Avaliação de uma intervenção liderada por Agentes Comunitários de Saúde (ACS) em pacientes de Diabetes Mellitus tipo 2 no interior do Amazonas

Abstract

Introduction: Primary Health Care (PHC) is characterized as the gateway to the Unified Health System (SUS), responsible for the comprehensive care of users with Type 2 Diabetes Mellitus. PHC health teams, especially Community Health Agents (CHAs), play a fundamental role in promotion, prevention and home monitoring. A significant increase in cases of DM2 in Brazil is estimated by 2045, requiring effective prevention and control strategies. Therefore, the adoption of healthier lifestyles, supported by educational interventions, are essential strategies in coping with DM2. Objective: To evaluate an intervention led by community health agents in patients with Type 2 Diabetes Mellitus on behavior change and clinical parameters. Methodology: This is a community trial study, inserted in a larger study entitled “Intervention led by Community Health Agents for the management of Type 2 Diabetes in the interior of Amazonas”. The study was conducted in the city of Iranduba, involving six UBS divided into control (n=3) and intervention (n=3) groups. Thirty-five CHAs participated, 17 in the intervention group and 18 in the control group. Each CHA indicated, for convenience, 10 users with DM2, totaling 104 participants in the intervention group and 93 in the control group. The CHAs in the intervention group received theoretical and practical training on the management of DM2 and monitored the users for 6 months. The control group did not receive training and maintained routine monitoring of the users. A questionnaire was applied to the users before and after the six months of intervention. Sociodemographic, behavioral and clinical variables were collected. Jamovi statistical software (version 2.6.26) was used for statistical analyses. Results: Most participants were female, most frequently 59 years of age, married or in a stable union, white or brown skin color and with less than 8 years of education. Most reported an income of up to one minimum wage, no paid work, and a diagnosis of DM2 less than 5 years ago. The most common treatment for DM2 was oral medication, and multiple comorbidities were present, with the most prevalent being high blood pressure. Positive results were observed in the intervention group regarding behavior change, especially regarding self-care, including medication adherence, adoption of a healthy diet with lower consumption of ultra-processed foods, and reduction of screen time during meals and during leisure time, which are seen as sedentary behavior. Conclusion: Educational interventions on the management of DM2, carried out by CHAs in PHC users, demonstrate positive impacts on behaviors related to self-care. Reinforcing the importance of investing in ongoing training and in the appreciation of these professionals, strengthening SUS services in addressing chronic conditions.