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Availability and accessibility to heart failure treatment in latin america

Session Poster Session 2

Speaker Stephania Galindo

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure – Treatment
  • Session type : Poster Session

Authors : SGC Stephania Galindo Coral (Cali,CO), JEG Juan Esteban Gomez Mesa (Cali,CO)

Authors:
SGC Stephania Galindo Coral1 , JEG Juan Esteban Gomez Mesa2 , 1Valle del Lili Foundation, Cardiology Department and Clinical Research Center - Cali - Colombia , 2Valle del Lili Foundation, Heart Failure/Cardiology department - Cali - Colombia ,

On behalf: CIFACAH investigators

Citation:

Introduction: Economic deprivation is considered an independent risk factor for Heart Failure (HF), beside this, there are other specific risk factors with greater incidence in Latin America (LA), such as hypertension, rheumatic fever and chagas disease. Prevalence of HF in LA is estimated in 1.0-2.0%. Decreased hospitalization and mortality are related to adherence to guideline-directed medical therapy (GDMT) and cardiac devices.

Purpose: Inadequate access to HF therapies deteriorates quality of life, increases hospitalization and mortality. This paperwork aims to reveal data about treatment access in LA; this information will help to generate new health policies and fulfill the specific needs for each country. 

Methods: A descriptive observational study was conducted in 19 countries of LA. A structured questionnaire was sent to each national coordinator of the Council of Heart Failure and Pulmonary Hypertension of the Interamerican Society of Cardiology. This questionnaire evaluated "availability" (available: yes, no) and "accessibility" (type of access: public, private, patient, donation or research) to 21 pharmacological agents , cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT). Data was collected since January 2017 until June 2018.

Results: All countries had "Availability" to cardiac devices (Table 1)and to, at least, one of the GDMT options. Public access (ideal coverage) to at least 50% of all therapies was found in 52.6% of countries (Figure 1) and patient access to at least 50% of all available therapies was found in 15.8% of countries.

Conclusion: LA has availability to, at least, one option for each of the GDMT therapies in HF patients. Public access is high for dobutamine (84.2%), moderate for devices (63% and 57.9% for CRT and ICD), and low for new GDMT options (21.1% for Ivabradine and ARNi: Sacubitril/Valsartan). Donation and research are still needed to access some treatments in some countries. Results will help health authorities and cardiovascular institutions to overcome economic deprivation effects and reach higher accessibility to GDMT and devices in each country.

Type of access ICD n(%) CRT n(%)
Public 12(63,2) 11(57,9)
Private 4(21) 5(26,3)
Patient 2(10,5) 2(10,5)
Research - -
Donation 1(5,3) 1(5,3)
Not available - -

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