Department of Global Health, Boston University School of Public Health, Boston, MA, USA.
School of Public Health, Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa.
Trop Med Int Health. 2018 Aug;23(8):879-885. doi: 10.1111/tmi.13081. Epub 2018 Jun 14.
To assess access to noncommunicable diseases (NCD) medicines in Kenya for patients diagnosed and prescribed treatment for asthma, diabetes and hypertension.
Households in eight purposively chosen counties were randomly selected. To be eligible, a household needed to have at least one member aged 18 years or older who had been previously diagnosed and prescribed medicines for one of the following NCDs: asthma, diabetes or hypertension. Using a logistic regression model, we explored the relationship between patient characteristics and the probability that patients had the medicines available at the time of the survey visit.
A total of 627 individuals were included in the analysis. The highest percentage of medicines availability was in households with diabetes patients (83.1%), followed by hypertension (77.1%) patients. The lowest availability of medicines was found in households with asthma patients (53.1%). The median household expenditure on medicines per month was US$7.00 for households with diabetes patients; it was US$4.00 for asthma. In general, strong predictors of having medicines at home was being older, having some education compared to no education, few household members, wealth, being diagnosed at private nonprofit facilities and having only one patient with NCDs in the household.
Our study found that nearly three-quarters of patients diagnosed and prescribed a medicine for hypertension, asthma or diabetes had the medicine available at home. Access challenges remain, in particular for patients from low-income households and for those diagnosed with asthma.
评估肯尼亚患有哮喘、糖尿病和高血压的患者获得非传染性疾病（NCD）药物的情况。
在八个有目的选择的县中，随机选择家庭。一个家庭需要至少有一名 18 岁或以上的成员，该成员曾被诊断出患有以下 NCD 之一，并开具了药物治疗：哮喘、糖尿病或高血压。我们使用逻辑回归模型，探讨了患者特征与患者在调查访问时是否有药物可用的概率之间的关系。
共有 627 人纳入分析。药品可获得性最高的是糖尿病患者家庭（83.1%），其次是高血压患者家庭（77.1%）。哮喘患者家庭的药品可获得性最低（53.1%）。每月每户用于药品的家庭支出中位数为糖尿病患者家庭 7 美元；哮喘患者家庭为 4 美元。一般来说，家中有药物的强预测因素是年龄较大、与无教育相比有一定教育程度、家庭成员较少、富有、在私立非营利性机构诊断以及家中只有一名 NCD 患者。
我们的研究发现，近四分之三被诊断出患有高血压、哮喘或糖尿病并开具药物治疗的患者在家中备有药物。获得药物的挑战仍然存在，特别是对于来自低收入家庭的患者和被诊断出患有哮喘的患者。
