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Implementation of ‘matrix support’ (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study

Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of hospitalisation and death in the city of Sao Bernardo do Campo. The municipality had difficulties in sustaining a pulmonology specialist team. Local policy has strengthened the knowledge of the primary care teams to improv...

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Autores principales: Martins, Sonia Maria, Salibe-Filho, William, Tonioli, Luís Paulo, Pfingesten, Luís Eduardo, Braz, Patrícia Dias, McDonnell, Juliet, Williams, Siân, do Carmo, Débora, de Sousa, Jaime Correia, Pinnock, Hilary, Stelmach, Rafael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989903/
https://www.ncbi.nlm.nih.gov/pubmed/27536853
http://dx.doi.org/10.1038/npjpcrm.2016.47
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author Martins, Sonia Maria
Salibe-Filho, William
Tonioli, Luís Paulo
Pfingesten, Luís Eduardo
Braz, Patrícia Dias
McDonnell, Juliet
Williams, Siân
do Carmo, Débora
de Sousa, Jaime Correia
Pinnock, Hilary
Stelmach, Rafael
author_facet Martins, Sonia Maria
Salibe-Filho, William
Tonioli, Luís Paulo
Pfingesten, Luís Eduardo
Braz, Patrícia Dias
McDonnell, Juliet
Williams, Siân
do Carmo, Débora
de Sousa, Jaime Correia
Pinnock, Hilary
Stelmach, Rafael
author_sort Martins, Sonia Maria
collection PubMed
description Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of hospitalisation and death in the city of Sao Bernardo do Campo. The municipality had difficulties in sustaining a pulmonology specialist team. Local policy has strengthened the knowledge of the primary care teams to improve the management of these diseases. Our aim is to pilot the implementation of an educational intervention based on collaborative care focused on reducing respiratory-related referrals. We implemented ‘matrix support’: a Brazilian collaborative educational intervention promoting specialist training and support for primary care physicians in three health territories with the highest number of referrals. Clinicians and nurses from primary care attended an 8-h workshop. The backlog of respiratory referrals was prioritised, where Asthma and COPD represented 70% of referral reasons. Initially, pulmonologists held joint consultations with physicians and nurses; as confidence grew, these were replaced by round-table note-based case discussions. The primary outcome was the number of asthma and COPD referrals. Almost all primary healthcare professionals in the three areas (132 of 157–87%) were trained; 360 patients were discussed, including 220 joint consultations. The number of respiratory referrals dropped from 290 (the year before matrix support) to 134 (the year after) (P<0.05). Referrals for asthma/COPD decreased from 13.4 to 5.4 cases per month (P=0.09) and for other lung diseases from 10.8 to 5.3 cases per month (P<0.05). Knowledge scores showed a significant improvement (P<0.001). Matrix-support collaborative care was well-accepted by primary care professionals associated with improved knowledge and reduced respiratory referrals. The initiative attracted specialists to the region overcoming historical recruitment problems.
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spelling pubmed-49899032016-08-31 Implementation of ‘matrix support’ (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study Martins, Sonia Maria Salibe-Filho, William Tonioli, Luís Paulo Pfingesten, Luís Eduardo Braz, Patrícia Dias McDonnell, Juliet Williams, Siân do Carmo, Débora de Sousa, Jaime Correia Pinnock, Hilary Stelmach, Rafael NPJ Prim Care Respir Med Article Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of hospitalisation and death in the city of Sao Bernardo do Campo. The municipality had difficulties in sustaining a pulmonology specialist team. Local policy has strengthened the knowledge of the primary care teams to improve the management of these diseases. Our aim is to pilot the implementation of an educational intervention based on collaborative care focused on reducing respiratory-related referrals. We implemented ‘matrix support’: a Brazilian collaborative educational intervention promoting specialist training and support for primary care physicians in three health territories with the highest number of referrals. Clinicians and nurses from primary care attended an 8-h workshop. The backlog of respiratory referrals was prioritised, where Asthma and COPD represented 70% of referral reasons. Initially, pulmonologists held joint consultations with physicians and nurses; as confidence grew, these were replaced by round-table note-based case discussions. The primary outcome was the number of asthma and COPD referrals. Almost all primary healthcare professionals in the three areas (132 of 157–87%) were trained; 360 patients were discussed, including 220 joint consultations. The number of respiratory referrals dropped from 290 (the year before matrix support) to 134 (the year after) (P<0.05). Referrals for asthma/COPD decreased from 13.4 to 5.4 cases per month (P=0.09) and for other lung diseases from 10.8 to 5.3 cases per month (P<0.05). Knowledge scores showed a significant improvement (P<0.001). Matrix-support collaborative care was well-accepted by primary care professionals associated with improved knowledge and reduced respiratory referrals. The initiative attracted specialists to the region overcoming historical recruitment problems. Nature Publishing Group 2016-08-18 /pmc/articles/PMC4989903/ /pubmed/27536853 http://dx.doi.org/10.1038/npjpcrm.2016.47 Text en Copyright © 2016 The Author(s) http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Article
Martins, Sonia Maria
Salibe-Filho, William
Tonioli, Luís Paulo
Pfingesten, Luís Eduardo
Braz, Patrícia Dias
McDonnell, Juliet
Williams, Siân
do Carmo, Débora
de Sousa, Jaime Correia
Pinnock, Hilary
Stelmach, Rafael
Implementation of ‘matrix support’ (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study
title Implementation of ‘matrix support’ (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study
title_full Implementation of ‘matrix support’ (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study
title_fullStr Implementation of ‘matrix support’ (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study
title_full_unstemmed Implementation of ‘matrix support’ (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study
title_short Implementation of ‘matrix support’ (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study
title_sort implementation of ‘matrix support’ (collaborative care) to reduce asthma and copd referrals and improve primary care management in brazil: a pilot observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989903/
https://www.ncbi.nlm.nih.gov/pubmed/27536853
http://dx.doi.org/10.1038/npjpcrm.2016.47
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