Avaliação clínica de crianças acompanhadas pelo Programa de Atenção Integral à Criança com Asma (PROAICA).

Abstract

Asthma has become a important public health problem, due to the significant increase in the prevalence and mortality of this disease in recent decades. Since 1996, the medical and government entities promoted the creation of consensus on the issue in order to plan measures to improve health care and reduce morbidity and mortality of this disease. In this context, emerged asthma control programs in various regions of the country, including the Programa de Atenção Integral à Criança com Asma – PROAICA – (Integrated Asthma Management Program for Children) in Fortaleza, Ceará. It is noticed that there is increasing discussion on the topic in the medical field, but there are few studies that evaluate the clinical impact of PROAICA. This research aims to evaluate the clinical response of children participating in the program and to verify the relationship of clinical outcome with the adherence to drug treatment and/or environmental. For this, it was performed an analytical descriptive retrospective documentary study, through datas collected from medical records of patients who participated in the program at the Health Unit Lineu Jucá, in Fortaleza, Ceará, in the period of 2009 to 2014. These data were stored and processed using Epi Info 7.0 s program. Results show clinical improvement of patients after the start of participation in the program, as well as improvement in the classification of asthma severity when comparing the first to the last medical consultation. It has seen an increase of 28.06% in patients classified as intermittent, reduction of 20.15% of mild persistent cases and a decrease of 10.79% in those classified as moderate persistent. However, happened an increase of 2.88% of critically ill patients. There was improvement in clinical control rating, an increase of 26.77% of patients with controlled asthma and reduction of 19.72% and 7.05%, respectively, in patients with partially controlled and uncontrolled classification. There was a significant reduction in asthma attack frequency, school absenteeism, care in emergencies and hospitalizations in crises. It was also higher exercise tolerance and adherence to drug treatment, the latter exerted a reduction in asthma attacks. However, there is not information on the environmental control in most of the medical records and, in those that contained the information, most patients did not perform this control. The analyzed data show the importance of the program and their collaboration for the control of asthma, facilitating better view of the difficulties still encountered in its implementation in order to promote possible changes to ensure better care and greater effectiveness of PROAICA.