A workshop on asthma management programs and centers in Brazil: reviewing and explaining concepts.
OBJECTIVE
To report the results of a workshop regarding asthma management programs and centers (AMPCs) in Brazil, so that they can be used as a tool for the improvement and advancement of current and future AMPCs.


METHODS
The workshop consisted of five presentations and the corresponding group discussions. The working groups discussed the following themes: implementation of asthma management strategies; human resources needed for AMPCs; financial resources needed for AMPCs; and operational maintenance of AMPCs.


RESULTS
The workshop involved 39 participants, from all regions of the country, representing associations of asthma patients (n = 3), universities (n = 7), and AMPCs (n = 29). We found a direct relationship between a lack of planning and the failure of AMPCs. Based on the experiences reported during the workshop, the common assumptions about AMPCs in Brazil were the importance of raising awareness of managers; greater community participation; interdependence between primary care and specialized care; awareness of regionalization; and use of medications available in the public health system.


CONCLUSIONS
Brazil already has a core of experience in the area of asthma management programs. The implementation of strategies for the management of chronic respiratory disease and their incorporation into health care system protocols would seem to be a natural progression. However, there is minimal experience in this area. Joint efforts by individuals with expertise in AMPCs could promote the implementation of asthma management strategies, thus speeding the creation of treatment networks, which might have a multiplier effect, precluding the need for isolated centers to start from zero.
University of São Paulo, School of Medicine, Hospital das Clínicas, São Paulo, Brazil. Department of Pulmonology, Heart Institute, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - HC-FMUSP, University of São Paulo School of Medicine Hospital das Clínicas - São Paulo, Brazil.
Rafael
R
Stelmach
State University at Londrina, Londrina, Brazil. (Paraná) State University at Londrina; and Coordinator. Programa Respira Londrina (Breathe, Londrina Program), Londrina, Brazil.
Alcindo
A
Cerci Neto
Programa Criança que Chia, Belo Horizonte, Brazil. Programa Criança que Chia (Wheezing Child Program), Belo Horizonte City Hall, Belo Horizonte, Brazil.
Ana Cristina de Carvalho Fernandez
AC
Fonseca
Jundiaí School of Medicine, Jundiaí, Brazil. Jundiaí School of Medicine, Jundiaí, Brazil.
Eduardo Vieira
EV
Ponte
Fortaleza Municipal Department of Health, Fortaleza, Brazil. Programa de Atenção Integral à Criança e Adulto com Asma de Fortaleza - PROAICA, Integrated Asthma Management Program for Chidren and Adults in Fortaleza - Fortaleza Municipal Department of Health, Fortaleza, Brazil.
Gerardo
G
Alves
University Hospital, Federal University of Maranhão, São Luís, Brazil. Asthma Patient Care Program, Federal University of Maranhão University Hospital, São Luís, Brazil.
Ildely Niedia
IN
Araujo-Costa
Federal University of Minas Gerais, Belo Horizonte, Brazil. Federal University of Minas Gerais; and Pediatric Pulmonologist. Centro Multidisciplinar para Asma de Difícil Controle - CEMAD, Multidisciplinary Center for the Treatment of Difficult-to-Control Asthma - and Programa Criança que Chia (Wheezing Child Program), Belo Horizonte City Hall, Belo Horizonte, Brazil.
Laura Maria de Lima Belizário Facury
LM
Lasmar
Programa Respira Londrina, Londrina, Brazil. Programa Respira Londrina (Breathe, Londrina Program), Londrina, Brazil.
Luci Keiko Kuromoto de
LK
Castro
Conceição Hospital Group, Porto Alegre, Brazil. Asthma Program, Conceição Hospital Group, Porto Alegre, Brazil.
Maria Lucia Medeiros
ML
Lenz
Asthma Patient Management Program, Montenegro, Brazil. Asthma Patient Management Program - RESPIRAÇÃO - Montenegro, Brazil.
Paulo
P
Silva
University of São Paulo, School of Medicine, Hospital das Clínicas, São Paulo, Brazil. Department of Pulmonology. Heart Institute, University of São Paulo School of Medicine Hospital das Clínicas, São Paulo, Brazil.
