Use of statins in primary health care – Brazil
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Universidade Federal de Minas Gerais
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Membros da banca
Resumo
Background: Several literature reviews have highlighted the benefits of using statins in the prevention
of cardiovascular disease. The scientific evidences
support the inclusion of statins in many protocols
and the promotion of their use on a global scale.
Population-based studies on the use of statins are still
scarce, with the main evidence from randomized
clinical trials. Knowledge of the profile of medicines
use in the real world is essential for improving health
care and public policies.
Objectives: This study aims to characterize the use of
statins in primary health care of the Unified Health
System (SUS) in Brazil and assess the associated factors to the statins use.
Methods: This is a cross-sectional study of evaluative
nature and integrates the National Research of Access, Use and Promotion of Rational Use of Drugs
(PNAUM). Interviews were conducted with patients
and health professionals through semi-structured
questionnaires in SUS primary health care services.
Drugs were described by the Brazilian nonproprietary
name and classified according to the fifth level of the
Anatomical Therapeutic Chemical Index (ATC). Absolute and relative frequencies were used to describe
the variables, using the plan of complex sample analysis. For comparison of the groups, the Pearson chisquare test was used. The association between use
of statins and sociodemographic variables and indicators of health conditions was assessed by logistic regression model. The variables selected in the
univariate models (p-value ≤0.20) were included in
the multivariate model, where remained those with
p-value <0.05. The quality of model was checked
by the Hosmer–Lemeshow test.
Results: The prevalence of statins use among drug
users was 9.4% in the primary health care services.
The average of medicines used per person was 4.1.
The most used drugs were simvastatin (90.3% CI
95% 84.2–94.2), atorvastatin (4.7% CI 95% 1.7–
12.4) and rosuvastatin (1.9% CI 95% 0.9–3.9). However, rosuvastatin is not included in the national list
of essential medicines. Statins use was significantly associated with age 45–64 years old (OR 2.49), the
caucasian race (OR 1.40), presence of metabolic disorders (OR 9.67), diseases of the circulatory system (OR
1.47) and polypharmacy (five or more drugs used)
(OR 9.35).
Conclusions: The average of medicines used per
person and the association between polypharmacy
and statins use may be related to inappropriate use
of drugs. This study provides elements for the improvement of safe prescription practices and to qualify the use of medicines in the SUS primary health
care.
Abstract
Assunto
Estatinas, Atenção Primária à Saúde
Palavras-chave
Estatinas, Atenção Primária à Saúde
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Curso
Endereço externo
https://onlinelibrary.wiley.com/doi/full/10.1002/pds.4275