Avaliação de um programa de atendimento ao hipertenso na saúde suplementar

Abstract

Systemic arterial hypertension is a disease with a high prevalence and low control rates. Private health through health plans has been stimulated by the National Supplementary Health Agency to carry out health promotion and disease prevention programs, seeking to avoid cardiovascular complications and reduce costs with disease treatments and their complications. The Cooperativa Médica Unimed Imperatriz implemented the Health Care Program in 2016. No studies were found that evaluated the programs of the supplementary health care network. The objective of the present study was to verify the effects of a hypertensive care program on blood pressure levels, biochemical tests and adherence to drug treatment in the context of a supplementary health service. A quasi-experimental study of the type before and after which was performed with patients who entered the program, from September 2016 to February 2017. The convenience sample consisted of beneficiaries of the Unimed Imperatriz, aged 18 years or over, of both sex, participants in the Hypertensive Care Program. The initial and final evaluation consisted of: a questionnaire for the collection of personal data, life habits, personal and family history, weight and height verification for the calculation of body mass index, blood pressure measurement and abdominal circumference; Morinsky-Green test (applied only to patients on drug treatment to evaluate adherence to this treatment). Results of laboratory tests were also collected: LDL, HDL, fasting glycemia, total cholesterol and triglycerides. The participants were also evaluated to determine the degree of complexity of health care and to determine the frequency of telemonitoring and home visits. The intervention lasted six months with monthly telemonitoring, periodic home visits of the team and group meetings. We selected 36 and completed the program 15 (41.7%) participants who composed the final sample. The mean age was 62.6 ± 16.6 years, 80% female, 80% with high school education or more. The mean body mass index was 29.1 ± 5.2 kg / m2 and 11 (73.3%) were overweight. There was a reduction of SBP from 134 ± 18.7 to 121.4 ± 13.2 mmHg (p = 0.01) and DBP from 78.8 ± 11.6 to 72.1 ± 7.8 mmHg (p = 0 , 02) increased exercise frequency from 0.8 ± 0.28 to 1.7 ± 0.4 times per week (p = 0.038) and frequency of high drug compliance increased from 46.7% to 93, 3%. Participants' satisfaction with the program was 8.7 ± 0.52 points. The evaluated program improved SBP and DBP values, frequency of physical activity and drug compliance