Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana 44036-900, Brazil.
Boehringer Ingelheim do Brasil Química e Farmacêutica, São Paulo 04794-000, Brazil.
Int J Environ Res Public Health. 2024 May 19;21(5):647. doi: 10.3390/ijerph21050647.
Delayed initiation of effective antifibrotic therapy in patients with interstitial lung diseases (ILD) may influence the progression and outcome of the disease. This study analyzes the differences in the journey of patients with ILD in the Brazilian and Mexican health systems. An evaluative study was conducted in reference centers for interstitial lung diseases in Brazil and Mexico with a panel of four specialists. The patient's journey in both countries begins when the patient seeks medical care after observing a chronic respiratory symptom. In both countries, due to diagnostic complexity, these patients arrive at ILD referral centers at an advanced stage of the disease. Once diagnosis is established, the treatment onset differs between Mexico and Brazil. In Brazil, access to antifibrotic drugs through the public health system has been a significant challenge, and their cost makes them unaffordable for most people. This situation forces medical specialists to provide only supportive care to patients until these drugs can be accessed. In Mexico, antifibrotics have been available in health sectors since 2018. Brazil and Mexico have several similarities regarding the initial journey of the patient due to diagnosis difficulties. Still, the outcome tends to be different due to a difference in access to treatment with antifibrotics. For this reason, advancing health policies that ensure proper treatment for patients with ILD is crucial for the sustainability and reliability of the health system.
在患有间质性肺疾病 (ILD) 的患者中延迟开始有效的抗纤维化治疗可能会影响疾病的进展和结果。本研究分析了巴西和墨西哥卫生系统中ILD 患者的就医路径差异。在巴西和墨西哥的间质性肺疾病参考中心进行了一项评估性研究,由一个由四名专家组成的小组进行。两国的患者就医之旅始于患者在观察到慢性呼吸道症状后寻求医疗护理时开始。在这两个国家,由于诊断的复杂性,这些患者在疾病的晚期才到达ILD 转诊中心。一旦确定诊断,巴西和墨西哥在开始治疗的时间上存在差异。在巴西,通过公共卫生系统获得抗纤维化药物一直是一个重大挑战,而且这些药物的费用使大多数人无法负担。这种情况迫使医学专家只能为患者提供支持性护理,直到可以获得这些药物。在墨西哥,自 2018 年以来,抗纤维化药物已在卫生部门中使用。由于诊断困难,巴西和墨西哥的患者在初始就医路径方面有许多相似之处。然而,由于在获得抗纤维化药物治疗方面存在差异,结果往往不同。出于这个原因,推进卫生政策以确保ILD 患者得到适当的治疗对于卫生系统的可持续性和可靠性至关重要。