Objective
To evaluate the implementation of care pathways for systemic arterial hypertension (SAH) and type 2 diabetes (T2DM) at the primary health care level in two regions of Northeastern Brazil.
Methods
A descriptive, cross-sectional, before-and-after analysis was conducted, involving the identification of barriers to implementation, situational diagnosis, development of an implementation plan, health team training, and implementation assessment through a self-administered questionnaire. The following clinical indicators were evaluated: proportion of individuals with stratified cardiovascular risk among the total number of patients; proportion of individuals with SAH or T2DM who achieved blood pressure and glycemic control; and percentage of patients diagnosed with SAH or T2DM.
Results
Implementation began in January 2023 in the 1st Health Region of Mata Atlântica (1RSPB, state of Paraíba) and in June 2023 in the 7th Metropolitan Health Region (7RSRN, state of Rio Grande do Norte). The final assessment occurred in December 2023. In the 1RSPB, increases were noted in the percentages of cardiovascular risk stratification (0 to 36%, P < 0.001), blood pressure control (33.4% to 62.6%, P < 0.001), and glycemic control (26.7% to 77.9%, P < 0.001). In the 7RSRN, cardiovascular risk stratification increased from 0 to 17.4%. Changes in the percentages of patients with controlled SAH (47.9% to 48.4%, P = 0.72) and T2DM (59.2% to 57.3%, P = 0.41) were not statistically significant.
Conclusion
The implementation of HTN and T2DM care pathways was feasible, with greater improvements observed in the healthcare network with lower baseline control levels and longer implementation duration.