Improving Access to the Glycated Hemoglobin Test in Rural Communities With Point-of-Care Devices: An Application Study

Background: Living in a rural or remote area is frequently associated with impaired access to health services, which directly affects the possibility of early diagnosis and appropriate monitoring of diseases, mainly non-communicable ones, because of their asymptomatic onset and evolution. Point-of-c...

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Autores principales:	Marianne Silveira Camargo, Luiz Carlos Santana Passos, Sostenes Mistro, Daniela Arruda Soares, Clavdia Nickolaevna Kochergin, Vivian Carla Honorato dos Santos de Carvalho, Jéssica Caline Lemos Macedo, Taciana Borges Andrade Cortes, Amós Alves de Souza, Davi Rumel, Marcio Galvão Oliveira
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	diabetes mellitus glycated hemoglobin A point-of-care testing primary health care rural communities Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/204f8aa5faff4e10afb15e47c6e5b640
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spelling	oai:doaj.org-article:204f8aa5faff4e10afb15e47c6e5b6402021-11-22T05:57:45ZImproving Access to the Glycated Hemoglobin Test in Rural Communities With Point-of-Care Devices: An Application Study2296-858X10.3389/fmed.2021.734306https://doaj.org/article/204f8aa5faff4e10afb15e47c6e5b6402021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.734306/fullhttps://doaj.org/toc/2296-858XBackground: Living in a rural or remote area is frequently associated with impaired access to health services, which directly affects the possibility of early diagnosis and appropriate monitoring of diseases, mainly non-communicable ones, because of their asymptomatic onset and evolution. Point-of-care devices have emerged as useful technologies for improving access to several laboratory tests closely patients' beds or homes, which makes it possible to eliminate the distance barrier.Objective: To evaluate the application of point-of-care technology for glycated hemoglobin (HbA1c) estimation in the assessment of glycemic control and identification of new diagnoses of diabetes in primary care among rural communities in a Brazilian municipality.Materials and Methods: We included individuals aged 18 years or older among rural communities in a Brazilian municipality. From September 2019 to February 2020, participants were assessed for anthropometrics, blood pressure, and capillary glycemia during routine primary care team activities at health fairs and in patient groups. Participants previously diagnosed with diabetes but without recent HbA1c test results or those without a previous diagnosis but with random capillary glycemia higher than 140 mg/dL were considered positive and were tested for HbA1c by using a point-of-care device.Results: At the end of the study, 913 individuals were accessed. Of these, 600 (65.7%) had no previous diagnosis of diabetes, 58/600 (9.7%) refused capillary glycemia screening and 542/600 (90.7%) were tested. Among tested individuals, 73/542 (13.5%) cases without a previous diagnosis of diabetes, were positive for capillary glycemia. Among positives, 31/73 (42.5%) had HbA1c levels that were considered indicative of prediabetes and 16/73 (21.9%) were newly diagnosed with diabetes. Among the participants, 313/913 (34.3%) were previously diagnosed with diabetes. Recent HbA1c results were unavailable for 210/313 (67.1%). These individuals were tested using point-of-care devices. Among them, 143/210 (68.1%) had HbA1c levels higher than target levels (>7% and >8% for adults and elderly individuals, respectively.Conclusion: The application of point-of-care devices for HbA1c level measurement improved the access to this test for people living in rural or remote areas. Thus, it was possible to include this technology in the routine activities of primary health care teams, which increased the rates of new diagnoses and identification of patients with uncontrolled glycemia.Marianne Silveira CamargoLuiz Carlos Santana PassosSostenes MistroDaniela Arruda SoaresClavdia Nickolaevna KocherginVivian Carla Honorato dos Santos de CarvalhoJéssica Caline Lemos MacedoTaciana Borges Andrade CortesAmós Alves de SouzaDavi RumelMarcio Galvão OliveiraFrontiers Media S.A.articlediabetes mellitusglycated hemoglobin Apoint-of-care testingprimary health carerural communitiesMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetes mellitus glycated hemoglobin A point-of-care testing primary health care rural communities Medicine (General) R5-920
