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

Sonia Maria Martins, William Salibe-Filho, Luís Paulo Tonioli, Luís Eduardo Pfingesten, Patrícia Dias Braz, Juliet McDonnell, Siân Williams, Débora Do Carmo, Jaime Correia De Sousa, Hilary Pinnock, Rafael Stelmach*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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 â 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

Original languageEnglish
Article number16047
Journalnpj Primary Care Respiratory Medicine
Volume26
DOIs
Publication statusPublished - 18 Aug 2016

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