Geographical barriers in access to pulmonary arterial hypertension care in Brazilian public health system

Background Chronic noncommunicable diseases such as arterial hypertension have a high impact in the context of public health. Previous studies have shown improvements in blood pressure due to simple lifestyle changes, which were supported by electronic health (eHealth) solutions. Objective The aim of this study is to develop an eHealth platform and assess the effects of its use on the health conditions of patients with hypertension, with assistance from health professionals in the public health system of a Brazilian city. Methods The platform will include a server that centralizes all the data and business rules, a website dashboard for health professionals, and a mobile app for patients. We will analyze the effects of its use through a controlled, nonrandomized, nonblind, prospective, monocentric clinical trial. We will enroll 68 participants diagnosed with arterial hypertension and under medical follow-up and categorize them into two groups. The participants of the intervention group will use the platform as a monitoring method, whereas the participants of the control group will use conventional methods. In both groups, we will assess and compare the evolution of blood pressure and treatment adherence before, during, and after the intervention. Results The project was funded at the end of 2018. We have been developing the software since 2019 with plans to complete it in 2020, and we will enroll patients between 2020 and 2021. We expect to submit the first results for publication in 2020. Conclusions For the primary outcome, we expect a reduction and stabilization of blood pressure. For the secondary outcomes, we hope to see improvements in treatment adherence, physical activities and dietary practices, and acceptance of the eHealth platform. In public health, the technology that favors disease control also helps reduce complications and, consequently, treatment costs. The platform might encourage the adaptation of medical assistance to incorporate this technology into patient monitoring. International Registered Report Identifier (IRRID) PRR1-10.2196/15299

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Pulmonary hypertension: epidemiology

ESC CardioMed ◽

10.1093/med/9780198784906.003.0575 ◽

2018 ◽

pp. 2484-2487

Author(s):

Jose Leonidas Alves ◽

Susana Hoette ◽

Rogério Souza

Keyword(s):

Pulmonary Hypertension ◽

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Health System ◽

Heart Diseases ◽

Developed Countries ◽

Older Age ◽

Disease Awareness ◽

The World ◽

Pulmonary Arterial

The epidemiology of pulmonary hypertension has been better studied in the last decade. Registries coming from all parts of the world allowed not only the recognition of a change in pulmonary hypertension demographics in developed countries but also the existence of regional peculiarities in less developed regions that need to be accounted for in the development of appropriate health policies. Although left-sided heart diseases and lung diseases are believed to be the most prevalent causes of pulmonary hypertension, most of the available data are related to causes of pulmonary arterial hypertension. In this particular group, patients are now diagnosed at an older age, as compared with the data from the first national registries, from about 20 years ago. The reasons for such changes are not clear and might be related to factors such as disease awareness, diagnostic approach, treatment availability, and health system accessibility rather than to a change in the disease itself. This chapter summarizes the available data regarding the current epidemiology of pulmonary hypertension.

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