Analysis of access to hypertensive and diabetic drugs in the Family Health Strategy, State of Pernambuco, Brazil

Barreto, Maria Nelly Sobreira de Carvalho; Cesse, Eduarda Ângela Pessoa; Lima, Rodrigo Fonseca; Marinho, Michelly Geórgia da Silva; Specht, Yuri da Silva; Carvalho, Eduardo Maia Freese de; Fontbonne, Annick

doi:10.1590/1980-5497201500020010

Cited by 17 publications

(17 citation statements)

References 13 publications

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“…Universal health care should also reduce inequalities where levels of coverage are high. Brazil has implemented wide-ranging healthcare reforms, including provision of common medications for free, with one survey finding that over 90% of users of the public system, the Family Health Strategy, who were aware of hypertension were taking medicine [39]. Yet, while China has three insurance schemes that also provide some degree of coverage for most of the population, medicines are paid for out of pocket and can be expensive [40].…”

Section: Discussionmentioning

confidence: 99%

Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries

Palafox

McKee

Balabanova

et al. 2016

Int J Equity Health

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BackgroundEffective policies to control hypertension require an understanding of its distribution in the population and the barriers people face along the pathway from detection through to treatment and control. One key factor is household wealth, which may enable or limit a household’s ability to access health care services and adequately control such a chronic condition. This study aims to describe the scale and patterns of wealth-related inequalities in the awareness, treatment and control of hypertension in 21 countries using baseline data from the Prospective Urban and Rural Epidemiology study.MethodsA cross-section of 163,397 adults aged 35 to 70 years were recruited from 661 urban and rural communities in selected low-, middle- and high-income countries (complete data for this analysis from 151,619 participants). Using blood pressure measurements, self-reported health and household data, concentration indices adjusted for age, sex and urban-rural location, we estimate the magnitude of wealth-related inequalities in the levels of hypertension awareness, treatment, and control in each of the 21 country samples.ResultsOverall, the magnitude of wealth-related inequalities in hypertension awareness, treatment, and control was observed to be higher in poorer than in richer countries. In poorer countries, levels of hypertension awareness and treatment tended to be higher among wealthier households; while a similar pro-rich distribution was observed for hypertension control in countries at all levels of economic development. In some countries, hypertension awareness was greater among the poor (Sweden, Argentina, Poland), as was treatment (Sweden, Poland) and control (Sweden).ConclusionInequality in hypertension management outcomes decreased as countries became richer, but the considerable variation in patterns of wealth-related inequality - even among countries at similar levels of economic development - underscores the importance of health systems in improving hypertension management for all. These findings show that some, but not all, countries, including those with limited resources, have been able to achieve more equitable management of hypertension; and strategies must be tailored to national contexts to achieve optimal impact at population level.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-016-0478-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries

Palafox

McKee

Balabanova

et al. 2016

Int J Equity Health

View full text Add to dashboard Cite

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“…Important changes in the epidemiological profile that occurred in the last century led to a significant increase in life expectancy and increase in life expectancy and predominance of predominance of chronic non-communicable diseases (CNCD) 3 , 12 . Currently, health care in Brazil is characterized by an accelerated demographic transition and expressed by triple burden of disease: an agenda of infectious diseases not yet overcome, diseases associated with external causes, and the chronic conditions’ hegemony.…”

Section: Introductionmentioning

confidence: 99%

“…One of the nine global goals for CNCD control is to ensure 80% of availability of essential medicines and basic technologies, since the appropriate pharmacological treatment significantly reduces morbidity and mortality of these diseases. Appropriate availability, associated with sustainable funding and improvement of the health care system, contribute to ensure a universal coverage 3 , 7 , 24 , 25 .…”

Section: Introductionmentioning

confidence: 99%

Availability of essential medicines in primary health care of the Brazilian Unified Health System

et al. 2017

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OBJECTIVETo characterize the availability of tracer medicines in pharmaceutical services in primary health care of the Brazilian Unified Health System (SUS).METHODSThis is a cross-sectional and evaluative study, part of the Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). To analyze the availability of medicines, we verified 50 items selected from the Relação Nacional de Medicamentos Essenciais (Rename – National List of Essential Medicines) of 2012. Observation scripts were applied to medicine dispensing services in the primary health care. Interviews were carried out with patients, health care professionals, and public managers, using semi-structured questionnaires. The availability index was presented as the percentage of health units where the medicines were available. For statistical analysis, absolute, relative, and mean frequencies were presented (with 95% confidence intervals). The comparison of groups was carried out by Pearson Chi-square tests or variance analysis, when needed.RESULTSOne thousand, one hundred, and seventy-five observation scripts were filled in a national representative sample composed by 273 cities. Statistically significant differences were observed regarding the type of unit, infrastructure, and presence of a pharmacist between regions of Brazil. The average availability of tracer medicines in primary health care was 52.9%, with differences between regions and sampling strata. This index increased to 62.5% when phytotherapic medicines were excluded. We found limited availability of medicines for treatment of chronic and epidemiological diseases, such as tuberculosis and congenital syphilis.CONCLUSIONSThe low availability of essential medicines purchased centrally by the Brazilian Ministry of Health indicates deficiencies in supply chain management. The different views on the availability of tracer medicines in SUS confirm the general availability verified in this study. Among patients, about 60% said they obtain medicines in SUS units, data consistent with the lack of medicines reported by medicine dispensers and in line with physicians’ evaluations.

