Implementation of ‘matrix support’ (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study

Collaborative care could improve management of asthma and chronic obstructive pulmonary disease (COPD). To maximize resources available for asthma and COPD care, Sonia Martins, Rafael Stelmach and colleagues, of the Respiratory Group of Brazilian Society of Family Medicine and Community and University of Sao Paulo in Brazil, implemented a collaborative care model in three of the nine health territories in the city of Sao Bernardo do Campo in southeastern Brazil. Family doctors, nurses and healthcare managers attended an eight-hour workshop led by three pulmonologists and one primary care physician to raise professional awareness of the two conditions. Primary care physicians then conducted joint consultations with pulmonologists on patients, followed by individual case discussions without patients. The approach was effective in improving the knowledge and confidence of primary care professionals in managing asthma and COPD. It also decreased the number of referrals to specialists.