Case Study – Portugal | SIMPATHY project

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Portugal lacks any polypharmacy management program, and has no prospects for one in the near future. In addition to the lack of a polypharmacy programme, scientific literature also shows scarce concern for polypharmacy management and medication adherence in Portugal. The studies are limited to some hospital services or nursing homes, with few studies in primary care and ambulatory patients. Principal factors contributing to the absence of polypharmacy management programmes in Portugal include: lack of awareness due to the absence of national studies; deficient IT systems in healthcare institutions and lack of multidisciplinary culture in healthcare teams. Additionally, the implementation of cost-effectiveness policies in last recent years due to the serious economic crisis and significant cost restrictions prompted: • A reduction in the number of healthcare professionals; • a reduction in the investment in new technologies; • limitation in the introduction of new drugs; • reduction of medicines’ reimbursement by the Government; • an increase in user fees; • intensification of medicine price control by the Administration; and, • with further examples on a more minor scale. The Portuguese healthcare system (“Sistema Nacional de Saúde – SNS”) is publicly funded with the majority of healthcare services community based. Healthcare expenditure and medicines consent and consumption is regulated by different organizations administered by the Ministry of Health which is under National Government authority. So, in order to implement a sustainable polypharmacy management programme in Portugal, more efficient communication between the Ministry of Health and the organizations working under its authority would be necessary.