ABC Heart Fail Cardiomyop 2023; 3(4): e20230087
Availability of Natriuretic Peptide Testing in Primary Public Health Care in Brazil
Andressa Araujo Braga
, Marisa da Silva Santos
, Bernardo Rangel Tura
, Bruno Monteiro Barros
, Quenia Cristina Dias Morais
, Ione Gualandi Oliveira
Abstract
Background:
Early detection of heart failure makes it possible to intervene in risk factors, and treatment is capable of modifying the natural history of the disease. For diagnostic confirmation, natriuretic peptide (NP) testing or transthoracic echocardiography can be performed; the former is preferable when considering cost and accessibility. Although this test was incorporated into the Brazilian Unified Health System (SUS) in 2018, requests for this test were registered in only 4.63% of municipalities in the SUS Outpatient Information System (SIA/SUS) in 2022. This leads to difficulties in both heart failure diagnosis and access to specific treatments, given that the use of sacubitril valsartan sodium depends on the performance of this test.
Objective:
To evaluate the availability of NP testing in the SUS.
Methods:
Cross-sectional study carried out by means of telephone contact with a probabilistic sample of 255 Brazilian municipal health departments.
Results:
NP testing was reported as available in 20.78% (53/255) of contacts, either within the municipality (16.86% [43/255]) or in the reference municipality (3.92% [10/255]), while 78.04% (199/255) of interviewees reported that the test was not available through the SUS.
Conclusion:
Although NP testing has been incorporated into the SUS since 2018, we observed that the test was available in 12.23% of municipalities, in addition to those that actually registered a request in the SIA/SUS during the year studied (2022). This suggests that, in addition to the fact that the test is not offered in a uniform manner throughout the country, there are still municipalities where the test is available, but its use has not been registered.
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