Treatments used by chronic obstructive pulmonary disease patients in Brazil: National Survey of Health, 2013

Authors

DOI:

https://doi.org/10.11606/s1518-8787.2022056004090

Keywords:

Pulmonary Disease, Chronic Obstructive, epidemiology, Bronchitis, Chronic, Pulmonary Emphysema, Disease Management, Health Surveys

Abstract

OBJECTIVE: To estimate the prevalence of treatments used for the management of chronic obstructive pulmonary disease (COPD) in the Brazilian adult population. METHODS: A population-based cross-sectional study with data from the 2013 Brazilian National Survey of Health, including individuals aged 40 years or older, with a self-reported medical diagnosis of COPD, chronic bronchitis and/or emphysema, who were asked about treatments used for disease management. RESULTS: A total of 60,202 adults were interviewed, of which 636 were 40 years of age or older and had reported a medical diagnosis of COPD, emphysema, or chronic bronchitis. Less than half (49.4%) of the diagnosed population reported using some type of treatment, with differences regarding the macro-region of the country (South 53.8% – Northeast 41.2%, p = 0.007). Pharmacological treatment was the most reported, and emphysema patients had the highest proportion of those undergoing more than one type of treatment. Among the individuals who reported having only chronic bronchitis, 55.1% (95%CI: 48.7–61.4) used medication, 4.7% (95%CI: 2.6–8.3) underwent physical therapy, and 6.0% (95%CI: 3.6–9.9) oxygen therapy. On the other hand, among the emphysema patients, 44.1% (95%CI: 36.8–51.7) underwent drug treatment, 8.8% (95%CI: 5.4–14.2) physical therapy, and 10.0% (95%CI: 6.3–15.6) oxygen therapy. CONCLUSION: The prevalence of treatments for COPD management was below ideal in 2013. The pharmacological treatment was the main type of treatment, followed by oxygen therapy and physical therapy.

References

GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789-858. https://doi.org/10.1016/S0140-6736(18)32279-7

Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2021 Report. Estados Unidos da América; 2020 [citado 20 nov 2020]. Disponível em: https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.0-11Nov20_WMV.pdf

Fernandes FLA, Cukier A, Camelier AA, Fritscher CC, Costa CH, Pereira EDB, et al. Recommendations for the pharmacological treatment of COPD: questions and answers. J Bras Pneumol. 2017;43(4):290-301. https://doi.org/10.1590/S1806-37562017000000153

Pinto CR, Lemos ACM, Assunção-Costa L, Alcântara AT, Yamamura LLL, Souza GS, et al. Management of COPD within the Brazilian Unified Health Care System in the state of Bahia: an analysis of real-life medication use patterns. J Bras Pneumol. 2019;45(1):e20170194. https://doi.org/10.1590/1806-3713/e20170194

Humenberger M, Horner A, Labek A, Kaiser B, Frechinger R, Brock C, et al. Adherence to inhaled therapy and its impact on chronic obstructive pulmonary disease (COPD). BMC Pulm Med. 2018;18(1):163. https://doi.org/10.1186/s12890-018-0724-3

Moreira GL, Manzano BM, Gazzotti MR, Nascimento OA, Perez-Padilla R, Menezes AMB, et al. PLATINO, estudo de seguimento de nove anos sobre DPOC na cidade de São Paulo: o problema do subdiagnóstico. J Bras Pneumol. 2013;40(1):30-7. https://doi.org/10.1590/S1806-37132014000100005

Souza-Júnior PRB, Freitas MPS, Antonaci GA, Szwarcwald CL. Desenho da amostra da Pesquisa Nacional de Saúde 2013. Epidemiol Serv Saude. 2015;24(2):207-16.

Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional de Saúde, 2013: percepção do estado de saúde, estilos de vida e doenças crônicas: Brasil, grandes regiões e unidades da Federação. Rio de Janeiro: IBGE; 2014.

Menezes A, Wehrmeister F, Perez-Padilla R, Viana K, Soares C, Müllerova H, et al. The PLATINO study: description of the distribution, stability, and mortality according to the Global Initiative for Chronic Obstructive Lung Disease classification from 2007 to 2017. Int J Chron Obstruct Dis. 2017;12:1491-501. https://doi.org/10.2147/COPD.S136023

Barros AJD, Victora CG. Indicador econômico para o Brasil baseado no censo demográfico de 2000. Rev Saude Publica. 2005;39(4):523-9. https://doi.org/10.1590/S0034-89102005000400002

Dilélio AS, Tomasi E, Thumé E, Silveira DS, Siqueira FCV, Piccini RX, et al. Padrões de utilização de atendimento médico-ambulatorial no Brasil entre usuários do Sistema Único de Saúde, da saúde suplementar e de serviços privados. Cad Saude Publica. 2014;30(12):2594-606. https://doi.org/10.1590/0102-311X00118713

Malta DC, Stopa SR, Szwarcwald CL, Gomes NL, Silva Júnior JB, Reis AAC. A vigilância e o monitoramento das principais doenças crônicas não transmissíveis no Brasil - Pesquisa Nacional de Saúde, 2013. Rev Bras Epidemiol. 2015;18 Supl 2:3-16. https://doi.org/10.1590/1980-5497201500060002

Rogliani P, Ora J, Puxeddu E, Matera MG, Cazzola M. Adherence to COPD treatment: myth and reality. Respir Med. 2017;129:117-23. https://doi.org/10.1016/j.rmed.2017.06.007

Belleudi V, Di Martino M, Cascini S, Kirchmayer U, Pistelli R, Formoso G, et al. The impact of adherence to inhaled drugs on 5-year survival in COPD patients: a time dependent approach. Pharmacoepidemiol Drug Saf. 2016;25(11):1295-304. https://doi.org/10.1002/pds.4059

Pessôa CLC. Tratamento do tabagismo em pacientes com DPOC. Pulmão RJ. 2017;26(1):33-8.

