Effectiveness of clinical follow-up by telemonitoring for beneficiaries with chronic diseases in upplementary health

Keywords: Effectiveness, Health education, Self-management, Supplemental health, Program evaluation

Abstract

To verify the effectiveness of clinical follow-up by telemonitoring of beneficiaries with chronic diseases in supplementary health. Quasi-experimental study, from 2019, with beneficiaries of a medium-sized health plan operator in Paraná, state of Paraná. The only non-randomized group had 109 adults, independent for basic activities and who participated in this educational intervention, to support self-management, by monthly phone calls, coordinated by a nurse, for 12 months. Behavioral and clinical indicators were extracted from electronic medical records and compared using McNemar, Wilcoxon and paired t-tests. In the beginning, participants with healthy eating habits predominated. After the intervention, the occurrence of sufficient physical activity increased by 46.3% (p= 0.690) and the consumption of alcoholic beverages decreased by 78.0% (p= 0.000) and by 1.4% (p= 0.005), the body mass index. Such changes in the studied indicators suggest the effectiveness of clinical follow-up by telemonitoring in stimulating and maintaining healthy habits.

Author Biographies

Cristiane de Melo Aggio, Universidade Estadual do Centro Oeste - UNICENTRO
Department of Medicine, Universidade Estadual do Centro Oeste (UNICENTRO), Guarapuava (PR), Brazil
Sonia Silva Marcon, Universidade Estadual de Maringá - UEM
Department of Nursing, Postgraduate Program in Nursing, State University of Maringá (UEM), Maringá (PR), Brazil.
Maria José Quina Galdino, Universidade Estadual do Norte do Paraná - UENP
Department of Nursing, Postgraduate Program in Teaching, State University of Northern Paraná (UENP), Cornélio Procópio (PR), Brazil.
Eleine Aparecida Penha Martins, Universidade Estadual de Londrina - UEL
Department of Nursing, Postgraduate Program in Nursing, State University of Londrina (UEL), Londrina (PR), Brazil.
Gilselena Kerbauy Lopes, Universidade Estadual de Londrina - UEL
Department of Nursing, State University of Londrina (UEL), Londrina (PR), Brazil
Maria do Carmo Fernandes Lourenço Haddad, Universidade Estadual de Londrina - UEL
Department of Nursing, Postgraduate Program in Nursing, State University of Londrina (UEL), Londrina (PR), Brazil.

References

1. Becker RM, Heidemann ITSB. Health promotion in care for people with chronic non-transmitable disease: integrative review. Texto & Contexto Enferm [Internet]. 2020 [Cited 2021 apr 23]; 29: e20180250. Available from: https://www.scielo.br/j/tce/a/gDT5RNCrkcBNM5xbd6J65Tf/?lang=en&format=pdf. Doi: https://dx.doi.org/10.1590/1980-265X-TCE-2018-0250.

2. Assunção AA, França EB. Anos de vida perdidos por doença crônica NCDs atribuídos aos riscos ocupacionais no Brasil: estudo GBD 2016. Rev Saúde Públ [Internet]. 2020 [Cited 2021 apr 23]; 54: 28. Available from: https://www.revistas.usp.br/rsp/article/view/167772/159932. Doi: http://dx.doi.org/10.11606/s1518-8787.2020054001257.

3. Cappellen PV, Rice EL, Catalino LI, Fredrickson BL. Positive affective processes underlie positive health behaviour change. Psychology & Health [Internet]. 2017 [Cited 2021 apr 23]; 33(1): 77-97. Available from: https://www.tandfonline.com/doi/full/10.1080/08870446.2017.1320798. Doi: https://doi.org/10.1080/08870446.2017.1320798.

