Construction of a Nucleus for Support to Management of Asthma in Primary Care: Consolidation and Expansion of the "Focus on Control of Asthma (FOCA)" Project.

• Grant number: 12/51716-3
• Support Opportunities: Research Grants - Research in Public Policies for the National Health Care System (PP-SUS)
• Start date: July 01, 2013
• End date: December 31, 2019
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Agreement: CNPq - PPSUS
• Principal Investigator: Luisa Karla de Paula Arruda
• Grantee: Luisa Karla de Paula Arruda
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Asthma in one of the most common chronic disease, with prevalences of 10% and 17% in adults and children, respectively, in Brazil. In a previous study, carried out in Primary Care Units of the North District of the City of Ribeirão Preto, we have found that asthma is underdiagnosed, and that patients frequently seek medical care only during acute exacerbations. After a year of a capacitating program aimed at physicians non-specialist in asthma care, and other health care professionals (FOCA Project), we have observed that there was significant increase in delivery of inhaled medications for asthma: Albuterol for acute exacerbations and Beclomethasone for prevention of exacerbations, in keeping with current national and international guidelines. The present study is aimed at strenghtening the capacitating program at the North District, and at expanding it to the Units of the East District of the Prefeitura. The focus will be at the patient who seeks care at the Emergency Room for acute symptoms of asthma (index case), who will be re-directed to Primary Care for diagnosis and preventive treatment of acute attacks of asthma. Priority will be given to capacitation in service, by which members of our group of asthma specialists and selected professionals of Prefeitura who had been trained in the previous program will work with patients' case discussions, treatment protocols and use of medications and inhalation devices, at the work site. Emergency Rooms of the two districts will be equipped with a coded electronic registry of all visits of patients with acute symptoms of asthma. Outcome measures will be: seek for Emergency care for asthma; evaluation of delivery asthma medications by the pharmacy; and follow up of each participant patient for a period of one year. At the end of this project, elements for creation of a Nucleus of Support to management of asthma at primary care setting will be established; this nucleus could serve as a model to improve the resolution capacity of primary care in management of asthma in our country. (AU)