Sales MPU, Araújo AJ, Chatkin JM, Godoy I, Pereira LFF, Castellano MVCO, et al. Update on the approach to smoking in patients with respiratory diseases. J Bras Pneumol. 2019;45(3):e20180314. https://doi.org/10.1590/1806-3713/e20180314

Sousa CA, César CLG, Barros MBA, Carandina L, Goldbaum M, Pereira JCR. Doença pulmonar obstrutiva crônica e fatores associados em São Paulo, SP, 2008-2009. Rev Saude Publica. 2011;45(5):887-96. https://doi.org/10.1590/S0034-89102011005000051

Leal LF, Bertoldi AD, Menezes AMB, Borges RB, Mengue SS, Gazzana MB, et al. Indicação, acesso e utilização de medicamentos para doenças respiratórias crônicas no Brasil: resultados da Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM), 2014. Cad Saude Publica. 2018;34(10):e00202817. https://doi.org/10.1590/0102-311x00208217

Gonçalves-Macedo L, Lacerda EM, Markman-Filho B, Lundgren FLC, Luna CF. Trends in morbidity and mortality from COPD in Brazil, 2000 to 2016. J Bras Pneumol. 2019;45(6):e20180402. https://doi.org/10.1590/1806-3713/e20180402

Silva RM, Caetano R. Programa ‘Farmácia Popular do Brasil’: caracterização e evolução entre 2004-2012. Cienc Saude Colet. 2015;20(10):2943-56. https://doi.org/10.1590/1413-812320152010.17352014

Drummond ED, Simões TC, Andrade FB. Acesso da população brasileira adulta a medicamentos prescritos. Rev Bras Epidemiol. 2018;21:e180007. https://doi.org/10.1590/1980-549720180007

Pinto LF, Giovanella L. Do Programa à Estratégia Saúde da Família: expansão do acesso e redução das internações por condições sensíveis à atenção básica (ICSAB). Cienc Saude Colet. 2018;23(6):1903-14. https://doi.org/10.1590/1413-81232018236.05592018

Kauling GP, Ceretta LB, Schwalm MT, Dagostin VS, Soratto MT. Utilização de medicamentos: limites e possibilidades das orientações dos Agentes Comunitários de Saúde às famílias. Mundo Saude. 2013;37(1):44-55.

Montes de Oca M, Menezes A, Wehrmeister FC, Lopez Varela MV, Casas A, Ugalde L, et al. Adherence to inhaled therapies of COPD patients from seven Latin American countries: The LASSYC study. PLoS One. 2017;12(11):e0186777. https://doi.org/10.1371/journal.pone.0186777

Dimitrova A, Izov N, Maznev I, Vasileva D, Nikolova M. Рhysiotherapy in patients with chronic obstructive pulmonary disease. Open Access Maced J Med Sci. 2017;5(6):720-3. https://doi.org/10.3889/oamjms.2017.176

Castro AP, Neves VR, Aciole GG. Diferenças regionais e custos dos procedimentos de fisioterapia no Sistema Único de Saúde do Brasil, 1995 a 2008. Rev Panam Salud Publica. 2011;30(5):469-76.

Ryrsø CK, Godtfredsen NS, Kofod LM, Lavesen M, Mogensen L, Tobberup R, et al. Lower mortality after early supervised pulmonary rehabilitation following COPD-exacerbations: a systematic review and meta-analysis. BMC Pulm Med. 2018;18(1):154. https://doi.org/10.1186/s12890-018-0718-1

Ministério da Saúde (BR), Secretaria de Atenção à Saúde. Portaria SAS/MS Nº 609, de 6 de junho de 2013, retificada em 14 de junho de 2013. Aprova o Protocolo Clínico e Diretrizes Terapêuticas - Doença Pulmonar Obstrutiva Crônica. Brasília, DF; 2013.

Fernandes FLA, Cukier A, Camelier AA, Fritscher CC, Costa CH, Pereira EDB, et al. Recomendações para o tratamento farmacológico da DPOC: perguntas e respostas. J Bras Pneumol. 2017;43(4):290-301. https://doi.org/10.1590/s1806-375620170000001

Malta DC, Bernal RTI, Lima MG, Araújo SSC, Silva MMA, Freitas MIF, et al. Noncommunicable diseases and the use of health services: analysis of the National Health Survey in Brazil. Rev Saude Publica. 2017;51 Suppl 1:4s https://doi.org/10.1590/s1518-8787.2017051000090

Published

2022-12-07

Issue

Section

Original Articles

How to Cite

Marques, G. Ávila, Oliveira, P. D. de, Montzel, M., Menezes, A. M. B., Malta, . D. C., Sardinha, L. M. V., & Wehrmeister, F. C. (2022). Treatments used by chronic obstructive pulmonary disease patients in Brazil: National Survey of Health, 2013. Revista De Saúde Pública, 56, 119. https://doi.org/10.11606/s1518-8787.2022056004090

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