(UN)FOLLOW-UP OF HYPERTENSIVE PATIENTS IN A YEAR OF THE COVID-19 PANDEMIC – THE REALITY OF A FAMILY HEALTH UNIT

• Autor(a) principal: Cabral, Filipe
• Data de Publicação: 2023
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.58043/rphrc.66
• topic: Hipertensão; COVID-19; SARS-CoV-2; Cuidados de Saúde Primários; Follow-Up; Hypertension; COVID-19; SARS-CoV-2; Primary Care; Follow-Up

Introduction: Hypertension is a prevalent problem whose follow-up occurs mainly in Primary Health Care (PHC). The need to respond to the COVID-19 pandemic led to restructuring and changes in the provision of services, with a consequent decrease in scheduled activity. Objectives: To assess the impact of the COVID-19 pandemic on the follow-up and health status of hypertensive patients by evaluating 3 outcomes: (i) Percentage of patients who complied with existing recommendations for the follow-up of hypertensive patients under of the PHC; (ii) Percentage of patients who started and/or intensified antihypertensive drug therapy during this period; Comparison of the blood pressure profile of patients without pharmacological changes before and after the scheduled activity suspension date. Methods: Selection of patients from the Family Health Unit Marco with the code K86 or K87 (Hypertension with or without complications) on 02/01/2020; Exclusion criteria: users not followed at the Family Health Unit and without consultation within 6 months before the date of suspension of the scheduled activity. Variables: gender, age, blood pressure, heart rate, body mass index, usual medication and date of consultations held between 15/09/2019 and 01/02/2021; Analysis: t test - continuous variables before and after the scheduled activity suspension date; McNemar test - categorical variables. Significance level: p<0.05. Results: n=1740. Only 27.6% hypertensive patients complied with the follow-up recommendations. 10.2% of patients started and/ or intensified antihypertensive drug therapy. There was a significant worsening in the tension profile (SBP [128.2 vs 134.3mmHg, p<0.001], DBP (74.9 vs 77.6mmHg, p<0.001) and MBP [92.7 vs 96.5mmHg, p<0.001]) and a significant reduction in the percentage of controlled hypertensive patients (BP<140/90mmHg) in patients not subject to pharmacological changes before and after suspension of scheduled activity (95.9% vs 80.3%, p<0.001). Conclusions: The pandemic had a negative impact on the follow-up and health status of hypertensive patients followed in PHC. Accelerating the process of returning to the programmed face-to-face activity and monitoring these patients by other means (eg teleconsultation) will be essential to reverse this trend and improve their outcome.