Urtasun Martín Alejandro, Dorati Cristian, Cañás Martín, Bruzzone María Silvina, Marín Gustavo H, Iusef Venturini Nasim, Mordujovich Buschiazzo Perla
Centro de Información de Medicamentos Fundación FEMEBA La Plata Argentina Centro de Información de Medicamentos, Fundación FEMEBA, La Plata, Argentina.
Centro Universitario de Farmacología Facultad de Ciencias Médicas Universidad Nacional de La Plata, Centro Colaborador de la OPS/OMS La Plata Argentina Centro Universitario de Farmacología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Centro Colaborador de la OPS/OMS, La Plata, Argentina.
Rev Panam Salud Publica. 2024 Feb 12;48:e3. doi: 10.26633/RPSP.2024.3. eCollection 2024.
Conduct an analysis to determine the existence and updating of national essential medicines lists (EMLs) and clinical practice guidelines (CPGs) for the treatment of diabetes in Latin America and the Caribbean (LAC); and compare the medicines included in each country's list and guidelines both with each other and with those of the World Health Organization (WHO).
Cross-sectional study. EMLs and CPGs for diabetes were found on the websites of the Pan American Health Organization and national health authorities. Medicines were noted and analyzed according to pharmacological group, based on the fourth level of nomenclature of the Anatomical Therapeutic Chemical (ATC) classification system. F1 scoring was used to assess the proximity of EMLs to the WHO Model List of Essential Medicines (MLEM).
Of the total number of countries, 87.2% have EMLs, and 91% have CPGs (78% and 45% updated in the last five years, respectively). Compared to the six hypoglycemic groups of the MLEM, the EMLs had a median (range) of 6 (4-13) and an F1 score of 0.80; This indicates proper alignment. CPGs had a median (range) of 12 (1-12) hypoglycemic drugs compared to eight in the WHO guidelines. CPGs had a median of 15 more drugs than their respective EMLs.
While most LAC countries have EMLs and CPGs for diabetes, the lack of concordance among them limits their effectiveness. It is necessary to align the processes and criteria for the development of these two tools for policymaking on medicines.
进行一项分析,以确定拉丁美洲和加勒比地区(LAC)治疗糖尿病的国家基本药物清单(EML)和临床实践指南(CPG)的存在情况及更新情况;并将每个国家清单和指南中包含的药物相互比较,以及与世界卫生组织(WHO)的药物进行比较。
横断面研究。在泛美卫生组织和国家卫生当局的网站上查找糖尿病的EML和CPG。根据解剖治疗化学(ATC)分类系统的第四级命名法,按药理组对药物进行记录和分析。使用F1评分评估EML与WHO基本药物示范清单(MLEM)的接近程度。
在所有国家中,87.2%有EML,91%有CPG(过去五年中分别有78%和45%进行了更新)。与MLEM的六个降糖药物组相比,EML的中位数(范围)为6(4 - 13),F1评分为0.80;这表明一致性良好。与WHO指南中的八种降糖药物相比,CPG的中位数(范围)为12(1 - 12)种。CPG所含药物的中位数比其各自的EML多15种。
虽然大多数LAC国家有糖尿病的EML和CPG,但它们之间缺乏一致性限制了其有效性。有必要使这两种药物政策制定工具的制定过程和标准保持一致。