Desfechos de saúde em idosos hipertensos e sua associação com fatores individuais e relativos a seus médicos na Atenção Primária à Saúde

Abstract

Among the Continuing Medical Education (CME) strategies that aim the improvement of the quality of care there is the "Peer Review" model. This one is multifaceted, based on physicians‘ reality and aimed at performance progress through clinical update and improvement of communication skills. Despite the evidence of lowering health costs and of a better professional performance and clinical outcomes in developed countries, there is little evidence of their results in low-resource settings. This work aims to answer this question by checking the association of Controlled Blood Pressure (BP) and Trust in the Doctor with variables related to patients and the doctors that assist them in Primary Health Care (PHC) in the city of Montes Claros, Minas Gerais, Brazil. This is a cross-sectional, analytical and observational study. 700 elder patients with hypertension of 70 Family Health Strategy (FHS) teams and their doctors were evaluated. These doctors have diverse educational background, some having participated in the Continuing Educational Program for family physicians Peer Review groups (CEP). Descriptive, bivariate and multivariate analyzes were made. After multivariate analysis, the variables negatively associated with Controlled BP were male gender (OR=2.00; p<0.001) among those relating to patients and have not been supervisor or PEP participant for at least 02 years (OR=1.73; p=0.046) among the related to doctors. Relatively to Trust in the Doctor, this showed negative association with lack of access to the same doctor in the last 02 years (OR=2.77; p=0.012) and not receiving information about the consequences of the disease (OR=3.18; p=0.019) among the variables relating to patients and not have been participating or PEP supervisor for a period of at least 01 year (OR=3.77; p=0.046) among the ones related to doctors. We conclude therefore that the ―Peer Review‖ model of CME, when followed its methodology and applied for a certain period of time, can influence health outcomes of populations in low-resource environments.