Cuidados em saúde entre portadores de diabetes mellitus autorreferido no Brasil, Pesquisa Nacional de Saúde, 2013

Malta, Déborah Carvalho; Iser, Betine Pinto Moehlecke; Chueiri, Patrícia Sampaio; Stopa, Sheila Rizzato; Szwarcwald, Célia Landmann; Schmidt, María Inês; Duncan, Bruce Bartholow

doi:10.1590/1980-5497201500060003

Cited by 25 publications

(27 citation statements)

References 19 publications

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“…Advances in the care for diabetes have been made in the Brazilian national health system since the turn of the century, most notably the incorporation of diabetes care as a priority in primary care [10, 11], the increase in the number of specialty clinics, and the greater availability of services for the diagnosis and treatment of diabetes [12]. Recent surveys indicate that the percentage of adults ≥18 years referring never having done a glucose testing is small, between 11 and 24 % [13, 14]. Greater diagnosis as an explanation for at least part of the rise in self-reported diabetes in Brazil is supported by similar findings from the United States, in which nationally representative survey data from 1988 to 2012 document that a decrease in the proportion of unknown diabetes can explain part of the rise in diabetes prevalence in that country [15, 16].…”

Section: Discussionmentioning

confidence: 99%

Trends in the prevalence of self-reported diabetes in Brazilian capital cities and the Federal District, 2006–2014

Iser

Vigo

Duncan

et al. 2016

Diabetol Metab Syndr

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BackgroundDiabetes is increasing globally, particularly in low and middle income countries, posing a great challenge to health systems. Brazil is currently ranked 4th in the world in terms of the absolute number of persons with diabetes. Our aim was to analyze the trend in self-reported diabetes prevalence between 2006 and 2014 in Brazilian adults.MethodsWe used data from the national telephone survey—VIGITEL. Over 40,000 individuals from probabilistic sample of subjects ≥18 years old residing in 26 state capitals and the Federal District were interviewed per year in each location. Estimates were weighted to represent the surveyed population. We analyzed trends with a linear regression model. We adjusted prevalence with a probability predictive margins model, using as reference categories: men, 18–24 years, ≥12 years of schooling and lean/normal weight.ResultsFrom 2006 to 2014, the overall prevalence increased from 5.5 to 8.0 %, a net rise of 0.26 %/year (P = 0.001). After adjustment for sex, age, schooling and BMI categories, the trend decreased only slightly to 0.25 %/year. Relatively greater adjusted increases were present in men (0.28 %/year), in those ≥65 years (0.52 %/year), with ≤8 years of schooling (0.33 %/year) and in those overweight (0.24 %/year). The most consistent upward trends were observed among men (coefficient of determination, R2 = 0.93), those with educational attainment of 0–8 years (R2 = 0.81), those > 65 years (R2 = 0.79) and those who were overweight (R2 = 0.75). There was no significant trend in diabetes prevalence for the obese. As expected, the prevalence of self-reported diabetes was always higher among those with greater age, less schooling, in women, and in those with obesity. Being obese was associated with having more than twice the prevalence of diabetes of those normal/underweight.ConclusionsPrevalence of self-reported diabetes in Brazilian adults has risen between 2006 and 2014, especially among those 65 years or older, even after taking into account the sociodemographic and nutritional changes during the period. Regardless of possible causes (higher incidence, increased diagnosis or decreased mortality), this increase in prevalence has enormous implications for the health system, representing >300,000 newly diagnosed cases of diabetes yearly requiring health care.

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Section: Discussionmentioning

confidence: 99%

Trends in the prevalence of self-reported diabetes in Brazilian capital cities and the Federal District, 2006–2014

Iser

Vigo

Duncan

et al. 2016

Diabetol Metab Syndr

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“…Analyzing healthcare utilization among adults in Brazil, the general scenario seems adequate for those that reported being diabetic [7] or having high blood pressure [8], according to the 2013 PNS. However, 11.5 and 3 % of the population were never screened for blood glucose [7] and blood pressure, respectively [8].…”

Section: Introductionmentioning

confidence: 99%

“…However, 11.5 and 3 % of the population were never screened for blood glucose [7] and blood pressure, respectively [8]. Another obstacle in Brazilian public health is the lack of access to oral healthcare.…”

Section: Introductionmentioning

confidence: 99%

Inequities in Healthcare utilization: results of the Brazilian National Health Survey, 2013

