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Ferreira RL, do Nascimento IJB, de Almeida VIA, de Oliveira VRL, Marangne LG, dos Santos Gameleira F, Dutra TRC, de Oliveira Santos D, Dias Afonso MP, dos Santos PEA, de Oliveira HN, Vilhena Dias FM. The utilisation of primary health care system concepts positively impacts the assistance of patients with rare diseases despite limited knowledge and experience by health care professionals: A qualitative synopsis of the evidence including approximately 78 000 individuals. J Glob Health 2023; 13:04030. [PMID: 37539555 PMCID: PMC10401310 DOI: 10.7189/jogh.13.04030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
Background Individuals with rare diseases (RD) have been historically understudied. Previous publications reported that existing primary health care (PHC) workforces and associated infrastructure had been shown to improve their access and health-related outcomes in low- and middle-income countries (LMICs). As current evidence about the impact of PHC on patients diagnosed with RD is yet highly dispersed, this scoping review aimed to collate available evidence of the impact of PHC on patients with RD and summarize published information from multiple stakeholders about the perceived usefulness and barriers to effective use of the PHC system. Methods We searched Embase, Health System Evidence, PubMed, LILACS / BVS, and The Cochrane Library, from inception to September 1, 2022, for publications providing clear expert- or experience-based insights or data from patients living with RD at the PHC level of care. We included publications highlighting barriers to integrated care of patients with RD, reported by multiple social actors involved in caring for patients with RD. Two investigators screened publications, extracted data, and clustered information among records deemed eligible for inclusion. Data synthesis was performed using narrative and thematic-based analysis. Major findings identified and coded through a semantic-driven analysis were processed in vosViewer software and reported using descriptive statistics. Findings Eighty publications were included in this review. Quali-quantitative analyses evidenced that the PHC level is essential for approaching patients with RD, mainly due to its longitudinal, multidisciplinary, and coordinated care delivery. In addition, several publications highlighted that the medical curriculum is inappropriate for preparing health care providers to deal with patients presenting unusual signs and symptoms and being diagnosed with RD. PHC teams are essential in orienting patients and families on emergency events. Technology-related concepts were reported in 19 publications, emphasizing their effectiveness on early diagnosis, optimal treatment definition, improvement of quality of life, and long-lasting follow-up. Conclusions We provided valuable information on the effectiveness of the PHC in fostering a creative, integrative, and supportive environment for patients living with RD. Our results can be helpful to several stakeholders in deciding what actions are still pending to achieve a solid and positive experience for patients with RD in the PHC. Registration PROSPERO (CRD42022332347).
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Affiliation(s)
- Raquel Lemos Ferreira
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- Laboratório de Investigação de Pessoas com Doenças Raras (LIRA), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Israel Júnior Borges do Nascimento
- Pathology and Laboratory Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Division of Country Health Policies and Systems (CPS), World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Victor Izidro Alves de Almeida
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- Laboratório de Investigação de Pessoas com Doenças Raras (LIRA), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vanuza Regina Lommez de Oliveira
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- Laboratório de Investigação de Pessoas com Doenças Raras (LIRA), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Gomes Marangne
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- Laboratório de Investigação de Pessoas com Doenças Raras (LIRA), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Flávia dos Santos Gameleira
- Laboratório de Investigação de Pessoas com Doenças Raras (LIRA), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tárcia Regina Coura Dutra
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- Laboratório de Investigação de Pessoas com Doenças Raras (LIRA), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniela de Oliveira Santos
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- Laboratório de Investigação de Pessoas com Doenças Raras (LIRA), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcelo Pellizzaro Dias Afonso
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- Programa de Pós Graduação em Saúde Pública, da Faculdade de Medicina, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Paula Eduarda Alves dos Santos
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- Laboratório de Investigação de Pessoas com Doenças Raras (LIRA), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Helian Nunes de Oliveira
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- Laboratório de Investigação de Pessoas com Doenças Raras (LIRA), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, UFMG, Minas Gerais, Brazil
- Programa de Promoção de Saúde e Prevenção da Violência, Departamento de Medicina Preventiva e Social, Faculdade de Medicina, UFMG, Minas Gerais, Brazil
| | - Fernando Machado Vilhena Dias
- Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- Laboratório de Investigação de Pessoas com Doenças Raras (LIRA), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Programa de Promoção de Saúde e Prevenção da Violência, Departamento de Medicina Preventiva e Social, Faculdade de Medicina, UFMG, Minas Gerais, Brazil
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Pereira EC, Souza GCD, Schveitzer MC. Complementary and Alternative Medicine offered by nurses in Primary Health Care. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-11042022e110i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The aim of this study was to assess and analyze the provision of Complementary and Alternative Medicine in primary health care by nurses in the city of São Paulo, and the impact of the Covid-19 pan- demic on this provision. This was a descriptive time series study conducted with secondary data from the official database of the Informatics Department of the Unified Health System for the period from 2018 to 2020. The results showed that complementary therapies provided by nurses totaled 10,933 procedures in 2018, 24,684 in 2019, and 12,651 in 2020. Between 2018 and 2019, there was a 120% increase in provision, a trend that was interrupted in 2020 due to the Covid-19 pandemic. The provision of these therapies by nurses is a form of holistic care and expanded understanding of the health and disease process. However, despite the great potential for the application of this approach to health care, this category accounts for a small percentage of total services in the community studied.
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Pereira EC, Souza GCD, Schveitzer MC. Práticas Integrativas e Complementares ofertadas pela enfermagem na Atenção Primária à Saúde. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-11042022e110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Os objetivos do estudo foram mapear e analisar a oferta das Práticas Integrativas e Complementares (Pics) na atenção primária pela enfermagem no município de São Paulo e a interferência da pandemia da Covid-19 na oferta dessas práticas. Estudo descritivo de série temporal, realizado com dados secundá- rios a partir do banco de dados oficiais do Departamento de Informática do Sistema Único de Saúde no período entre 2018 e 2020. Os resultados demonstram que as Pics ofertadas pela enfermagem totalizaram 10.933 procedimentos em 2018, 24.684 em 2019 e 12.651 em 2020. Entre os anos de 2018 e 2019, houve um aumento de 120% na oferta, tendência interrompida em 2020 em decorrência da pandemia da Covid-19. A oferta dessas práticas pela enfermagem é uma forma de atendimento com vistas ao cuidado integral e apreensão ampliada do processo saúde-doença. Contudo, apesar do grande potencial para adoção dessa abordagem no cuidado, a categoria tem demonstrado percentuais pouco representativos do total ofertado no município analisado.
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