Dimensions of Access to Antihypertensive Medications in Ceilândia, Distrito Federal, Brazil (original) (raw)
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Access to Antihypertensive Agents in Brazil: Evaluation of the “Health Has No Price” Program
Clinical Therapeutics, 2014
Purpose: This article aims to evaluate access to antihypertensive agents during the first year of the "Health Has No Price" Program (Saúde Não Tem Preço [SNTP]) in Brazil. Methods: A longitudinal and observational study was performed based on the number of antihypertensive medications supplied in 55,000 private pharmacies distributed throughout the Brazilian territory during the period February 1, 2010, through January 31, 2012. The number of antihypertensive pills supplied in the first 12 months of the SNTP Program was compared with the number of pills supplied in the 12 months before its implementation. Findings: Six antihypertensive medicines showed an increase between 32% and 120% in the number of pills supplied in the first year of the program. In this same period, the growth of the Brazilian pharmaceutical market was 13%. Additionally, 11 medicines containing the same active ingredients as the antihypertensive agents in the SNTP Program, but at concentrations not available for free, were analyzed; it was found that none showed a change 48%, and 5 showed a reduction in the number of pills supplied after the implementation of the SNTP Program. The analysis of 7 fixed-dose combinations not available in the SNTP Program that were formulated with the same active ingredients showed a change below the annual percentage growth of the Brazilian pharmaceutical market. Implications: The SNTP Program may have contributed to increased access to antihypertensive medicines in Brazil.
Access to and use of high blood pressure medications in Brazil
Revista de saude publica, 2016
To analyze the access to and use of medicines for high blood pressure among the Brazilian population according to social and demographic conditions. Analysis of data from Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), a nationwide cross-sectional, population-based study, with probability sampling, carried out between September 2013 and February 2014 in urban households in the five Brazilian regions. The study evaluated the access and use of medicines to treat people with high blood pressure. The independent variables were gender, age, socioeconomic status and Brazilian region. The study also described the most commonly used drugs and the percentage of people treated with one, two, three or more drugs. Point estimations and confidence intervals were calculated considering the sample weights and sample complex plan. Prevalence of high blood pressure was 23.7% (95...
Journal of …, 2009
Objectives Hypertension is a highly prevalent disease worldwide, constituting one of the main risk factors for cardiovascular morbidity and mortality. The aims of this study were to evaluate the level of awareness and control of hypertension comparing sex, socioeconomic and educational level, BMI and drug therapy in over 40-year-old patients. The cost-effectiveness of the main pharmacologic classes of antihypertensives, as monotherapy and combination therapy, was also assessed. Methods In this randomized and cross-sectional populational study, a sample of 738 hypertensive adults with ages at least 40 years were evaluated. Of these, 345 (46.7%) were men and 393 (53.3%) were women. Results A total of 72.9% of the hypertensives knew about their disease. Women in the 40-49 and 50-59 age groups and obese individuals had a higher rate of awareness of their hypertensive status. The rates of awareness were similar in different social classes and educational levels, however, blood pressure control varied. b-Blockers were the most effective drugs to control blood pressure with no differences being observed between monotherapy and combinations. Diuretics were the most cost-effective. Conclusion Approximately half of the participants received monotherapy. The best percentage of control with monotherapy was obtained with b-blockers but the diuretics treatment was the most cost-effective. The levels of awareness and control were high compared with developed countries, most evident in the higher social classes and higher education levels.
Pharmacological treatment of hypertensive patients can be purchased in drugstores neighborhood, however in this way self-medication may be situations that can lead to irrational use thereof. The aim of this study was to characterize the population acquires antihypertensive medication in a group of drugstores in a neighborhood in Santiago de Cali. The sample size was calculated using the formula of proportions through Epidat software version 4. Was developed a survey with questions demographic and related to the use and knowledge of antihypertensives, which was applied users who just bought these medicines in drugstores. Multiple logistic regression analysis was performed, choosing models that show overall significance (p <0.05) and each of the independent variables (p <0.05) and its confidence interval 95% .The drug plus acquired by the respondents was the losartan. Most respondents claim not to have recommended taking these drugs to others, ignoring the adverse effects and have no medical formula to purchasing. Most stated that when purchasing these drugs without a prescription do it to save time and money. Multivariate analysis found association between adverse reactions to these drugs with recommending these medications and submit medical formula, besides to recommend these medications was found also associated with education to primary and male gender. Belonging to the subsidized regime associated with it the doctor who suggests these drugs, known adverse reactions and have up to Primary. For its part belong to the contributory scheme was associated with suggest antihypertensive and knowing adverse reactions.
