11.161, de 4 de agosto de 2022. Altera o Decreto n\u00ba 7.508, de 28 de junho de 2011, e o Decreto n\u00ba 7.646, de 21 de dezembro de 2011, para dispor sobre a Comiss\u00e3o Nacional de Incorpora\u00e7\u00e3o de Tecnologias no Sistema \u00danico de Sa\u00fade e sobre o processo administrativo para incorpora\u00e7\u00e3o, exclus\u00e3o e altera\u00e7\u00e3o de tecnologias em sa\u00fade pelo Sistema \u00danico de Sa\u00fade","year":"2022"},{"key":"ref22","series-title":"Minist\u00e9rio da Sa\u00fade (MS). Diretrizes metodol\u00f3gicas: elabora\u00e7\u00e3o de diretrizes cl\u00ednicas","year":"2023"},{"issue":"1","key":"ref23","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s12961-020-00588-8","article-title":"Individual, health system, and contextual barriers and facilitators for the implementation of clinical practice guidelines a systematic metareview","volume":"18","author":"Correa VC","year":"2020","journal-title":"Health Res Policy Syst"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/1748-5908-6-26","article-title":"How can we improve guideline use A conceptual framework of implementability","volume":"6","author":"Gagliardi AR","year":"2011","journal-title":"Implement Sci"},{"issue":"1","key":"ref25","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s12961-022-00815-4","article-title":"Strategies for the implementation of clinical practice guidelines in public health an overview of systematic reviews","volume":"20","author":"Pereira VC","year":"2022","journal-title":"Health Res Policy Syst"},{"issue":"7","key":"ref26","article-title":"Access to medicines for Alzheimer's disease provided by the Brazilian Unified National Health System in Minas Gerais State, Brazil","volume":"32","author":"Almeida-Brasil CC","year":"2016","journal-title":"Cad Saude Publica"},{"issue":"1","key":"ref27","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s42358-019-0091-7","article-title":"Access to high-cost medications for psoriatic arthritis in the National Health System in Brazil the long path up to dispensation","volume":"59","author":"Silva MRR","year":"2019","journal-title":"Adv Rheumatol"},{"issue":"11","key":"ref28","first-page":"5499","article-title":"Access to high-priced medicines inequalities in the organization and the results among Brazilian states","volume":"26","author":"Rover MRM","year":"2021","journal-title":"Cien Saude Colet"},{"issue":"9779","key":"ref29","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1016\/S0140-6736(11)60054-8","article-title":"The Brazilian health system history, advances, and challenges","volume":"377","author":"Paim J","year":"2011","journal-title":"Lancet"},{"issue":"3","key":"ref30","first-page":"590","article-title":"Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil","volume":"45","author":"Machado MA","year":"2011","journal-title":"Rev Saude Publica"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"130","DOI":"10.11606\/s1518-8787.2020054002301","article-title":"Judicializa\u00e7\u00e3o de medicamentos efetiva\u00e7\u00e3o de direitos ou ruptura das pol\u00edticas p\u00fablicas?","volume":"54","author":"Oliveira YMdC","year":"2020","journal-title":"Rev Saude Publica"},{"issue":"1","key":"ref32","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1186\/s12913-017-2430-x","article-title":"Legal access to medications a threat to Brazil's public health system?","volume":"17","author":"Chieffi AL","year":"2017","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"ref33","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12961-023-00966-y","article-title":"How to improve the dissemination of clinical practice guidelines in the Brazilian Unified Health System Report of a pilot project","volume":"21","author":"Pereira VC","year":"2023","journal-title":"Health Res Policy Syst"}],"container-title":["Ci\u00eancia &amp; Sa\u00fade Coletiva"],"original-title":["Crit\u00e9rios utilizados em protocolos cl\u00ednicos e diretrizes terap\u00eauticas para gest\u00e3o da assist\u00eancia farmac\u00eautica"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S1413-81232026000101817&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T15:12:50Z","timestamp":1769440370000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1413-81232026000101817&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["S1413-81232026000101817"],"URL":"https:\/\/doi.org\/10.1590\/1413-81232026311.14282025en","relation":{"has-translation":[{"id-type":"doi","id":"10.1590\/1413-81232026311.14282025","asserted-by":"subject"}]},"ISSN":["1678-4561","1413-8123"],"issn-type":[{"value":"1678-4561","type":"electronic"},{"value":"1413-8123","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"e14282025"}}