Use of statins in primary health care – Brazil

• Autor(a) principal: Renata Cristina Rezende Macedo do Nascimento
• Data de Publicação: 2017
• Outros Autores: Juliana Alvares, Augusto Afonso Guerra Júnior, Francisco de Assis Acurcio
• Tipo de documento: Artigo de conferência
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.1002/pds.4275; http://hdl.handle.net/1843/46348
• topic: Estatinas; Atenção Primária à Saúde; Estatinas; Atenção Primária à Saúde

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.