Journal of Clinical Medicine Research, 2016
Background: Around 30% of Brazilian population is hypertensive. Brazilian's Family Health Strategy (FHS) is a community-based approach to provide primary health care and control chronic disease as hypertension. The aims of this pilot study were to study hypertension prevalence and awareness and to analyze the feasibility of FHS program with community healthy agents (CHA) to collect data about hypertensive subjects in Matao, Brazil. Methods: A cross-sectional study was conducted in subjects equal or older than 40 years old in a neighborhood belonging to FHS program. CHA were trained to collect data and to assess blood pressure (BP) with an automated device. Hypertension diagnosis was defined if systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg or subject had previous use of hypertensive drug. Chi-square test and univariate logistic regression analysis were applied with significance level of 5% and a confidence interval of 95%. Results: In 625 subjects, hypertension prevalence was 68.8% and women (71.9%) were more hypertensive than men (63.2%) (P = 0.02). Prevalence of hypertension increased with age group, from 46.3% (40-49 years) to 82.5% (70-79 years) (P < 0.001). The overall prevalence of pre-hypertension was 40.1%: stage 1, 25.7% and stage 2, 17.0%. Hypertension awareness was 81.8% and 79.8% reported use of anti-hypertensive drugs. BP was not controlled in 61.8% and 67.7% of them was using anti-hypertensive drugs. CHA reported no difficulties to collect data and BP assessment with the automated device. Conclusion: We observed a high hypertension prevalence rate, awareness, and subjects with uncontrolled hypertension even with use of anti-hypertensive drugs. CHA from FHS program are a feasible option to BP control in future studies involving larger populations.
Pharmaceutical Care in Primary Care: an Experience with Hypertensive Patients in the North of Brazil
International Journal of Cardiovascular Sciences, 2022
, 1 conducted in urban areas of the five geographical regions of Brazil, the prevalence of self-reported hypertension in the country is 23.7% (95% confidence interval, CI, 22.8-24.6), with a greater predominance in the elderly (>60 years old) (59.0%). The access to hypertension drug therapy is greater in the South and lower in the Midwest and Northeast regions; 56% of these therapies were provided by the Brazilian Unified Health System (SUS), 16% by the Popular Pharmacy Program (Programa Farmácia Popular), and 2.3% by other sources. Although the management of systemic arterial hypertension (SAH) is easily achieved in primary health care, hypertension control rates are still low (18.0-19.6%). 2 Poor treatment adherence has been considered the main cause of increased morbidity and mortality from
PLOS ONE, 2015
High blood pressure (HBP) is the leading risk factor for years of life lost in Brazil. Factors associated with HBP awareness, treatment and control need to be understood better. Our aim is to estimate prevalence, awareness, and types of anti-hypertensive treatment and to investigate the association of HBP control with social position. Data of 15,103 (54% female) civil servants in six Brazilian state capitals collected at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010) were used to estimate prevalence and cross-sectional association of HBP control with education, per capita family income and self-reported race, using multiple logistic regression. Blood pressure was measured by the oscillometric method. 35.8% were classified as presenting HBP; 76.8% of these used anti-hypertensive medication. Women were more aware than men (84.8% v. 75.8%) and more often using medication (83.1% v. 70.7%). Adjusted HBP prevalence was, in ascending order, Whites (30.3%), Browns (38.2%) and Blacks (49.3%). The therapeutic schemes most used were angiotensin-converting enzyme inhibitors, in isolation (12.4%) or combined with diuretics (13.3%). Among those in drug treatment, controlled blood pressure was more likely in the (postgraduate) higher education group than among participants with less than secondary school education (PR = 1.21; 95% CI: 1.14-1.28), and among Asian (PR = 1.21; 95% CI: 1.12-1.32) and 'Whites (PR = 1.19; 95% CI: 1.12-1.26) compared to Blacks. Socioeconomic and racial inequality-as measured by different indicators-are PLOS ONE |
2016
High blood pressure (HBP) is the leading risk factor for years of life lost in Brazil. Factors associated with HBP awareness, treatment and control need to be understood better. Our aim is to estimate prevalence, awareness, and types of anti-hypertensive treatment and to investigate the association of HBP control with social position. Data of 15,103 (54 % female) civil servants in six Brazilian state capitals collected at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010) were used to estimate prevalence and cross-sectional association of HBP control with education, per capita family income and self-reported race, using multiple logistic regression. Blood pressure was measured by the oscillometric method. 35.8 % were classified as presenting HBP; 76.8 % of these used anti-hypertensive medication. Women were more aware than men (84.8 % v. 75.8%)
Acta Scientiarum. Health Science, 2012
The systemic arterial hypertension (SAH) currently a major public health problem, presents high medical and socioeconomic costs, and occurs concurrently with other diseases, of infectious origin or not. This study aimed to describe the sociodemographic profile of hypertensive patients with or without co-morbidities assisted in a health reference centre in a municipality of the northwest of the Paraná State, Southern Brazil. We gathered data from 250 medical records, concerning age, gender, race, marital status, educational level, professional duties, place of origin, reasons for seeking the services, occurrences of comorbidities, and duration of systemic arterial hypertension. SAH occurred more often in the age group of 60-69 years old. The female gender was significantly different from the male. We observed the predominance of married (60.0%), Caucasian (76.0%), with fundamental level of education (54.4%), housewife (39.6%), living in neighborhood towns (58.0%), born in other regions than the Southern Brazil and have seek the service mainly for reasons not related to hypertension (p < 0.05). Cardiopathy of diverse etiology, Diabetes mellitus, Chagas disease and acute myocardial heart attack were identified in 98 patients (39.2%). Long-standing SAH was observed on 65.2% of the patients. The knowledge of the profile of the hypertensives, and principal associated diseases allows directing health actions in order to optimize resources, and make effective control of blood pressure and co-morbidities, including alternative intervention approaches to increase life expectation of patients.