Experience of reorganizing the hypertension and diabetes care line at UBS Mangueirão

Abstract

INTRODUCTION: The territory of the Basic Unit Sargento Alexandre de Morais (UBS Mangueirão) located in the municipality of São Gonçalo do Amarante, in the State of Rio Grande do Norte (RN). The team has an enrolled population of 428 hypertensive users and 169 with Diabetes Mellitus. Access to medical and nursing consultations is through scheduling, spontaneous demand and emergency consultations. In the first four months of 2022, the Ministry of Health (MS) launched the results of PREVINE BRASIL - a new financing policy for Primary Health Care (PHC), in which UBS Mangueirão had a percentage of Requests for Glycated Hemoglobin for Diabetics and measurement of blood pressure (BP) for Hypertensive users, considerably below the target stipulated by the Ministry of Health at that time. In view of this, the need arose for a strategy to improve the rates, in order not only to guarantee funding, but also to improve the monitoring of the target audience. OBJECTIVE: To report the experience of carrying out an active search for users with Hypertension associated with Diabetes (HIPERDIA), within the respective Lines of Care. DEVELOPMENT: The strategy used in the search for users was, initially, to know quantitatively and nominally the residents in the territory with the mentioned diseases, a spreadsheet was built with the data from the individual registration carried out by the Community Health Agents (ACS), a search for each user's medical record, in order to obtain the following data: a) dates of the last consultation, b) requested glycated hemoglobin and c) BP measurement performed by a nurse or doctor. Subsequently, users with outdated exams were invited to a medical and/or nursing consultation at the unit, with a view to obtaining the aforementioned data, in addition to adjusting the dosage of medications and other needs identified during the consultation. RESULTS: The active search was carried out from November to December 2022, with users assisted from January 2023 until the present writing of this work, in a continuous manner, with the following diseases: 164 with Hypertension, 06 with a history of of cerebrovascular accident and 10 of acute myocardial infarction, 30 with obesity, 23 insulin-dependent diabetics and 54 non-dependent. The following tests were requested: 93 of total cholesterol and fractions, 05 electrocardiograms, 94 blood glucose levels, 93 glycated hemoglobins. Thirty-eight tests of total cholesterol, 36 of HDL and LDL, 39 of blood glucose and 33 of glycated hemoglobin were evaluated. CONTRIBUTIONS TO THE SUS AND THE POPULATION: The present work contributed to update the monitoring of health care and cardiovascular risk, of individuals in the assigned territory, as well as serving as a tool to enforce the goal proposed by the Ministry of Health for PREVINE BRASIL, which is 50% for both BP measurement and glycated hemoglobin request.