Profile of patients in use of direct oral anticoagulants treated via judicial in a medium-sized municipality of the state of Minas Gerais
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2022.194887Keywords:
Health's Judicialization, Pharmacovigilance, Direct acting oral anticoagulants, WarfarinAbstract
Fundamentals: The Brazilian health system is based on the principles established in the Federal Constitution, which include equality, universality, equity and popular participation, in a completely free health model. Brazil is in great challenge to offer quality care to the entire population. It is often necessary to ask the court for support to gain access to public health. Among the lawsuits involving health issues, the majority refer to the supply of medicines. Among the drugs requested, direct oral anticoagulants (DOACs) stand out, which indicate that they have better safety and similar efficacy in relation to warfarin, a standardized medication in the SUS for the treatment of venous thromboembolism (VTE) and atrial fibrillation (AF). Objective: To assess the profile of patients and requests for direct oral anticoagulants (DOACs) served by court. Methods: Descriptive documental study carried out in Divinópolis/MG from of all cases judged with a favorable opinion by the court regarding the request of DOACs. Data collection was carried out from three secondary sources: court proceedings, medical records of patients in basic health units and in the Health Information System (SIS). Results: A total of 74 processes referring to the request of DOACs in the city of Divinópolis-MG were included in the study. It was observed that 74.3% of the individuals were female, with a mean age of 70 years. The most common diagnosis was atrial fibrillation (36.5%). About 52.7% of physicians reported that there was a therapeutic attempt with warfarin before the introduction of DOACs and convenience (24.3%) was the most used justification for choosing DOACs, followed by difficulty in controlling the INR (20.3%). Another finding was that 25.7% of the patients never obtained the medication requested through the courts at the SUS pharmacy. Conclusion: We conclude that the judicial demand that drowns both the judicial system and the health system could be avoided if the recommendations of the National Commission for the Incorporation of Technologies in the Unified Health System were followed to establish the distribution of health education. In addition, in court proceedings important information is lacking to assist the judge in issuing an opinion and are most often based on only one medical opinion.
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