Nucleus for Pharmaceutical Policies, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil.
BMJ Open. 2013 May 3;3(5):e002224. doi: 10.1136/bmjopen-2012-002224.
To assess scientific publication and map research gaps on access to medicines (ATM) in Latin American and the Caribbean low-income and middle-income countries (LMIC).
Scoping review. Two independent reviewers assessed studies for inclusion and extracted data from each study.
Search strategies were developed and the following databases were searched: MEDLINE, ISI, SCOPUS and Lilacs, from 2000 to 2010.
Research articles and reviews published in English, Spanish and Portuguese were included. Studies including only high-income countries were excluded, as well as those carried out in very limited settings and discussion papers.
The 77 articles retained were categorised through consensus among the research team according to the level of the health system addressed, ATM domain and research issues covered. Publications on ATM have increased over time during the study period (r 0.93, p=0.00; R(2) 0.85). The top five countries covered were Brazil (68.8%), Mexico (15.6%), Colombia (11.7%), Argentina (10.4%) and Peru (10.4%). 'Health services delivery' and 'patients, household and communities' were the health system levels most frequently covered. The ATM domains 'leadership and governance', 'sustainable financing, affordability and price of medicines', 'medicines selection and use' and 'availability of medicines' were the top four explored. There are research gaps in important areas such as 'human resources for health', 'global policies and human rights', 'production of medicines' and 'traditional medicine'.
The upward trend on scientific publication reflects a growing research capacity in the region, which is concentrated on research teams in selected countries. The gaps on research capacity could be overcome through research collaboration among countries. It is important to strengthen these collaborations, assuring that interests and needs from the LMIC are addressed and local capacity building is promoted.
评估拉丁美洲和加勒比低收入和中等收入国家（LMIC）获取药物（ATM）方面的科学出版物并绘制研究空白图。
范围综述。两名独立评审员评估纳入研究的标准，并从每项研究中提取数据。
制定了搜索策略，并搜索了以下数据库：2000 年至 2010 年间的 MEDLINE、ISI、SCOPUS 和 Lilacs。
纳入发表在英语、西班牙语和葡萄牙语的研究文章和综述。排除仅包括高收入国家的研究，以及在非常有限的环境中进行的和讨论文件。
通过研究团队之间的共识，根据所涉及的卫生系统水平、ATM 领域和所涵盖的研究问题，对保留的 77 篇文章进行了分类。在研究期间，ATM 方面的出版物呈增长趋势（r 0.93，p=0.00；R(2) 0.85）。涵盖的前五个国家是巴西（68.8%）、墨西哥（15.6%）、哥伦比亚（11.7%）、阿根廷（10.4%）和秘鲁（10.4%）。最常涵盖的卫生系统层面是“卫生服务提供”和“患者、家庭和社区”。ATM 领域“领导和治理”、“可持续筹资、药物可负担性和价格”、“药物选择和使用”以及“药物供应”是探索最多的前四个领域。在重要领域，如“卫生人力资源”、“全球政策和人权”、“药物生产”和“传统医学”，存在研究空白。
科学出版物呈上升趋势反映了该地区研究能力的增长，这些研究主要集中在选定国家的研究团队中。可以通过国家间的研究合作来克服研究能力方面的差距。加强这些合作非常重要，确保解决 LMIC 的利益和需求，并促进当地能力建设。
