Observational studyNPJ primary care respiratory medicine2016
Implementation of 'matrix support' (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study.
Observational study in NPJ primary care respiratory medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- 2020 Brazilian Thoracic Association recommendations for the management of asthma.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e TisilogiaGuideline
- Article
- Understanding the role and organization of health workers delivering non-communicable disease management in primary care in low- and middle-income countries: a scoping review.BMC primary care · 2025Article
- Healthcare needs in elderly patients with chronic heart failure in view of a personalized blended collaborative care intervention: a cross sectional study.Frontiers in cardiovascular medicine · 2024Article
- Understanding and controlling asthma in Latin America: A review of recent research informed by the SCAALA programme.Clinical and translational allergy · 2023Review
- Telemedicine in healthcare access during the covid-19 pandemic: a scoping review.Revista de saude publica · 2023Article
- Accuracy and economic evaluation of screening tests for undiagnosed COPD among hypertensive individuals in Brazil.NPJ primary care respiratory medicine · 2022Article
- Effectiveness of Agreement Criteria and Flows of Collaborative Care in Primary Mental Health Care in Brazil.International journal of environmental research and public health · 2022Article
- Knowledge, attitudes and practices of patients and healthcare professionals regarding oral health and COPD in São Paulo, Brazil: a qualitative study.NPJ primary care respiratory medicine · 2021Article
- COVID-19 poses novel challenges for global primary care.NPJ primary care respiratory medicine · 2020Article
- Improving primary care management of asthma: do we know what really works?NPJ primary care respiratory medicine · 2020Review
- A worldwide charter for all children with asthma.Pediatric pulmonology · 2020Article
- Article
- Celebrating World Asthma Day in Brazil: is the glass half full or half empty?Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2019Article
- Asthma patients' perception on their care pathway: a qualitative study.NPJ primary care respiratory medicine · 2019Article
- Global Alliance against Chronic Respiratory Diseases (GARD) Brazil success case: overcoming barriers.Journal of thoracic disease · 2018Article
- Standards for reporting implementation studies (StaRI): enhancing reporting to improve care.NPJ primary care respiratory medicine · 2017Article
- An expert review on breaking barriers in severe asthma in Brazil: Time to act.Chronic respiratory diseaseArticle
- Improvement Strategies for the Challenging Collaboration of General Practitioners and Specialists for Patients with Complex Chronic Conditions: A Scoping Review.International journal of integrated careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of hospitalisation and death in the city of Sao Bernardo do Campo. The municipality had difficulties in sustaining a pulmonology specialist team. Local policy has strengthened the knowledge of the primary care teams to improve the management of these diseases. Our aim is to pilot the implementation of an educational intervention based on collaborative care focused on reducing respiratory-related referrals. We implemented 'matrix support': a Brazilian collaborative educational intervention promoting specialist training and support for primary care physicians in three health territories with the highest number of referrals. Clinicians and nurses from primary care attended an 8-h workshop. The backlog of respiratory referrals was prioritised, where Asthma and COPD represented 70% of referral reasons. Initially, pulmonologists held joint consultations with physicians and nurses; as confidence grew, these were replaced by round-table note-based case discussions. The primary outcome was the number of asthma and COPD referrals. Almost all primary healthcare professionals in the three areas (132 of 157-87%) were trained; 360 patients were discussed, including 220 joint consultations. The number of respiratory referrals dropped from 290 (the year before matrix support) to 134 (the year after) (P<0.05). Referrals for asthma/COPD decreased from 13.4 to 5.4 cases per month (P=0.09) and for other lung diseases from 10.8 to 5.3 cases per month (P<0.05). Knowledge scores showed a significant improvement (P<0.001). Matrix-support collaborative care was well-accepted by primary care professionals associated with improved knowledge and reduced respiratory referrals. The initiative attracted specialists to the region overcoming historical recruitment problems.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.