Background and Aims

Stroke care in Brazil has improved with the organization of acute stroke care. But it was not enough to reduce the 400,000 cases that occur each year. We present a strategy of modifying the primary prevention for stroke in Brazil with the restructuring of primary care.

Methods

The strategy is a task force, uniting the Pan American Health Organization, the Brazilian Ministry of Health, the Medical Societies acting to plan, train and implement the restructuring of primary care, based on the HEARTS program of the World Health Organization and Cut Stroke in Half of the World Stroke Organization. It is a gradual and monitored change in the way of care in primary care, adapting the programs through flowcharts and simplification of processes through protocols.

Results

The steps for implementation: 1)Organization of a committee with neurologists, cardiologists and family doctors; 2)Choice of 8 health units to implement a pilot; 3)Preparation and adaptation of technical protocols for screening and treatment of hypertension and diabetes (based on the HEARTS program); 4)Implementation of a protocol for atrial fibrilation screening with a point-of-care mobile ECG recording; 5)Preparation of printed material for lifestyle modification; 6)Implementation of Stroke Riskometer App; 6)Preparation of an educacion course for primary care professionals including community health works; 7)Implementation of decision, data collection and monitoring software enriched with artificial intelligence.

The implementation starts on June 2021 and will be expanded to 60 Units of Health in the whole country in 2022.

Conclusions

The success of implementation in the country has potential to decrease in 50% the incidence of stroke.