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“…6 However, despite the expanded access, there are still many reports of complaints related to lack of medication, difficulty in obtaining consultations in the Health Units, in addition to unsatisfactory physical examination and anamnesis, showing that there are still many aspects to be improved in this field of Family Health. 6,7,12 Another problem is the low index of medical records, which impairs and limits the conclusions of the research carried out and the veracity of the epidemiological data. [5][6][7][8] It is important to point out that all these problems are found, still in the present day, in Public Health in Brazil.…”

Section: Analysis Of Access To Drug Treatment For Hypertension and DImentioning

confidence: 99%

Studies on diabetic patients in primary care

Jasmim

Queluci

2018

Rev enferm UFPE on line.

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Objective: to analyze the scientific productions about diabetic patients in Primary Care. Method: integrative review carried out in the Lilacs, Medline and BDENF databases, from August 2016 to January 2017, in search of articles published in the last ten years in Portuguese that deal with diabetic patients in Primary Care. A bibliographic analysis was performed, as well as an exploratory and critical reading of the 14 selected studies. Results: problems such as difficulty in obtaining consultations, lack of medication in the Health Units and physical examination / unsatisfactory anamnesis, as well as an increase in the incidence of the disease as age progression and increased risk for cardiovascular diseases in diabetic patients were evidenced. Conclusion: the need for investment and development of Public Health in Brazil is evident. The importance of professional qualification is appreciated, in order to strengthen the assistance and educational actions in the Family Health Strategy, aiming at the higher quality of life of the patients. Thus, the study contributes to the areas of teaching, research and assistance by expanding knowledge in the area and stimulating investments and studies in this scenario. Descriptors: Diabetes Mellitus; Primary Health Care; Primary Prevention; Health Promotion; Family Health Strategy; Family Health.RESUMOObjetivo: analisar as produções científicas sobre pacientes diabéticos na Atenção Primária. Método: revisão integrativa realizada nas bases de dados Lilacs, Medline e BDENF, no período de agosto de 2016 a janeiro de 2017, em busca de artigos publicados nos últimos dez anos, em português, que versassem sobre os pacientes diabéticos na Atenção Primária. Foi realizada a análise bibliográfica, além de leitura exploratória e crítica das 14 pesquisas selecionadas. Resultados: evidenciaram-se problemas como dificuldade em conseguir consultas, falta de medicamentos nas Unidades de Saúde e exame físico/anamnese insatisfatório, além de relato do aumento da incidência da doença conforme progressão da idade e risco aumentado para doenças cardiovasculares em pacientes diabéticos. Conclusão: é evidente a necessidade de investimento e desenvolvimento da Saúde Pública no Brasil. Percebe-se a importância da capacitação dos profissionais, a fim de fortalecer a assistência e as ações educativas na Estratégia de Saúde da Família, visando à maior qualidade de vida dos pacientes. Desse modo, o estudo contribui para as áreas de ensino, pesquisa e assistência ampliando o conhecimento na área e estimulando investimentos e estudos nesse cenário. Descritores: Diabetes Mellitus; Atenção Primária à Saúde; Prevenção Primária; Promoção da Saúde; Estratégia Saúde da Família; Saúde da Família.RESUMEN Objetivo: analizar las producciones científicas sobre pacientes diabéticos en la Atención Primaria. Método: una revisión integradora realizada en las bases de datos LILACS, MEDLINE y BDENF, de agosto 2016 a enero 2017, en busca de artículos publicados en los últimos diez años en portugués, que abordasen sobre pacientes diabéticos en Atención Primaria. Se realizó el análisis bibliográfico, además de lectura exploratoria y crítica de las 14 encuestas seleccionadas. Resultados: se evidenciaron problemas como dificultad en conseguir consultas, falta de medicamentos en las Unidades de Salud y examen físico / anamnesis insatisfactorio, además de relato del aumento de la incidencia de la enfermedad conforme progresión de la edad y riesgo aumentado para enfermedades cardiovasculares en pacientes diabéticos. Conclusión: es evidente la necesidad de inversión y desarrollo de la Salud Pública en Brasil. Se percibe la importancia de la capacitación de los profesionales, a fin de fortalecer la asistencia y las acciones educativas en la Estrategia de Salud de la Familia, buscando la mayor calidad de vida de los pacientes. De este modo, el estudio contribuye a las áreas de enseñanza, investigación y asistencia, ampliando el conocimiento en el área y estimulando inversiones y estudios en ese escenario. Descriptores: Diabetes Mellitus; Atención Primaria de Salud; Prevención Primaria; Promoción de la Salud; Estrategia de Salud Familiar.

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Analysis of access to hypertensive and diabetic drugs in the Family Health Strategy, State of Pernambuco, Brazil

Abstract: It is necessary to increase efforts to ensure access to these drugs in the primary health care network.

Cited by 17 publications

References 13 publications

Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries

Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries

Availability of essential medicines in primary health care of the Brazilian Unified Health System

Studies on diabetic patients in primary care

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