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Int J Health Plann Manage ; 34(1): e46-e71, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30408231

RESUMO

OBJECTIVE: To present a systematic narrative review, informed by international experience, on the use of genomic analysis technologies in the primary care of noncommunicable chronic diseases (NCDs) during the last 20 years. METHODS: We used the methodology for conducting systematic reviews proposed by the Center for Coordination and Information on Evidence for Policies and Practices. The selected articles were organized by time, place, study design, and type of DNA sequencing. Finally, we analyzed the implications of our findings for health systems in middle-income and low-income countries focusing on a NCD high prevalence country such as México. RESULTS: Evidence concerning the use of DNA sequencing in primary care for NCDs was scarce and geographically concentrated in high-income countries. Use was limited by costs, insufficient knowledge among health care personnel, and a lack of confidence on the part of users. CONCLUSIONS: The use of DNA sequencing for primary care of NCDs is a challenge for low- and middle-income countries. More evidence is needed on cost effectiveness, public funding mechanisms, and the training of health care personnel for its implementation.


Assuntos
Países em Desenvolvimento , Testes Genéticos , Doenças não Transmissíveis/terapia , Atenção Primária à Saúde , Análise de Sequência de DNA , Predisposição Genética para Doença/genética , Humanos , Doenças não Transmissíveis/prevenção & controle , Atenção Primária à Saúde/métodos
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