Estudo da conformidade e dos processos de uso dos esfigmomanômetros da rede de atenção básica de um munícipio do Recôncavo Baiano

Abstract

Introduction: hypertension is a major risk factor associated with cardiovascular diseases development. Non-calibrated sphygmomanometers use is a systematic bias in blood pressure measurement procedure in primary care setting, contributing to public policies’ failure in assisting hypertensive patients. Objective: the study’s main objective was to verify sphygmomanometers’ non-reliability and its related working processes, in primary care network in the municipality of Santo Antônio de Jesus-Bahia. Methodology: This is a descriptive, census research, with cross-sectional design and quantitative approach. The reliability verification protocol was equivalent to that recommended by Brazilian regulatory bodies. Additionally, a questionnaire regarding working processes involving sphygmomanometers’ utilization was applied to health unit managers. For data analysis, basic descriptive statistics, bivariate relationships (Student's “t” test, Mann-Whitney, Chi-square, or Fischer's exact test when appropriate) and multivariate analysis (logistic regression) were applied, with a significance level of 5%. Results: a total of 106 sphygmomanometers from 28 primary care units were included. All devices were from the aneroid model, with 33% inserted in rural territory. Only 3 (3%) devices had undergone periodic evaluation at any point during their usage time. 49 (44%) non-reliable sphygmomanometers were identified. Calibration error greater than 4 mmHg was identified in 32% of the sample and cuff’s air leak was present in 24%. In 4 primary care facilities there were no reliable devices for clinical use. The mean absolute error found between non-reliable devices was 7.35 ± 3,93 mmHg mmHg, with a maximum error of up to 19.5 mmHg. Only 2 health facilities reported having any periodic verification protocol for blood pressure devices. Measurement by the triage model was adopted by 60% of the primary care network, with 68% of the facilities allowing sphygmomanometer use in multiple environments. Logistic regression showed that for each facility’s extra environment of utilization there was an increase of 22% in the likelihood for device’s reliability loss. Conclusion: sphygmomanometers’ non-reliability rate in the primary care setting proved to be high, and it was showed that teams' working processes were associated with non-reliable devices frequency.