Acesso a serviços de saúde na Baixada Santista de pessoas portadoras de hipertensão arterial e ou diabetes

Abstract

Arterial Hypertension (AH) and Diabetes Mellitus (DM) are considered a worldwide epidemics whose control poses a challenge to health care services. Within the National Health System, the Family Health Program currently has the dual role of being a system gateway and reference structure. Bearing in mind this scenario, this study assessed the access of AH and DM patients to health care and therapeutic drugs. A household survey was conducted in five municipalities with over 100,000 inhabitants in the Baixada Santista. A two-stage self-weighted probabilistic sample was used. Results estimated a prevalence of 26.3% for AH and of 8.8% for DM, AH being more prevalent among women. As to health care, 85.3% of the individuals with AH interviewed reported having had their arterial pressure checked, and 70.2% of those with DM reported having had their glucose blood serum level tested in the preceding six months. Drug treatment was prescribed to 99.4% of these patients, and 62.8% of AH patients purchased such drugs from private drugstores, and 57.9% of DM patients received drugs provided by health centers. Over 90% of the patients had no access to educational group activities, and 78% of AH and 92.5% of DM patients had no supervising home visits. These findings suggest the need for primary health care as the mainstay for the care provided to HA and DM.

Absence of routine medical consultation among hypertensive and/or diabetic elders: an epidemiological study based on the Brazilian National Household Survey 2008

“…However, the comparison of our results with those of the latter must consider some questions that distinguish ten: adult population 20 and time window used in the recal 11 . The findings show that the lower frequency of medical appointments among hypertensive patients in comparison to diabetic ones are consistent with those observed in the literature 19,21 . Maybe the highest risks of complications involving DM, in comparison to isolated AH, can contribute with the explanation for these findings.…”

“…In the specific case of hypertensive participants, the prevalence was similar to that observed in Bambuí (MG) (10.4%) 18 , however, being lower to those detected in other Brazilian investigations. In a regional study conducted in the state of São Paulo, the proportion of elders with AH who did not see a doctor constantly reached 31.2%, and, among the elderly with DM, it was 23.1% 19 . In the city of Campinas (SP), this percentage was 28.4%, but, in that case, the adult population was investigated (20 years old or older) 20 .…”

Risk factor control in hypertensive and diabetic subjects attended by the Family Health Strategy in the State of Pernambuco, Brazil: the SERVIDIAH study

“…It is also striking to note the low proportion of subjects that adhere to weight-loss diets (16.1% of hypertensive subjects and 13.6% of diabetic subjects). In a study of a sample of hypertensive and diabetic subjects from five municipalities located in the Baixada Santista in the South-east Region of Brazil, Bersusa et al 34 found that more than 80% of subjects made no efforts to maintain or lose weight and that around 70% of subjects engaged in no leisure-time physical activity. This common finding in studies of this age group 11,34,35,36 highlights the need for protective measures against cardiovascular disease such as incentives to participate in community programs, such as the well-known Academia da Cidade program in Brazil 37 , and the inclusion of physical educators and physiotherapists in primary care settings.…”

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

“…By 2014, access to medication in Brazil was only studied indirectly [16][17][18] or in local [19][20][21][22] and regional studies 23 , with different approaches, analytical cuts, methodologies and with little possibility of expansion of results. 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 .…”