Table1_Barriers and Facilitators in Access to Diabetes, Hypertension, and Dyslipidemia Medicines: A Scoping Review.XLSX

Objective: Identify barriers and facilitators in access to medicines for diabetes, hypertension, and dyslipidemia, considering patient, health provider, and health system perspectives.
Methods: Scoping review based on Joanna Briggs methodology. The search considered PubMed, Cochrane Library, CINAHL, Academic Search Ultimate, Web of Science, SciELO Citation Index, and grey literature. Two researchers conducted screening and eligibility phases. Data were thematically analyzed.
Results: The review included 219 documents. Diabetes was the most studied condition; most of the evidence comes from patients and the United States. Affordability and availability of medicines were the most reported dimension and specific barrier respectively, both cross-cutting concerns. Among high- and middle-income countries, identified barriers were cost of medicines, accompaniment by professionals, long distances to facilities, and cultural aspects; cost of transportation emerges in low-income settings. Facilitators reported were financial accessibility, trained health workers, medicines closer to communities, and patients’ education.
Conclusion: Barriers and facilitators are determined by socioeconomic and cultural conditions, highlighting the role of health systems in regulatory and policy context (assuring financial coverage and free medicines); providers’ role bringing medicines closer; and patients’ health education and disease management.

研究目标：明确糖尿病、高血压及血脂异常（dyslipidemia）患者的药物可及性障碍与促进因素，同时兼顾患者、医疗服务提供者与医疗体系三方视角。
研究方法：采用基于乔安娜·布里格斯研究方法（Joanna Briggs Methodology）的范围综述设计。检索范围涵盖PubMed、Cochrane Library、CINAHL、Academic Search Ultimate、Web of Science、SciELO引文索引（SciELO Citation Index）及灰色文献。由两名研究人员独立完成文献筛选与资格审查流程，并采用主题分析法对数据进行分析。
研究结果：本次综述共纳入219篇文献。其中糖尿病是被研究最为广泛的疾病，绝大多数研究证据来自患者视角与美国地区。药物可负担性与可及性分别为被报道最多的维度与具体障碍，二者均为跨领域的共性问题。在高收入与中等收入国家中，已识别的可及性障碍包括药物成本、缺乏专业人员照护、就医路程遥远以及文化因素；在低收入国家场景中，交通成本成为突出障碍。已报道的促进因素包括经济可及性保障、经过培训的医护人员、社区周边可获取药物以及患者健康教育。
研究结论：药物可及性的障碍与促进因素由社会经济与文化条件共同决定，研究重点凸显了三方面的关键作用：一是医疗体系在监管与政策层面的职能，即保障医保覆盖与免费药物供给；二是医疗服务提供者优化药物布局、拉近可及性的职责；三是患者健康教育与疾病自我管理的重要价值。