MANEJO DA HIPERTENSÃO E DIABETES NA ATENÇÃO BÁSICA: UMA REVISÃO SISTEMÁTICA DAS ESTRATÉGIAS DE CONTROLE E ACOMPANHAMENTO
Bibliographic record
Abstract
Objective: To evaluate the effectiveness of management strategies for systemic arterial hypertension and type 2 diabetes mellitus in primary health care, identifying the most effective approaches for blood pressure and glycemic control. Methods: Systematic review conducted according to PRISMA 2020 guidelines. A comprehensive search was performed in PubMed/MEDLINE, Embase, Cochrane Library, LILACS, SciELO, Scopus, and Web of Science databases from January 2009 to September 2024. We included randomized controlled trials and prospective cohort studies evaluating management strategies for adults with hypertension and/or diabetes in primary care settings. Two independent reviewers performed study selection, data extraction, and methodological quality assessment using RoB 2 for clinical trials and Newcastle-Ottawa Scale for observational studies. Primary outcomes were blood pressure control (<140/90 mmHg) and glycemic control (HbA1c <7%). Evidence certainty was assessed using the GRADE system. Results: We identified 2,847 records, of which 42 studies met inclusion criteria, involving 28,564 participants. The most effective strategies included: multiprofessional shared care (RR 1.34; 95% CI 1.18-1.52 for blood pressure control), structured health education programs (MD -0.8%; 95% CI -1.2 to -0.4 for HbA1c), and standardized clinical management protocols (RR 1.28; 95% CI 1.15-1.43 for glycemic control). Telemonitoring proved effective in contexts with adequate technological resources (MD -8.2 mmHg; 95% CI -12.1 to -4.3 for systolic blood pressure). Combined pharmacological and non-pharmacological interventions demonstrated superiority over isolated approaches. Evidence quality ranged from moderate to high for primary outcomes. Conclusions: Integrated multiprofessional strategies, standardized protocols, and structured educational programs are effective for hypertension and diabetes control in primary care. Implementation of shared care models and remote monitoring technologies can optimize clinical outcomes. The findings provide robust evidence to guide health policies and clinical protocols in primary care settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.085 | 0.166 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.012 | 0.008 |
| Bibliometrics | 0.013 | 0.014 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.007 | 0.006 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".