An article published on the British Medical Journal Open on December 31, 2024, titled “Pathway to care, treatment and disease burden of pulmonary arterial hypertension: a real-world survey of physicians and patients in Latin America”, reports on the findings of a cross-sectional survey with retrospective data collection. A total of 246 physicians, from University/teaching hospitals, regional centres, private practices and government institutions in Argentina, Brazil, Colombia and Mexico (Argentina, n=47; Brazil, n=74; Colombia, n=56; Mexico, n=69), provided data for 958 patients, of which 533 patients also self-reported data.
The study found that 70% of patients were female and 79% presented with mild to moderate disease severity. Right heart catheterization usage varied significantly between countries, with Argentina showing the highest implementation at 92% and Brazil the lowest at 64%. Only 28% of patients received simplified risk assessments in the previous year, ranging from 46% in Argentina to 16% in Brazil.
The most commonly reported symptoms were fatigue and dyspnoea on exertion, reported by 37% and 53% of physicians respectively, while patients reported these symptoms at higher rates of 68% and 67%. The use of pulmonary arterial hypertension-specific combination therapy showed marked differences across countries, ranging from 79% in Argentina and 70% in Colombia to much lower rates of 30% in Brazil and 21% in Mexico.
Treatment patterns revealed that 73% of patients received phosphodiesterase type 5 inhibitors, followed by 52% on endothelin receptor antagonists, with lower usage of prostacyclin pathway agents (15%) and soluble guanylate cyclase stimulators (11%).
Quality of life measurements, assessed using the EQ-5D instrument, showed similar results across countries, with patients in higher WHO functional classes reporting lower quality of life scores.
The findings point to several areas for improvement in pulmonary arterial hypertension care across Latin America, including the need for standardized diagnostic approaches, better access to specialized care centers, regular quality of life assessments, and addressing barriers to optimal treatment strategies. The study suggests that focusing on these areas could significantly improve patient outcomes in the region.
Read more at this link on the BMJ Open
Citation
Orozco-Levi M, Souza R, Bluro IM, Harley J, Hernández Oropeza JL, Lescano A, Meyer G, Pineda T, Ramirez A, Small M, Valencia A, Pulido T. Pathway to care, treatment and disease burden of pulmonary arterial hypertension: a real-world survey of physicians and patients in Latin America. BMJ Open. 2024 Dec 31;14(12):e087263. doi: 10.1136/bmjopen-2024-087263. PMID: 39740943.