Statin use in Brazil : findings and implications.

Abstract

Introduction and objectives: Stains 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. Prevalence of statin use and statins’ self-reported adherence were determined amongst medicine users. The association between statin use and sociodemographic/health condition variables were assessed using logistic regression. Results: 8,803 patients were interviewed; of which, 6,511 were medicines users. The prevalence of statins use was 9.4% with simvastatin (90.3%), atorvastatin (4.7%) and rosuvastatin (1.9%) the most used statins. Poor adherence was described by 6.5% of patients. Statins 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.