Habilidade de médicos generalistas da atenção primária à saúde no diagnóstico das doenças respiratórias mais prevalentes

Abstract

Respiratory conditions are among the diseases with higher mortality in the world. According to the World Health Organization (WHO) acute respiratory illnesses (ARI) in third place in the classification of the conditions that lead to more death and chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), currently ranks fourth. This dissertation is part of the first phase of the pilot project of the Strategy Practical Approach to Lung Health - Global Alliance Against Chronic Respiratory Disease PAL-GARD in the Metropolitan Region of Belo Horizonte (MRBH) and is justified by the lack of published literature on the assessment of skills general practitioners in relation to respiratory diseases, acute and chronic. This paper aims to verify the diagnostic ability of general practitioners (GPs) of Primary Health Care (PHC) through the assessment of agreement between diagnoses made by these professionals and pulmonologists and respiratory diseases including chronic and acute diseases most prevalent. The study was conducted in three cities of MRBH, Brazil. All GPs were invited and received guidance on the completion of a standardized questionnaire. Patients older than 15 years who sought a unit of PHC at least one of the symptoms: cough, dyspnea and wheezing chest, were included. Two pulmonologists audited questionnaires and developed their diagnostic hypotheses. The study included 60 GPs and 554 patients were distributed among ARI with 235 (42.4%) patients, asthma, 123 (17.3%), COPD 87 (15.7%) and suspected tuberculosis in 69 (12.4%). The degree of agreement obtained by the kappa statistic was moderate for all diseases and asthma despite the agreement to be the lowest 0.426 (95% CI, 0, 358, 0, 494) and the highest for COPD 0.548 (0.461, 0.635), the CI95 % overlap each other which can demonstrate the likelihood of misdiagnosis and low knowledge among GPs.