“I WON´T DO MY ROUTINE CHECK UP” – NEEDLE PHOBIA, A COMMON OBSTACLE TO HEALTH CARE
Needle phobia is a condition that affects about 10% of the population according to international studies. These patients avoid health care for most of their life, which is a major impediment for primary and secondary health care. The etiology of this phobia is based on the vasovagal reflex caused by the sting of the needle. Treatment of needle phobia is done through: patient education; relaxation techniques; use of benzodiazepines or topical anesthetics. METHOD: Male patient, 47 years old, unemployed, with 12 years of schooling. Clinical history: Type 2 Diabetes (since 2013) treated with oral antidiabetic medication, currently uncontrolled; Hypertension (since 2013); Medium-high global CV risk. The patient was advised to maintain a quarterly medical evaluation. However, of the 12 scheduled appointments between 2013 and 2015, the patient missed 8 (66.6%), most in the last two years. In September 2015, the patient admited his fear of being stung by a needle, and justified his absence to the last appointments due to the frequent request for blood tests. After the needle phobia was diagnosed, the patient was treated with benzodiazepines and oriented to psychological support. RESULTS AND CONCLUSIONS: This case demonstrates the importance of the family physician's role in recognizing patients with a diagnosis of needle phobia, which can be easily misinterpreted as patient´s low motivation and responsability for their health care. Collaboration with other areas of health care (nurses, psychologists) is essential to solving this problem.