# From diagnosis to daily life: A comparative pilot study on healthcare access and challenges for neurofibromatosis type 1 in public systems of Brazil and Portugal

## TL;DR

This study compares healthcare access and challenges for neurofibromatosis type 1 patients in Brazil and Portugal, finding similar barriers despite economic differences.

## Contribution

First comparative study on NF1 patient experiences in the public health systems of Brazil and Portugal.

## Key findings

- Portuguese patients had lower genetic and health literacy than Brazilian patients.
- Access to neurologists and psychiatrists was a major barrier in both countries.
- Both countries face similar challenges in multidisciplinary care for NF1.

## Abstract

•First study of NF1 patient experiences in the health systems of Brazil and Portugal.•Portuguese patients showed lower genetic and health literacy than Brazilians.•Access to neurologists and psychiatrists was a key barrier in both countries.•Despite economic differences, both nations face similar barriers in multidisciplinary care.•Findings highlight urgent need for national NF1 data and structured care pathways.

First study of NF1 patient experiences in the health systems of Brazil and Portugal.

Portuguese patients showed lower genetic and health literacy than Brazilians.

Access to neurologists and psychiatrists was a key barrier in both countries.

Despite economic differences, both nations face similar barriers in multidisciplinary care.

Findings highlight urgent need for national NF1 data and structured care pathways.

Neurofibromatosis type 1 is a systemic genetic disease with manifestations that include neurocognitive alterations. The disease's characteristics influence various areas of the lives of affected individuals, regardless of their place of residence.

This study compares the experiences of a small group of patients with type 1 neurofibromatosis in two public hospitals in Brazil and Portugal.

This is an exploratory, cross-sectional, and descriptive study. Patients of legal age or those responsible for underage patients were included in a health service in the Clinical Hospital of the State University of Campinas in Brazil and the Clinical Academic Center of Coimbra in Portugal. They answered an online form about quality of life and access to health.

18 participants were included, 13 Brazilians and 5 Portuguese. Most were female and had a mean age at diagnosis of 8.2-years. The mean age of Brazilians was 9.1-years for the first consultation with a geneticist and 15.5-years among Portuguese. The average number of professionals accessed was 4.5 among Brazilians and 3.8 among Portuguese.

Small sample size, restricted temporal aspect, convenience bias of participants with internet access, and self-declaration of data by participants.

Both Brazilians and Portuguese participants with neurofibromatosis type 1 presented similar difficulties regarding access to health. The differences found between the participants from both countries focus on access to medical geneticists and their health literacy. Expanding studies would help identify care priorities related to the specificities of NF1 that could improve the quality of life of affected individuals.