TY - JOUR
T1 - Statin use in Brazil
T2 - findings and implications
AU - do Nascimento, R. C.R.M.
AU - Guerra, A. A.
AU - Alvares, J.
AU - Gomes, I. C.
AU - Godman, B.
AU - Bennie, M.
AU - Kurdi, A. B.
AU - de Acurcio, F. A.
N1 - Funding Information:
The other statins (atorvastatin, fluvastatin, lovastatin and pravastatin) are provided through the Specialized Component of Pharmaceutical Services, funded by the federal and state governments20. However, to access these statins without co-payment, pre-assessment is mandatory and patients need to present all the documents, examinations and forms established by the Brazilian guidelines20. Whilst access to statins has been progressively facilitated with the inclusion of simvastatin through primary healthcare services and SUS pharmacies, there are concerns about their availability and usage30.
Funding Information:
Access to statin SUS Pharmacy (free of charge) Private Pharmacy Popular Pharmacyc (co-payment) Other Self-reported poor adherencee (yes) Causes of non-adherence Decision not to take the medicine Forgotten dose Lack of drug accessf Adverse events Other aUnweighted n value. bAccording to level five of the Anatomical Therapeutic Chemical (ATC) Classification Index40. cSimvastatin is available in the Popular Pharmacy Program network. The Ministry of Health fund up to 90% of the drugs price and the patient pays the difference between the product selling price and the percentage funded by the federal government. dDrug not provided by SUS. ePatients reported they did not take any dose of statin up to 7 days before the interview. fPatients didn’t have prescription or the statin wasn’t available in SUS Pharmacies.
Publisher Copyright:
© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/10/3
Y1 - 2018/10/3
N2 - Introduction and objectives: Statins have become an integral part of treatment to reduce cardiac events in patients with cardiovascular disease. However, their use within the public healthcare system in Brazil is unknown. Consequently, we sought to determine and characterize statin use in primary healthcare delivered by the public health system (SUS) in Brazil and evaluate associated patient factors to improve future use. Methods: Cross-sectional study with a national representative sample from five Brazilian regions, derived from the National Survey on Access, Use and Promotion of Rational Use of Medicines using a multi-stage complex sampling plan. Patients over 18 years old were interviewed from July 2014 to May 2015. The prevalences of statin use and self-reported statin adherence were determined amongst medicine users. The associations between statin use and sociodemographic/health condition variables were assessed using logistic regression. Results: A total of 8803 patients were interviewed, of whom 6511 were medicine users. The prevalence of statin use was 9.4% with simvastatin (90.3%), atorvastatin (4.7%) and rosuvastatin (1.9%) being the most used statins. Poor adherence was described by 6.5% of patients. Statin use was significantly associated with age ≥65 years old, higher educational level, residence in the South, metabolic and heart diseases, alcohol consumption and polypharmacy. Conclusions: This is the first population based study in Brazil to assess statin use in SUS primary healthcare patients. Addressing inequalities in access and use of medicines including statins is an important step in achieving the full benefit of statins in Brazil, with the findings guiding future research and policies.
AB - Introduction and objectives: Statins have become an integral part of treatment to reduce cardiac events in patients with cardiovascular disease. However, their use within the public healthcare system in Brazil is unknown. Consequently, we sought to determine and characterize statin use in primary healthcare delivered by the public health system (SUS) in Brazil and evaluate associated patient factors to improve future use. Methods: Cross-sectional study with a national representative sample from five Brazilian regions, derived from the National Survey on Access, Use and Promotion of Rational Use of Medicines using a multi-stage complex sampling plan. Patients over 18 years old were interviewed from July 2014 to May 2015. The prevalences of statin use and self-reported statin adherence were determined amongst medicine users. The associations between statin use and sociodemographic/health condition variables were assessed using logistic regression. Results: A total of 8803 patients were interviewed, of whom 6511 were medicine users. The prevalence of statin use was 9.4% with simvastatin (90.3%), atorvastatin (4.7%) and rosuvastatin (1.9%) being the most used statins. Poor adherence was described by 6.5% of patients. Statin use was significantly associated with age ≥65 years old, higher educational level, residence in the South, metabolic and heart diseases, alcohol consumption and polypharmacy. Conclusions: This is the first population based study in Brazil to assess statin use in SUS primary healthcare patients. Addressing inequalities in access and use of medicines including statins is an important step in achieving the full benefit of statins in Brazil, with the findings guiding future research and policies.
KW - Brazil
KW - Cardiovascular diseases
KW - drug utilization
KW - hypercholesterolemia
KW - pharmaceutical services
KW - primary healthcare
KW - statins
UR - http://www.scopus.com/inward/record.url?scp=85045252238&partnerID=8YFLogxK
U2 - 10.1080/03007995.2018.1451312
DO - 10.1080/03007995.2018.1451312
M3 - Article
C2 - 29528246
AN - SCOPUS:85045252238
SN - 0300-7995
VL - 34
SP - 1809
EP - 1817
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
IS - 10
ER -