Diabetes Mellitus and arterial hypertension control with educational and therapeutic groups in outpatient follow-up in a "Unidade Básica de Saúde" (Basic Health Unit)

Abstract

Health education is important to increase adherence to treatment and the control of patients with hypertension or diabetes, associated to the self-control of blood pressure or glycemia levels, physical activity and diet. The better understanding of the diseases is related to an improvement in quality of life, decrease in the number of decompensations, fewer hospital admissions, and better acceptance of the disease. An intervention in a population of diabetic and hypertensive patients, through the establishment of groups to promote educative measures, regular follow-up, drug supply, periodic control and treatment of medical intercurrences was proposed at a Basic Health Unit. Monthly meetings took place during the first three months, followed by periodic medical evaluations, disease control and drug supply for additional 27 months. A series of 191 patients was included for a follow-up. Comparing the initial results and those seen post-intervention, we observed a relative decrease of 42% and an absolute one of 26% in the number of patients with moderate and severe hypertension. Regarding the diabetic patients, there was an absolute decrease of 22% in those with glycemia levels above 200mg/dl and an increase of 33% for those with levels below 125mg/dl. For patients who depend on the public health system and drug supply by the government, mostly elderly patients with low schooling, the intervention proved to be effective, although the control of the diseases and all adherence determinants was not achieved. We suggest the implementation of this intervention.