Alberto
A
Cukier
Fortaleza Municipal Department of Health, Fortaleza, Brazil. Fortaleza Municipal Department of Health, Fortaleza, Brazil.
Alexssandra Maia
AM
Alves
Bahia State Asthma Control Program, Salvador, Brazil. Programa para Controle da Asma na Bahia - ProAR, Bahia State Asthma Control Program - Salvador, Brazil.
Aline Silva
AS
Lima-Matos
Goiânia Municipal Department of Health, Goiânia, Brazil. Programa Catavento (Pinwheel Program), Goiânia Municipal Department of Health, Goiânia, Brazil.
Amanda da Rocha Oliveira
Ada R
Cardoso
Federal University of São Paulo, Paulista School of Medicine, Department of Pulmonology, São Paulo, Brazil. Department of Pulmonology, Federal University of São Paulo Paulista School of Medicine, São Paulo, Brazil.
Ana Luisa Godoy
AL
Fernandes
Federal University of Minas Gerais, Hospital das Clínicas, Belo Horizonte, Brazil. Pulmonology Outpatient Clinic, Federal University of Minas Gerais Hospital das Clínicas, Belo Horizonte, Brazil.
Bruno Piassi de
BP
São-José
Federal University of Paraná, Curitiba, Brazil. Federal University of Paraná, Curitiba, Brazil.
Carlos Antônio
CA
Riedi
Federal University of Pernambuco, Hospital das Clínicas, Recife, Brazil. Allergy Outpatient Clinic, Recife Allergology Center; and Volunteer Preceptor. Asthma Outpatient Clinic, Federal University of Pernambuco Hospital das Clínicas, Recife, Brazil.
Deborah
D
Schor
Federal University of Pernambuco, Mother and Child Department, Recife, Brazil. Mother and Child Department, Federal University of Pernambuco, Recife, Brazil.
Décio Medeiros
DM
Peixoto
Porto Alegre Hospital de Clínicas, Montenegro, Brazil. Porto Alegre Hospital de Clínicas, Porto Alegre, Brazil and Asthma Patient Management Program - RESPIRAÇÃO - Montenegro, Brazil.
Diego Djones
DD
Brandenburg
Conceição Hospital Group, Porto Alegre, Brazil. Conceição Hospital Group, Porto Alegre, Brazil.
Elineide Gomes Dos Santos
EG
Camillo
School of Medical Sciences, Santa Casa de Misericórdia de Vitória, Vitória, Brazil. Asthma Program, Santa Casa de Misericórdia de Vitória School of Medical Sciences, Vitória, Brazil.
Faradiba Sarquis
FS
Serpa
Bahia State University at Feira de Santana, Department of Pediatrics, Feira de Santana, Brazil. Department of Pediatrics, Bahia State University at Feira de Santana; and Coordinator. Feira de Santana Asthma and Allergic Rhinitis Control Program, Feira de Santana, Brazil.
Heli Vieira
HV
Brandão
Porto Alegre Municipal Department of Health, Porto Alegre, Brazil. Asthma Program, Porto Alegre Municipal Department of Health, Porto Alegre, Brazil.
João Antonio Bonfadini
JA
Lima
Rio de Janeiro Municipal Department of Health, Rio de Janeiro, Brazil. Rio de Janeiro Municipal Department of Health, Rio de Janeiro, Brazil.
Jorge Eduardo
JE
Pio
Pontifical Catholic University of Rio Grande do Sul, School of Medicine, Porto Alegre, Brazil. Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Pontifical Catholic University of Rio Grande do Sul - School of Medicine, Porto Alegre, Brazil.
Jussara
J
Fiterman
Brazilian Association of Asthma Patients, Rio de Janeiro, Brazil. Associação Brasileira de Asmáticos - ABRA, Brazilian Association of Asthma Patients - Rio de Janeiro, Brazil.
Maria de Fátima
Mde F
Anderson
Federal University of Amazonas, Manaus, Brazil. Programa de Assistência e Controle da Asma - PACA, Asthma Care and Control Program - and Associate Professor. Universidade Federal do Amazonas - UFAM, Federal University of Amazonas - Manaus, Brazil.