4. Schmidt H. Chronic disease prevention and health promotion. In: Barrett DH, Ortmann LW, Dawson A, Saenz C, Reis A, Bolan G. Public health ethics: cases spanning the globe. Cham: Springer [Internet]; 2016 [Cited 2021 apr 23]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK435776/. Doi: https://doi.org/10.1007/978-3-319-23847-0

5. Paré G, Poba-Nzaou P, Sicotte C. Home telemonitoring for chronic disease management: an economic assessment. Int J Technol Assess Health Care [Internet]. 2013 [Cited 2021 apr 23]; 29(02): 155–61. Available from: https://www.cambridge.org/core/journals/international-journal-of-technology-assessment-in-health-care/article/abs/home-telemonitoring-for-chronic-disease-management-an-economic-assessment/7F1211EA7AA7BB99F8C602E2B7B67A0E. Doi: https://doi.org/10.1017/s0266462313000111.

6. Allegrante JP, Wells MT, Peterson JC. Interventions to support behavioral self-management of chronic diseases. Annu Rev Public Health [Internet]. 2019 [Cited 2021 apr 23]; 40:127-46. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6684026/. Doi: https://doi.org/10.1146/annurev-publhealth-040218-044008

7. Kivela K, Elo S, Kyngas H, Kaariainen M. The effects of health coaching on adult patients with chronic diseases: a systematic review. Patient Educ Couns [Internet]. 2014 [Cited 2021 apr 23]; 97(2): 147-57. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0738399114003000?via%3Dihub. Doi: https://doi.org/10.1016/j.pec.2014.07.026.

8. Dinh TTH, Clark R, Bonner A, Hines S. The effectiveness of health education using the teach-back method on adherence and self-management in chronic disease: a systematic review protocol. JBI Database System Rev Implement Rep [Internet]. 2013 [Cited 2021 apr 23]; 11(10): 30-41. Available from: https://journals.lww.com/jbisrir/Fulltext/2013/11100/The_effectiveness_of_health_education_using_the.3.aspx. Doi: https://doi.org/10.11124/jbisrir-2013-900.

9. Brady TJ, Anderson LA, Kobau R. Chronic disease self-management support: public health perspectives. Front Public Health [Internet]. 2015 [Cited 2021 apr 23]; 2: 234. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410343/. Doi: 10.3389/fpubh.2014.00234.

10. Park MJ, Green J, Jung HS, Park YS. Trajectories of change after a health-education program in Japan: decay of impact in anxiety, depression, and patient-physician communication. Peer J [Internet]. 2019 [Cited 2021 apr 23]; 7: e7229. Available from: https://peerj.com/articles/7229/. Doi: https://doi.org/10.7717/peerj.7229.

11. Ministério da Saúde (BR). Guia metodológico de avaliação e definição de indicadores: doenças crônicas não transmissíveis e Rede Carmem. Brasília: Ministério da Saúde [Internet]; 2007 [Cited 2021 apr 24]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/guia_rede_carmen.pdf.

12. Agência Nacional de Saúde Suplementar (BR). Cartilha para a modelagem de programas para promoção da saúde e prevenção de riscos e doenças. Rio de Janeiro: ANS [Internet]; 2011 [Cited 2021 apr 24]. Available from: http://www.ans.gov.br/images/stories/Materiais_para_pesquisa/Materiais_por_assunto/cartilha_promoprev_web.pdf.

13. Unimed do Brasil (BR). Comitê de atenção integral à saúde. Manual de atenção integral à saúde do Sistema Unimed. 1 v. São Paulo: Unimed do Brasil, 2013. 182 p.

14. Secretaria de Estado da Saúde de Santa Catarina. Indicadores de Dados Básicos RIPSA/SC [Internet]. Florianópolis: Secretaria de Estado da Saúde de Santa Catarina; 2021 [cited 29 June 2021]. Available from: http://www.sc.ripsa.org.br/php/level.php?lang=pt&component=91&item=2.

15. Cavalcanti AM, Oliveira ACL. Autocuidado apoiado: manual do profissional de saúde. Curitiba: Secretaria Municipal da Saúde [Internet]; 2012 [Cited 2021 apr 24]. Available from: https://www.conasems.org.br/curitiba-publica-manual-sobre-de-autocuidado-apoiado-para-os-profissionais-de-saude-e-usuarios-da-ab/.

