Programa de prestação de cuidados de saúde remotos melhora a pressão arterial e os níveis de colesterol
A doença cardíaca é a principal causa de morte nos Estados Unidos e em todo o mundo. A redução da pressão alta e do colesterol pode ajudar a reduzir a morbidade e a mortalidade, mas visitas pessoais frequentes para medir e gerenciar essas....
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)
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A doença cardíaca é a principal causa de morte nos Estados Unidos e em todo o mundo. A redução da pressão alta e do colesterol pode ajudar a reduzir a morbidade e a mortalidade, mas visitas pessoais frequentes para medir e gerenciar essas leituras podem ser um fardo para os pacientes.
Uma equipe do Mass General Brigham implementou um programa remoto de assistência médica destinado a gerenciar a pressão arterial e os níveis de colesterol dos pacientes . O novo programa alavancou soluções digitais para ajudar a quebrar barreiras ao atendimento, especialmente entre populações de pacientes tradicionalmente carentes.
Em um estudo de pesquisa que incluiu mais de 10.000 participantes do sistema Mass General Brigham, os pesquisadores descobriram que o programa reduziu significativamente a pressão arterial e o colesterol LDL. Os resultados são publicados no JAMA Cardiology .
"Entrar em um consultório físico pode representar um fardo alto para pacientes que têm condições crônicas ou para pessoas que moram longe", disse o autor correspondente Benjamin Scirica, MD, MPH, da Divisão de Medicina Cardiovascular do Brigham and Women's Hospital, um membro fundador do Mass General Brigham.
"Iniciamos este programa de atendimento remoto antes do início da pandemia. E quando a pandemia começou, vimos um aumento significativo em nossas inscrições e um maior interesse nas vantagens do atendimento remoto. Os pacientes querem soluções inovadoras para se envolver mais facilmente com o sistema de saúde . Nosso programa fornece fortes evidências de que o atendimento remoto pode funcionar e pode fazer a diferença na vida dos pacientes."
As estratégias e intervenções de prestação de cuidados de saúde para controlar a pressão arterial elevada e o colesterol elevado podem variar muito em termos de acessibilidade e qualidade, e essas diferenças podem exacerbar as disparidades nos cuidados. Estudos anteriores descobriram que, aos 55 anos, 3 em cada 4 adultos negros desenvolveram hipertensão em comparação com cerca de metade dos homens brancos e 40% das mulheres brancas. Programas de assistência cardiovascular oferecidos remotamente têm o potencial de oferecer maior acesso a cuidados equitativos e de alta qualidade.
Os avanços na tecnologia de cuidados de saúde tornaram possível oferecer muitas opções de tratamento de saúde aos pacientes em suas casas, em vez de exigir visitas ao consultório ou ao hospital. O programa de otimização de hipertensão e colesterol se encaixa nos maiores esforços do Mass General Brigham para transformar a prestação de cuidados de saúde, ajudando os pacientes a acessar serviços e monitorar a saúde em casa, especialmente em um momento em que a capacidade hospitalar está em um ponto crítico.
"Este estudo é um dos maiores, se não o maior estudo de implementação clínica em uma rede de saúde", disse o autor principal Alexander Blood, MD, MSc, também da Divisão de Medicina Cardiovascular do Brigham.
"Encontramos os pacientes onde eles estão. Nos comunicamos com eles e co-gerenciamos sua saúde por meio dos canais de sua preferência, incluindo portais de pacientes, mensagens de texto, e-mail ou telefonemas. É assim que imaginamos adaptar muitos outros sistemas no futuro para atender às necessidades do paciente."
Nos últimos cinco anos, Blood, Scirica e uma equipe do Mass General Brigham desenvolveram uma série de programas de gerenciamento de doenças crônicas entregues remotamente. Os programas, formados por navegadores treinados, mas não licenciados, e farmacêuticos licenciados, são apoiados pela equipe profissional do sistema de saúde Mass General Brigham. Eles usam soluções digitais, como manguitos de pressão arterial conectados digitalmente, para ajustar os medicamentos com base na resposta do paciente à terapia.
Para estudar a eficácia da intervenção, a equipe de pesquisa inscreveu os participantes, forneceu educação e enviou dispositivos de monitoramento de pressão arterial para casa, que enviaram automaticamente os resultados da pressão arterial de volta ao programa. Este programa foi entregue a mais de 10.000 pacientes em dezenas de clínicas e centenas de consultórios no sistema.
Os pesquisadores descobriram que, com planejamento e cuidados intencionais, eles foram capazes de melhorar os resultados de saúde, fornecer cuidados consistentes e alcançar populações carentes. A equipe viu resultados positivos, incluindo reduções na pressão alta e melhorias nos níveis de colesterol em um grupo grande e diversificado de pessoas. O programa de lipídios recrutou 8.103 participantes e o programa de hipertensão recrutou 3.658 participantes.
Mais de 424.000 leituras de pressão arterial e 139.000 laudos laboratoriais foram coletados no programa. A redução média da pressão arterial sistólica foi de 9,7 mmHg nos pacientes inscritos no programa de hipertensão e a redução média do colesterol foi de 37 mmHg. Taxas semelhantes de matrícula e reduções de sangue e colesterol foram observadas em diferentes populações raciais, étnicas e de idioma primário.
Scirica explica que o controle da hipertensão e dos níveis elevados de colesterol pode ajudar a reduzir eventos cardiovasculares, como ataques cardíacos e derrames, e aliviar os custos de saúde a jusante , mas são necessários estudos futuros para avaliar os efeitos financeiros do programa.
Como é o caso em muitos programas clínicos, muitos pacientes não completaram totalmente o programa – 276 pacientes desistiram do programa de hipertensão e 817 desistiram do programa de lipídios. A equipe observa que são necessárias mais pesquisas sobre estratégias de engajamento, incentivos e intervenções para melhorar os níveis de retenção.
No geral, os pesquisadores concluíram que o programa demonstrou com sucesso uma abordagem padronizada, sustentável e remota para efetivamente reduzir e manter melhores níveis de pressão arterial e colesterol.
"Quando olhamos para a prática clínica local e nacional, vemos muitos pacientes que não recebem as terapias mais atualizadas", disse Blood. "Precisamos iniciar programas que produzam soluções e superem barreiras para pacientes historicamente mal atendidos".