Boccolini

Souza

2016

Int J Equity Health

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BackgroundThe Brazilian Unified Health System is a public healthcare system that has universal and equitable access among its main principles, but the continental size of the country and the complexity of the public health system complicate the task of providing equal access to all. We aim to investigate the factors associated with inequities in healthcare utilization in Brazil.MethodsWe employed data from a nationally representative cross-sectional study (2013 National Health Survey; n = 60,202). The outcome was underutilization of healthcare by adults, defined as lack of utilization of one or more of these services: physician or dentist consultation, and blood glucose or blood pressure screening. A logistic regression model, considering the complex sample, was employed (alpha = 5 %).Results0.7 % of the sample never visited a physician, 3.3 % never visited a dentist, 3 % never underwent blood pressure screening, 11.5 % never underwent blood glucose screening, and 15 % never utilized at least one of these services. Multivariate models showed a higher likelihood of underutilization of healthcare among individuals of the lowest social class “E” (AOR = 6.31, 95 % CI = 3.76–10.61), younger adults (Adjusted Odds Ratio, or AOR = 4.40, 95 % CI = 3.78–5.12), those with no formal education or incomplete primary education (AOR = 2.93, 95 % CI = 2.30–3.74), males (AOR = 2.16, 95 % CI = 1.99–2.35), and those without private health insurance (AOR = 2.11, 95 % CI = 1.83–2.44). Individuals self-classified as “white” were less likely to report underutilization (AOR = 0.82, 95 % CI = 0.75–0.90).ConclusionsDespite recent expansion of primary healthcare and oral health programs in Brazil, we observed gaps in healthcare utilization among the most vulnerable segments of the population.

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“…18 . Other analytical studies of the NHS estimated that 80.2% of people with DM who were 18 years of age or older used medicines (oral and/or insulin) 26 , of which 57.4% acquired at least one through the BPPP 25 .…”

Section: Discussionmentioning

confidence: 99%

“…Results from the Brazilian National Health Survey (NHS) provided information on the use of the Brazilian Popular Pharmacy Program (BPPP) 24 , the prevalence of use of NCD medicines 25 , and the care of people with self-reported DM in Brazil, such as the use of medications (oral or insulin) 26 . Adherence to treatment is defined as the degree to which a person's behavior -taking a medication, following a diet and/or performing lifestyle changes -corresponds to the recommendations agreed upon with a health professional 27 .…”

Section: Introductionmentioning

confidence: 99%

Acesso e adesão a medicamentos entre pessoas com diabetes no Brasil: evidências da PNAUM

Meiners

Tavares

Guimarães

et al. 2017

Rev. bras. epidemiol.

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ABSTRACT:Objective: To describe people with diabetes in Brazil and to compare their sociodemographic characteristics, access and self-reported adherence to diabetes prescribed drugs. Methods: Data analysis from the National Survey on Access, Use and Promotion of the Rational Use of Medicines, a household survey, with sampling by clusters, according to sex and age domains and national and macro-regional representativeness. Adults (≥ 20 years old) who reported having diabetes constituted the sample. The weighted frequencies of the variables in the sample were analyzed and the Pearson χ 2 test was applied to evaluate the statistical significance of the differences between the strata for the data of access, form of financing and adherence to the drugs, considering the level of significance of 5%. Results: We found a higher proportion of women, people over 60 years and economy class C. Most participants reported having two or more comorbidities, in addition to diabetes, and taking five or more drugs. Regarding access, 97.8% say they have access to prescription drugs for diabetes and 70.7% say they get them totally free of charge. There was low adherence to anti-diabetic treatment, with significant macro-regional differences (p = 0,001), and greater vulnerability in the South and Northeast regions. Conclusion: Better access to diabetes medicines in the country has been demonstrated. However, to improve the efficiency of health public spending, it is necessary to achieve higher rates of adherence to treatment.

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Cuidados em saúde entre portadores de diabetes mellitus autorreferido no Brasil, Pesquisa Nacional de Saúde, 2013

Cited by 25 publications

References 19 publications

Trends in the prevalence of self-reported diabetes in Brazilian capital cities and the Federal District, 2006–2014

Trends in the prevalence of self-reported diabetes in Brazilian capital cities and the Federal District, 2006–2014

Inequities in Healthcare utilization: results of the Brazilian National Health Survey, 2013

Acesso e adesão a medicamentos entre pessoas com diabetes no Brasil: evidências da PNAUM

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