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Abstract(s)
A DM é um grave problema mundial de saúde pública devido à sua elevada incidência e prevalência, sendo considerada uma das principais causas de morbilidade e mortalidade. Está associada a diversas complicações, nomeadamente a RD que constitui, atualmente, a principal causa de cegueira nos países ocidentais. A deficiência visual consequente da RD pode ser evitada se for diagnosticada e tratada precocemente. A prevenção da RD é fundamental e o rastreio é a forma mais efetiva de evitar a deficiência visual. O principal objetivo deste trabalho de investigação é comparar os custos suportados com a deficiência visual devido à RD com os custos associados à sua prevenção, onde se inclui o rastreio. Foi realizada uma revisão sistemática da literatura de acordo com as diretrizes PRISMA no período 2007-2018. Foram utilizados os motores de busca PubMed, ScienceDirect e RCAAP e incluídos na revisão sistemática 16 artigos, dos quais 3 são revisões sistemáticas e 13 avaliações económicas. O rastreio da RD é abordado em 11 dos artigos e os custos associados à deficiência visual em 5 artigos. Os resultados destes estudos mostram que um programa de rastreio da RD é sempre mais custo-efetivo e apresenta melhores QALYs em comparação com a inexistência de rastreio. A telemedicina é um método de rastreio que é económico e de mais fácil acesso à população. Relativamente à periodicidade do rastreio, a maioria dos estudos concluiu que o rastreio anual em indivíduos que apresentam estadios severos de RD é o ideal. Em indivíduos sem RD ou com RD não proliferativa ligeira deve ser considerado um rastreio a cada 2/3 anos. Quanto à deficiência visual esta acarreta elevados custos, nomeadamente custos médicos diretos e perdas de produtividade, para o indivíduo e para a sociedade. A prevenção da RD é fundamental visto que os custos associados são inferiores aos custos que a deficiência visual acarreta.
DM is a serious worldwide public health problem due to its high incidence and prevalence, being considered a major cause of morbidity and mortality. It is associated with several complications, namely DR, which is currently the leading cause of blindness in Western countries. Visual impairment resulting from DR can be avoided if the disease is diagnosed and treated early. DR prevention is crucial and screening is the most effective way to avoid visual impairment. The main aim of this Master Thesis is to compare the costs with visual impairment due to DR with the costs associated with is prevention, including screening. A systematic review of the literature was carried out in the 2007-2018 period using PRISMA guidelines. The PubMed, Science Direct and RCAAP search engines were used. The systematic review includes 16 articles, of which 3 are systematic reviews and 13 are economic evaluations. DR screening is addressed in 11 of the articles and the costs associated with visual impairment in 5 of the articles. The results of these studies show that a DR screening program is always more cost-effective and has better QALYs compared to the absence of screening. Telemedicine is a screening method that is affordable and accessible to the population. Regarding the frequency of the screening, most of the studies concluded that annual screening in individuals with severe DR stages is ideal. In individuals without DR or with mild non-proliferative DR the screening should be considered every 2/3 years. As for visual impairment, this entails high costs, namely direct medical costs and productivity losses, for the individual and for society. DR prevention is fundamental since the associated costs are lower than the costs that with visual impairment.
DM is a serious worldwide public health problem due to its high incidence and prevalence, being considered a major cause of morbidity and mortality. It is associated with several complications, namely DR, which is currently the leading cause of blindness in Western countries. Visual impairment resulting from DR can be avoided if the disease is diagnosed and treated early. DR prevention is crucial and screening is the most effective way to avoid visual impairment. The main aim of this Master Thesis is to compare the costs with visual impairment due to DR with the costs associated with is prevention, including screening. A systematic review of the literature was carried out in the 2007-2018 period using PRISMA guidelines. The PubMed, Science Direct and RCAAP search engines were used. The systematic review includes 16 articles, of which 3 are systematic reviews and 13 are economic evaluations. DR screening is addressed in 11 of the articles and the costs associated with visual impairment in 5 of the articles. The results of these studies show that a DR screening program is always more cost-effective and has better QALYs compared to the absence of screening. Telemedicine is a screening method that is affordable and accessible to the population. Regarding the frequency of the screening, most of the studies concluded that annual screening in individuals with severe DR stages is ideal. In individuals without DR or with mild non-proliferative DR the screening should be considered every 2/3 years. As for visual impairment, this entails high costs, namely direct medical costs and productivity losses, for the individual and for society. DR prevention is fundamental since the associated costs are lower than the costs that with visual impairment.
Description
Keywords
Retinopatia diabética Deficiência visual Rastreio Diabetic retinopathy visual impairment Cost-benefit