16. Ministério da Saúde (BR). Vigitel Brasil 2017 Saúde Suplementar: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. Brasília: Ministério da Saúde [Internet]; 2018 [Cited 2021 apr 24]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/vigitel_brasil_2017_saude_suplementar.pdf.

17. Queiroz MG, Aquino MLA, Brito ADL, Medeiros CCM, Simões MOS, Teixeira A, et a. Arterial hypertension in the elderly - prevalent disease in this population: an integrative review. Braz J of Develop [Internet]. 2020 [Cited 2021 apr 24]; 6(4): 22590-8. Available from: https://www.brazilianjournals.com/index.php/BRJD/article/view/9409/7936. Doi: https://doi.org/10.34117/bjdv6n4-428.

18. Tavares RE, Jesus MCP, Machado DR, Braga VAS, Tocantins FR, Merighi MAB. Healthy aging from the perspective of the elderly: an integrative review. Rev Bras Geriatr Gerontol [Internet]. 2017 [Cited 2021 apr 24]; 20(6): 878-89. Available from: https://www.scielo.br/j/rbgg/a/pSRcgwghsRTjc3MYdXDC9hF/?lang=en&format=pdf. Doi: https://doi.org/10.1590/1981-22562017020.170091.

19. Flores TR, Nunes BP, Assunção MCF, Bertold AD. Healthy habits: what kind of guidance the elderly population is receiving from health professionals? Rev Bras Epidemiol [Internet]. 2016 [Cited 2021 apr 24]; 19(1): 167-80. Available from: https://www.scielo.br/j/rbepid/a/qhMC8fBgstcPQMyKRBXckFS/?lang=en&format=pdf. Doi: https://doi.org/10.1590/1980-5497201600010015.

20. Mendes, EV. O cuidado das condições crônicas na atenção primária à saúde: o imperativo da consolidação da estratégia da saúde da família. Brasília: Organização Pan-Americana da Saúde [Internet]; 2012 [Cited 2021 apr 24]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/cuidado_condicoes_atencao_primaria_saude.pdf

21. Alves DC, Ugá MAD, Portela MC. Promoção da saúde, prevenção de doenças e utilização de serviços: avaliação das ações de uma operadora de plano de saúde brasileira. Cad Saúde Colet [Internet]. 2016 [Cited 2021 apr 24]; 24(2): 153-61. Available from: https://www.scielo.br/j/cadsc/a/L5C8SGtcTLDNGHcPyYX8fvR/?lang=pt. Doi: https://doi.org/10.1590/1414-462X201600020199.

22. Ogata AJN. Promoção da saúde e prevenção de riscos e doenças na saúde suplementar brasileira: resultados do laboratório de inovação. Brasília: Organização Panamericana da Saúde [Internet]; 2014 [Cited 2021 apr 24]. Available from: https://iris.paho.org/bitstream/handle/10665.2/49108/9789275718162-por.pdf?sequence=1&isAllowed=y.

23. Carvalho FFB, Cohen SC, Akerman M. Refletindo sobre o instituído na Promoção da Saúde para problematizar 'dogmas'. Saúde Debate [Internet]. 2017 [Cited 2021 apr 24]; 41(Spe 3): 265-76. Available from: https://www.scielo.br/j/sdeb/a/xV7FHzBmscvF7J3Xt85Yc9t/?lang=pt. Doi: https://doi.org/10.1590/0103-11042017S320.

24. Senger AEV, Ely LS, Gandolfi T, Schneider RH, Gomes I, De Carli GA. Alcoolismo e tabagismo em idosos: relação com ingestão alimentar e aspectos socioeconômicos. Rev Bras Geriatr Gerontol [Internet]. 2011 [Cited 2021 apr 24]; 14(4): 713-9. Available from: https://www.scielo.br/j/rbgg/a/jXqtvX8RFS54NmNs7vm65Lx/abstract/?lang=pt. Doi: https://doi.org/10.1590/S1809-98232011000400010.

