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Line of care for patients with sleep apnea in Primary Health Care in the city of Araguari - Minas Gerais
The Obstructive Sleep Apnea Syndrome (OSAS) is characterized by airway obstruction and an important cardiovascular and metabolic risk factor, has a high prevalence in the general population and a high social cost. Despite this scenario, treatment is still restricted to a few specialized centers in Brazil, most of them in the private sphere. The absence of public policies that allow access to diagnosis and treatment, especially in the interior of the states, and the lack of knowledge of users of the Unified Health System (SUS) about OSAS disorders, make the problem even greater.
To implement and enable the care line for patients with OSAS in Primary Health Care (PHC) in the SUS in the municipality of Araguari.
1-Training of physicians from PHC Araguari on general aspects of OSAS (community identification and treatment). 2- Screening of patients with clinical suspicion of OSAS and carrying out type IV polygraphy (Biologix®) allowing the assessment of nocturnal desaturation and remote report by a responsible physician. 3- OSAS-positive patients were re-evaluated and referred for treatment with CPAP, which was paid for by the health department. The adaptation of masks and titration at home was performed by the physiotherapist through automatic CPAP and the telemonitoring technology of the Airview® platform. Clinical follow-up was carried out with the physician of the referral unit and shared with the multidisciplinary team, resulting in the development of a comprehensive care line.
From April to September 2021, 64 patients with clinical suspicion of OSAS were screened and type IV polygraphy was performed (33 women/31 men), mean age 51.8 years; BMI of 34.5 kg/m2. Eight patients with normal diagnosis were obtained, 27 with mild OSAS, 18 with moderate OSAS and 10 with severe OSAS, totaling a rate of 43% between moderate and severe. These patients, associated with symptoms, were treated with CPAP and weekly remote monitoring by the multidisciplinary team of the service. Adherence to CPAP during this period was 61% (> 4 hr per day, 70% of the period of use).
The journey of the patient with OSAS performed by the PHC proved to be effective and feasible, allowing for greater access to the diagnosis by SUS users and treatment and implementation of the OSAS patient care line in the municipality of Araguari.
Sleep Apnea, SUS, Primary Health Care.
Pollyana Machado Xavier, Rosana Ferreira Lima Nobre, Helena Aparecida Souza Carisio, Marislene Pulsena Cunha Nunes, Laerte Honorato Borges Júnior