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The impact of an intervention to improve diabetes management in primary healthcare professionals' practices in Brazil.
da Silva Marinho, Michelly Georgia; Fontbonne, Annick; Vasconcelos Barbosa, Jessyka Mary; de Melo Rodrigues, Heloisa; Freese de Carvalho, Eduardo; Vieira de Souza, Wayner; Pessoa Cesse, Eduarda Angela.
Afiliação
  • da Silva Marinho MG; Department of Community Health, Aggeu Magalhães Research Centre, Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil.
  • Fontbonne A; UMR 204 Nutripass, Institute of Research for Development (IRD), Montpellier University, Montpellier, France. Electronic address: annick.fontbonne@ird.fr.
  • Vasconcelos Barbosa JM; Department of Community Health, Aggeu Magalhães Research Centre, Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil.
  • de Melo Rodrigues H; Department of Statistics, Federal University of Pernambuco (UFPE), Recife, Brazil.
  • Freese de Carvalho E; Department of Community Health, Aggeu Magalhães Research Centre, Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil.
  • Vieira de Souza W; Department of Community Health, Aggeu Magalhães Research Centre, Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil.
  • Pessoa Cesse EA; Department of Community Health, Aggeu Magalhães Research Centre, Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil.
Prim Care Diabetes ; 11(6): 538-545, 2017 12.
Article em En | MEDLINE | ID: mdl-28663022
AIMS: To evaluate the results of a structured intervention in primary healthcare to improve type 2 diabetes management. METHODS: The intervention was implemented in 2011-2012 in two cities in the State of Pernambuco, Brazil, and evaluated in 2013 by interviewing healthcare professionals about their practices in all primary care facilities of these two cities (intervention group), and of two paired control cities (control group). Comparisons between the intervention and control groups were made using standard parametric tests. RESULTS: The percentage of professionals who measured adherence to treatment, developed educational actions to control high-risk situations or prevent complications, or declared that they "explained" the disease to the patients, was higher in the control group (p<0.05). Multidisciplinary involvement, requests for electrocardiograms and referrals to specialists were also more frequent in the control group (p<0.01). The only differences favoring the intervention group were the higher proportion of nurses (p<0.05) and community health workers (p<0.01) trained for diabetes management and a greater frequency of discussing the cases of diabetic patients at team meetings (p<0.01). CONCLUSIONS: These negative results raise questions about the effectiveness of actions aiming to improve diabetes management in primary care, and reinforce the need for careful evaluation of their impact.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Prática Profissional / Autocuidado / Educação de Pacientes como Assunto / Avaliação de Processos em Cuidados de Saúde / Prestação Integrada de Cuidados de Saúde / Indicadores de Qualidade em Assistência à Saúde / Diabetes Mellitus Tipo 2 / Melhoria de Qualidade Tipo de estudo: Clinical_trials / Diagnostic_studies / Evaluation_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Prim Care Diabetes Assunto da revista: ENDOCRINOLOGIA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Prática Profissional / Autocuidado / Educação de Pacientes como Assunto / Avaliação de Processos em Cuidados de Saúde / Prestação Integrada de Cuidados de Saúde / Indicadores de Qualidade em Assistência à Saúde / Diabetes Mellitus Tipo 2 / Melhoria de Qualidade Tipo de estudo: Clinical_trials / Diagnostic_studies / Evaluation_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Prim Care Diabetes Assunto da revista: ENDOCRINOLOGIA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido