Gestao compartilhada do tratamento com psicofarmacos: inquerito com usuarios de CAPS de quatro grandes cidades brasileiras/Shared decision-making of psychopharmaceutical treatment: survey with users of CAPS from four large Brazilian cities

• Published in: Ciência & saude coletiva 2022-07, Vol.27 (7), p.2553
• Main Authors: Colaco, Rafael Freitas, Onocko-Campos, Rosana Teresa
• Format: Article
• Language: Portuguese
• ISSN: 1413-8123
• DOI: 10.1590/1413-81232022277.17162021

In this article we describe the characteristics of the treatment negotiation process with medications at the Centros de Atengao Psicosso-cial (CAPS) in four major Brazilian municipalities. A structured questionnaire was applied to 1,630 CAPS users in the cities of Campinas, For-taleza, Porto Alegre and Sao Paulo. Most users undergoing treatment at the CAPS did not start using medication at the CAPS, but already in the first contact with health services. Almost all users were medicated when starting treatment at CAPS and most of them were medicated at the first visit. Between 55.2% and 40.7% (depending on the municipality) reported not having received information on the time needed to use the medication. A very high proportion of users reported having changed the dose of the medication alone (40.5% to 28.7%) or having been medicated against their will (35.7% to 15.6%), which indicates limits on building consensus among staff, users and families on the use of medication. CAPS users participate little in the medication decision process. There are problems from the provision of information to problems in building consensus involving the introduction and continued use of the drug. Key words Mental health services, Assessment, Psychotropic drugs, Shared decision-making, Mixed studies Neste artigo descrevemos as caracteristi-cas do processo de negociacao do tratamento com medicamentos nos Centros de Atencao Psicossocial (CAPS) de quatro grandes municipios brasileiros. Foi aplicado questiondrio estruturado com 1.630 usuarios de CAPS nos municipios de Campinas, Fortaleza, Porto Alegre e Sao Paulo. A maior parte dos usudrios em tratamento nos CAPS nao ini-ciou o uso de medicamento nos mesmos, mas jd no primeiro contato com outros servigos de saude. Quase todos os usuarios foram medicados ao iniciar tratamento no CAPS, sendo que a maior parte deles foi medicada jd no primeiro atendi-mento. Entre 55,2% e 40,7% (a depender do mu-nicipio) referiram nao ter recebido informagao so-bre o tempo necessdrio de uso da medicagao. Uma proporgao bastante alta de usudrios relatou jd ter alterado a dose da medicagao sozinha (40,5% a 28,7%) ou ter sido medicada contra sua vontade (35,7% a 15,6%), o que indica limites na constru-gao de consenso entre equipe, usudrios e familias sobre o uso de medicagao. Os usuarios de CAPS participam pouco do processo de decisao acerca da medicagao. Hd problemas desde a oferta de infor-magao ate a construgao de consenso envolvendo a introdugao e o us