Maria do Socorro de Lucena
Mdo S
Cardoso
Santa Casa Sisters of Mercy, Hospital of Porto Alegre, Porto Alegre, Brazil. Universidade de Santa Cruz do Sul - UNISC, University of Santa Cruz do Sul - Santa Cruz do Sul, Brazil; and Pulmonologist. Pereira Filho Ward, Irmandade da Santa Casa de Misericórdia de Porto Alegre - ISCMPA, Santa Casa Sisters of Mercy Hospital of Porto Alegre - Porto Alegre, Brazil.
Marcelo Tadday
MT
Rodrigues
Uruguaiana Municipal Department of Health, Uruguaiana, Brazil. Programa Infantil de Prevenção de Asma - PIPA, Children's Asthma Prevention Program - Uruguaiana Municipal Department of Health, Uruguaiana, Brazil.
Marilyn Nilda Esther Urrutia
MN
Pereira
Sorocaba Municipal Asthma Program, Sorocaba, Brazil. Sorocaba Municipal Asthma Program, Sorocaba, Brazil. Physician. Programa Respira Rio, Rio de Janeiro, Brazil. Programa Respira Rio (Breathe, Rio Program), Rio de Janeiro, Brazil.
Marti
M
Antila
Brazilian Society of Family and Community Medicine, Rio de Janeiro, Brazil. Grupo de Trabalho de Problemas Respiratórios - GRESP, Working Group on Respiratory Problems - Sociedade Brasileira de Medicina de Família e Comunidade - SBMFC, Brazilian Society of Family and Community Medicine - Rio de Janeiro, Brazil.
Sonia Maria
SM
Martins
Brasília Mother and Child Hospital, Brasília, Brazil. Programa de Atendimento ao Paciente Asmático do Distrito Federal - PAPA-DF, Asthma Patient Management Program in the Federal District of Brasília - and Supervisor. Residency Program in Pediatric Allergy and Immunology, Brasília Mother and Child Hospital, Brasília, Brazil.
Vanessa Gonzaga Tavares
VG
Guimarães
Associação Brasileira de Asmáticos, São Paulo, Brazil. Department of Allergy and Immunology, Edmundo Vasconcelos Hospital Complex; and Director. Associação Brasileira de Asmáticos-São Paulo - ABRA, Brazilian Association of Asthma Patients-SP - São Paulo, Brazil.
Yara Arruda Marques
YA
Mello
Itabira Municipal Department of Health, Itabira, Brazil. Projeto Respirai (Breathe Project), Itabira Municipal Department of Health, Itabira, Brazil.
Wenderson Clay Correia de
WC
Andrade
São Camilo University Center, School of Medicine, São Paulo, Brazil. Department of Pulmonology, ABC School of Medicine, Santo André, Brazil; and Professor. São Camilo University Center School of Medicine, São Paulo, Brazil.
William
W
Salibe-Filho
Associação Brasileira de Asmáticos, São Paulo, Brazil. Niterói Municipal Health Foundation, Niterói, Brazil. Pediatrician and Director of Government Policy and International Relations. Associação Brasileira de Asmáticos-São Paulo - ABRA, Brazilian Association of Asthma Patients-SP - São Paulo, Brazil.
Zelina Maria da Rocha
ZM
Caldeira
Federal University of Bahia, School of Medicine, Salvador, Brazil. Federal University of Bahia School of Medicine; and Coordinator. Center of Excellence in Asthma, Salvador, Brazil.
Álvaro Augusto Souza da
ÁA
Cruz-Filho
Federal University of Minas Gerais, Department of Pediatrics, Belo Horizonte, Brazil. Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Paulo
P
Camargos
D001249:Asthma / Q000628:therapy*; D001938:Brazil; D002908:Chronic Disease; D003695:Delivery of Health Care; D019468:Disease Management; D019538:Health Care Surveys; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D009313:National Health Programs; D016730:Program Development
Academic medical centers; Area health education centers; Asthma; Health planning organizations; Managed care programs; Regional medical programs