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BIBTEX RIS

University and Public Health System Partnership: A Systematic Intervention for Assistance of Patients with Asthma in Brazil

2013; Elsevier BV; Volume: 131; Issue: 2 Linguagem: Inglês

10.1016/j.jaci.2012.12.1508

1097-6825

Marcos Reis Gonçalves, Janaína Michelle Lima Melo, Adriana S. Moreno, Virgínia Paes Leme Ferriani, Ana Carla Sousa Araújo, Élcio Oliveira Vianna, Marcos de Carvalho Borges, Pérsio Roxo Júnior, Rosa Gomes dos Santos Ferreira, Luane Marques de Mello, Jorgete Silva, Patricia Stefanelli, Larissa Bertacchini de Oliveira, Andrea Vernier, Luana Queiroz, Rosangela Villela, Marina M. Dias, Davi Casale Aragon, Nélio Augusto Mesquita Domingos, L. Karla Arruda,

School Health and Nursing Education

Despite existence of guideline resources, diagnosis and management of asthma remains a challenge in real world. We aimed to asses outcomes of a one-year capacitation program on asthma for non-specialists working in the Public Health System in Brazil. A group of 16 allergists/immunologists developed a capacitation program in 11 Public Health Units. The program comprised lectures on asthma and hands-on training on spirometry and use of inhalation devices; production of didactic material; and development of a protocol on management of asthma. Spacers and spirometry were provided. Each researcher visited one Health Unit 2-4 times a month, to accompany the non-specialist on patients visits to the clinic, perform case discussions, and deliver short lectures to the health professionals. Records of asthma medications provided to patients upon physicians′ prescription in the North District were compared to those from three other Districts with no intervention. At baseline, prescription of Beclomethasone 250mcg/puff was 3.4% higher in intervention group as compared to controls, and no significant increases were observed after one year. Prescription of Beclomethasone 50 mcg/puff (children 5 years-old and younger, per protocol) increased 3.6% after one year, being zero before the program. There was increase in prescription of Albuterol spray (10.4%x5.5%, intervention x controls), which paralleled decrease in prescriptions of Albuterol syrup, Albuterol oral tablets and oral Aminophylline (-3.7%x-1.2%;-2.8%x0.2%;-5.9%x-2.8%, p < 0.01, respectively). A systematic capacitation program was successful in decreasing oral bronchodilators and increasing inhaled Albuterol as rescue medication, however more emphasis on the use of inhaled corticosteroids may be necessary.