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Improving Access to the Glycated Hemoglobin Test in Rural Communities With Point-of-Care Devices: An Application Study.
Camargo, Marianne Silveira; Passos, Luiz Carlos Santana; Mistro, Sostenes; Soares, Daniela Arruda; Kochergin, Clavdia Nickolaevna; de Carvalho, Vivian Carla Honorato Dos Santos; Macedo, Jéssica Caline Lemos; Cortes, Taciana Borges Andrade; de Souza, Amós Alves; Rumel, Davi; Oliveira, Marcio Galvão.
Afiliação
  • Camargo MS; Program of Post-graduation in Medicine and Health, Federal University of Bahia, Salvador, Brazil.
  • Passos LCS; Program of Post-graduation in Medicine and Health, Federal University of Bahia, Salvador, Brazil.
  • Mistro S; Program of Post-graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil.
  • Soares DA; Program of Post-graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil.
  • Kochergin CN; Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil.
  • de Carvalho VCHDS; Program of Post-graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil.
  • Macedo JCL; Program of Post-graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil.
  • Cortes TBA; Program of Post-graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil.
  • de Souza AA; Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil.
  • Rumel D; Department of Community Health, School of Medicine, Municipal University of São Caetano do sul, São Caetano Do Sul, Brazil.
  • Oliveira MG; Program of Post-graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil.
Front Med (Lausanne) ; 8: 734306, 2021.
Article em En | MEDLINE | ID: mdl-34881257
Background: Living in a rural or remote area is frequently associated with impaired access to health services, which directly affects the possibility of early diagnosis and appropriate monitoring of diseases, mainly non-communicable ones, because of their asymptomatic onset and evolution. Point-of-care devices have emerged as useful technologies for improving access to several laboratory tests closely patients' beds or homes, which makes it possible to eliminate the distance barrier. Objective: To evaluate the application of point-of-care technology for glycated hemoglobin (HbA1c) estimation in the assessment of glycemic control and identification of new diagnoses of diabetes in primary care among rural communities in a Brazilian municipality. Materials and Methods: We included individuals aged 18 years or older among rural communities in a Brazilian municipality. From September 2019 to February 2020, participants were assessed for anthropometrics, blood pressure, and capillary glycemia during routine primary care team activities at health fairs and in patient groups. Participants previously diagnosed with diabetes but without recent HbA1c test results or those without a previous diagnosis but with random capillary glycemia higher than 140 mg/dL were considered positive and were tested for HbA1c by using a point-of-care device. Results: At the end of the study, 913 individuals were accessed. Of these, 600 (65.7%) had no previous diagnosis of diabetes, 58/600 (9.7%) refused capillary glycemia screening and 542/600 (90.7%) were tested. Among tested individuals, 73/542 (13.5%) cases without a previous diagnosis of diabetes, were positive for capillary glycemia. Among positives, 31/73 (42.5%) had HbA1c levels that were considered indicative of prediabetes and 16/73 (21.9%) were newly diagnosed with diabetes. Among the participants, 313/913 (34.3%) were previously diagnosed with diabetes. Recent HbA1c results were unavailable for 210/313 (67.1%). These individuals were tested using point-of-care devices. Among them, 143/210 (68.1%) had HbA1c levels higher than target levels (>7% and >8% for adults and elderly individuals, respectively. Conclusion: The application of point-of-care devices for HbA1c level measurement improved the access to this test for people living in rural or remote areas. Thus, it was possible to include this technology in the routine activities of primary health care teams, which increased the rates of new diagnoses and identification of patients with uncontrolled glycemia.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Screening_studies Idioma: En Revista: Front Med (Lausanne) Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Screening_studies Idioma: En Revista: Front Med (Lausanne) Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça