The geographical access of users with diabetes and hypertension to the 'there's a people's pharmacy here' programme (atfp), brazil
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Institute of Collective Health / Federal University of Bahia Brazilian Collective Health Association (ABRASCO) R. Basílio da Gama, s/n - Canela, Salvador - BA, 40110-040 Brazil
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Faculty of Medicine - Federal University of Bahia
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Faculty of Economics - Federal University of Bahia Brazilian Collective Health Association (ABRASCO) Praça da Piedade, 06 - Dois de Julho, Salvador - BA, 40070-010 Brazil
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Institute of Collective Health / Federal University of Bahia
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A806
ABSTRACT
Introduction:
Access to medication constitutes one of the most important socio-economic challenges to treatment continuity. In Brazil, one initiative to expand access to the medication available through primary healthcare is the ‘There’s a People’s Pharmacy Here’ Programme _(Programa Aqui Tem Farmácia Popular_: ATFP), created in 2004; a partnership between the federal government and the private sector, which, since 2010, has dispensed medication to patients with hypertension and diabetes, free of charge. AIM: To identify the factors associated with geographical access to medication for the treatment of Diabetes and Hypertension in Brazil.
Methods:
An individualized, descriptive study involving all the dispensation of medication, between 2001 and 2017, for diabetes and hypertension treatment to the users of pharmacies in the Primary Healthcare Network and private retail pharmacies accredited by the ATFP Programme. We calculated the travel patterns from user households to dispensing sites, adopting 3 measures (800, 1,000 and 1,250 metres) to infer “geographically hard to access.” To obtain the differences and their respective significance, we applied Pearson’s Chi-Squared test, while Estimates of Prevalence Ratios (PR) were used to ascertain the associations between the independent variables.
Results:
Between 2010 and 2015, 961,862 medication dispensations were undertaken to treat diabetes and 3,270,635 to treat hypertension, distributed through the Primary Healthcare Network and the accredited retail pharmacies of the ATFP Programme. Across the country, the median distance travelled by users to collect their diabetes medication was 1.5 km, while for hypertension medication, it was 1.3 km. The findings reveal that most users find their medication geographically hard to access regardless of pathology and distance cut-off point.
Considerations:
An analysis of access to ATFP medication allowed us to identify that in the North, Northeast and Central-West regions, users travel greater distances to collect medications. The first two regions are the poorest in Brazil.