Em tempos de covid-19: atenção primária à saúde na prevenção e tratamento da hipertensão arterial sistêmica

Abstract

The pandemic of COVID-19 represents one of the greatest recent health challenges. There was a need to reorganize the work process of the Primary Health Care teams in order to meet both the demand for mitigation of the cases of COVID-19 and to maintain the regular supply of its actions. OBJECTIVE: To understand the work process in the Family Health Strategy regarding the assistance to Systemic Arterial Hypertension in the city of Floriano-PI, in the context of the pandemic of the new coronavirus, focusing on the changes that occurred and the new work arrangements. METHODOLOGY: This is narrative research with a qualitative approach carried out with ten professionals from the Family Health Strategy of Floriano-PI, through interviews. The analysis of information was performed according to the Content Analysis technique proposed by Laurence Bardin, from which three categories emerged: Reorganization of the work process for monitoring of hypertensive patients: before and during the pandemic; Barriers to monitoring of hypertensive patients in the pandemic period; and Repercussion of changes in treatment adherence by hypertensive patients. RESULTS: It was noticed the centralization of the PHC teams' actions for drug treatment, little offer of promotion and prevention actions, besides making clear the relevance of issues such as risk stratification of hypertensive patients and the registration of people and families, the need for articulation with other points of specialized care to ensure the completeness of care and the adoption of the use of PPE as a form of protection. In the process of resuming care, it was observed the prioritization of the most severe cases and the dispensing of prescriptions and medications, the active search by community agents, scheduled care by appointment, vaccination against COVID-19, and the incorporation of information technology were strategies used for the resumption of actions. Regarding the obstacles related to the care of hypertensive patients during the pandemic period, the fear of both the team and the population, the loss of the habit of going to the Unidade Básica de Saúde (Basic Health Unit), and the team's overload with vaccinations were highlighted. In the category that discussed the repercussions brought about by this reorganization process, there was evidence of losses in adherence to hypertension treatment and an increase in complications and deaths. CONCLUSIONS: The incomplete registration and risk stratification of hypertensive patients, as well as the difficulty in articulating with specialized assistance and the low offer of promotional activities contributed to the low effectiveness of assistance. The active search, vaccination, appointment assistance, and the use of technology were fundamental for the resumption of activities and for the registration and risk stratification, although vaccination overloaded the nursing staff, showing a failure in the operationalization of the campaign. The inequality perceived in the way the teams work together with the lack of information about the indicators was another obstacle found. The recognition by professionals of the importance of registration and risk stratification is a favorable point. The fragility of PHC was evident.