R C R M do Nascimento1,2, A A Guerra2,3, J Alvares2,3, I C Gomes4, B Godman5,6,7, M Bennie5, A B Kurdi5, F A de Acurcio2,3. 1. a Post-graduated Program of Medicines and Pharmaceutical Assistance, School of Pharmacy , Federal University of Minas Gerais (UFMG) , Belo Horizonte , Minas Gerais , Brazil. 2. b SUS Collaborating Centre for Technology Assessment and Excellence in Health (CCATES), School of Pharmacy , Federal University of Minas Gerais , Brazil. 3. c Department of Social Pharmacy, School of Pharmacy , Federal University of Minas Gerais (UFMG) , Belo Horizonte , Minas Gerais , Brazil. 4. d Faculdade de Ciências Médicas , Belo Horizonte , Minas Gerais , Brazil. 5. e Strathclyde Institute of Pharmacy and Biomedical Sciences , University of Strathclyde , Glasgow , UK. 6. f Division of Clinical Pharmacology , Karolinska Institutet , Stockholm , Sweden. 7. g Health Economics Centre , Liverpool University Management School , Liverpool , UK.
Abstract
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.
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.
Authors: Marina Morgado Garcia; Pamela Santos Azevedo; Andrew Mirelman; Leandro Pinheiro Safatle; Roberto Iunes; Marion Clark Bennie; Brian Godman; Augusto Afonso Guerra Junior Journal: Front Pharmacol Date: 2020-04-14 Impact factor: 5.810