25. Andrade GF, Loch MR, Silva, AM Rigo Silva. Mudanças de comportamentos relacionados à saúde como preditores de mudanças na autopercepção de saúde: estudo longitudinal (2011-2015). Cad Saúde Pública [Internet]. 2019 [Cited 2021 apr 24]; 35(4): e00151418. Available from: https://www.scielo.br/j/csp/a/Z6yS8MdywQVgyBQsBL5wtyn/?lang=pt. Doi: https://doi.org/10.1590/0102-311X00151418.

26. Sociedade Brasileira de Diabetes (BR). Diretrizes da Sociedade Brasileira de Diabetes 2019-2020. São Paulo: AC Farmacêutica [Internet]; 2019 [Cited 2021 apr 24]. Available from: https://www.diabetes.org.br/profissionais/images/DIRETRIZES-COMPLETA-2019-2020.pdf.

27. Yugar-Toledo JC, Moreno JH, Gus M, Rosito GBA, Scala LCN, Muxfeldt ES, et al. Posicionamento brasileiro sobre hipertensão arterial resistente – 2020. Arq Bras Cardiol [Internet]. 2020 [Cited 2021 apr 24]; 114(3): 576-96. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792719/. Doi: 10.36660/abc.20200198.

28. Pereira LD, Bellinati NVC, Kanan LA. Autoeficácia para o gerenciamento de doenças crônicas escala de 6 itens: avaliação da autoeficácia no gerenciamento da doença crônica. Rev Cuidarte [Internet]. 2018 [Cited 2021 apr 24]; 9(3): 2435-45. Available from: https://revistas.udes.edu.co/cuidarte/article/view/561. Doi: http://dx.doi.org/10.15649/cuidarte.v9i3.561.

29. Manso MEG, Câmara R, Souza SA, Maciel TD, Farina DBL. Programa de gerenciamento de doenças crônicas em um plano de saúde, São Paulo, Brasil. Ciênc Cuid Saúde [Internet]. 2016 [Cited 2021 apr 24]; 15(2): 321-7. Available from: https://periodicos.uem.br/ojs/index.php/CiencCuidSaude/article/view/28683. Doi: https://doi.org/10.4025/cienccuidsaude.v15i2.28683.

30. Resende ALV, Barbosa EF, Santiago LO, Silva NCF, Ruas RG, Pimentel AL. Avaliação de qualidade de vida e custos na saúde suplementar baseada no plano de cuidado multidisciplinar de pacientes com doenças crônicas não transmissíveis. Rev Med Minas Gerais [Internet]. 2017 [Cited 2021 apr 24]; 27(Supl 1): 23-9. Available from: http://www.rmmg.org/artigo/detalhes/2036. Doi: http://www.dx.doi.org/10.5935/2238-3182.20170005.

31. Levy D, de Almeida LM, Szklo A. The Brazil SimSmoke policy simulation model: the effect of strong tobacco control policies on smoking prevalence and smoking attributable deaths in a middle income nation. PLoS Med [Internet]. 2012 [Cited 2021 apr 24]; 9(11): e1001336. Available from: https://pubmed.ncbi.nlm.nih.gov/23139643/. Doi: https://doi.org/10.1371/journal.pmed.1001336.

32. Paula ADC, Maldonado JMSV, Gadelha CAG. Healthcare telemonitoring and business dynamics: challenges and opportunities for SUS. Rev Saúde Públ [Internet]. 2020 [Cited 2021 June 29];54: 65. Available from: https://www.scielo.br/j/rsp/a/WzcMD7NTfbWhTjPRsKn8MTh/?format=pdf&lang=en. Doi: https://doi.org/10.11606/s1518-8787.2020054001996

Published
2022-01-31
Section
Artigos Originais