spellingShingle	diabetes mellitus glycated hemoglobin A point-of-care testing primary health care rural communities Medicine (General) R5-920 Marianne Silveira Camargo Luiz Carlos Santana Passos Sostenes Mistro Daniela Arruda Soares Clavdia Nickolaevna Kochergin Vivian Carla Honorato dos Santos de Carvalho Jéssica Caline Lemos Macedo Taciana Borges Andrade Cortes Amós Alves de Souza Davi Rumel Marcio Galvão Oliveira Improving Access to the Glycated Hemoglobin Test in Rural Communities With Point-of-Care Devices: An Application Study
description	Background: Living in a rural or remote area is frequently associated with impaired access to health services, which directly affects the possibility of early diagnosis and appropriate monitoring of diseases, mainly non-communicable ones, because of their asymptomatic onset and evolution. Point-of-care devices have emerged as useful technologies for improving access to several laboratory tests closely patients' beds or homes, which makes it possible to eliminate the distance barrier.Objective: To evaluate the application of point-of-care technology for glycated hemoglobin (HbA1c) estimation in the assessment of glycemic control and identification of new diagnoses of diabetes in primary care among rural communities in a Brazilian municipality.Materials and Methods: We included individuals aged 18 years or older among rural communities in a Brazilian municipality. From September 2019 to February 2020, participants were assessed for anthropometrics, blood pressure, and capillary glycemia during routine primary care team activities at health fairs and in patient groups. Participants previously diagnosed with diabetes but without recent HbA1c test results or those without a previous diagnosis but with random capillary glycemia higher than 140 mg/dL were considered positive and were tested for HbA1c by using a point-of-care device.Results: At the end of the study, 913 individuals were accessed. Of these, 600 (65.7%) had no previous diagnosis of diabetes, 58/600 (9.7%) refused capillary glycemia screening and 542/600 (90.7%) were tested. Among tested individuals, 73/542 (13.5%) cases without a previous diagnosis of diabetes, were positive for capillary glycemia. Among positives, 31/73 (42.5%) had HbA1c levels that were considered indicative of prediabetes and 16/73 (21.9%) were newly diagnosed with diabetes. Among the participants, 313/913 (34.3%) were previously diagnosed with diabetes. Recent HbA1c results were unavailable for 210/313 (67.1%). These individuals were tested using point-of-care devices. Among them, 143/210 (68.1%) had HbA1c levels higher than target levels (>7% and >8% for adults and elderly individuals, respectively.Conclusion: The application of point-of-care devices for HbA1c level measurement improved the access to this test for people living in rural or remote areas. Thus, it was possible to include this technology in the routine activities of primary health care teams, which increased the rates of new diagnoses and identification of patients with uncontrolled glycemia.
format	article
author	Marianne Silveira Camargo Luiz Carlos Santana Passos Sostenes Mistro Daniela Arruda Soares Clavdia Nickolaevna Kochergin Vivian Carla Honorato dos Santos de Carvalho Jéssica Caline Lemos Macedo Taciana Borges Andrade Cortes Amós Alves de Souza Davi Rumel Marcio Galvão Oliveira
author_facet	Marianne Silveira Camargo Luiz Carlos Santana Passos Sostenes Mistro Daniela Arruda Soares Clavdia Nickolaevna Kochergin Vivian Carla Honorato dos Santos de Carvalho Jéssica Caline Lemos Macedo Taciana Borges Andrade Cortes Amós Alves de Souza Davi Rumel Marcio Galvão Oliveira
author_sort	Marianne Silveira Camargo
title	Improving Access to the Glycated Hemoglobin Test in Rural Communities With Point-of-Care Devices: An Application Study
title_short	Improving Access to the Glycated Hemoglobin Test in Rural Communities With Point-of-Care Devices: An Application Study
title_full	Improving Access to the Glycated Hemoglobin Test in Rural Communities With Point-of-Care Devices: An Application Study
title_fullStr	Improving Access to the Glycated Hemoglobin Test in Rural Communities With Point-of-Care Devices: An Application Study
title_full_unstemmed	Improving Access to the Glycated Hemoglobin Test in Rural Communities With Point-of-Care Devices: An Application Study
title_sort	improving access to the glycated hemoglobin test in rural communities with point-of-care devices: an application study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/204f8aa5faff4e10afb15e47c6e5b640
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Improving Access to the Glycated Hemoglobin Test in Rural Communities With Point-of-Care Devices: An Application Study

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