ORGANIZATION OF PRIMARY HEALTHCARE FOR USERS WITH CHRONIC MUSCULOSKELETAL PAIN BY PROGNOSTIC STRATIFICATION

Primary healthcare provides coordinated care to the needs of users of the Brazilian Unified Health System (SUS), within the Health Care Network (RAS), in a collaborative intervention model that involves the primary, secondary and tertiary levels of healthcare. The prognostic stratification of SUS users with chronic musculoskeletal pain can help structure the care network and establish adequate flows for user care. To analyze the prognostic stratification of SUS users with chronic musculoskeletal pain referred to the pain neuroscience education program (EducaDor), in the city of Guarapuava, Brazil This is an exploratory cross-sectional observational study, following the recommendations of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). The sample consisted of 140 SUS users with chronic musculoskeletal pain, referred from primary healthcare in Guarapuava city to the EducaDor program. The prognostic stratification for chronic musculoskeletal pain was analyzed using the Keele STarT MSK Tool: 0 to 4 points for low risk, 5 to 8 points for medium risk, and 9 to 12 points for high prognostic risk. Sociodemographic data, performance and location of physiotherapeutic treatment (primary healthcare, or medium-complexity clinic) were collected. The study included 114 SUS users with chronic musculoskeletal pain, aged 55.46±11.9 years, and 79% (n=90) were women. 7% (n=8) of SUS users were low risk, 43% (n=49) were medium risk, and 50% (n=57) were high risk. It was also observed that primary healthcare did not carry out physical therapy interventions for users with low risk, intervening only in users with medium and high risk (n=31; 27.2%). Primary healthcare performs physical therapy interventions for SUS users with chronic musculoskeletal pain at medium and high prognostic risk. This indicates that an organizational redesign of the referral system for users with chronic musculoskeletal pain should be structured in the public health, keeping SUS users with low risk in primary healthcare. Those SUS users with medium and high risk should be referred to specialized services in the secondary level of healthcare. It is necessary to analyze the organization of primary healthcare regarding the referral system for SUS users with chronic musculoskeletal pain. The Keele STarT MSK Tool is an instrument that can be implemented in primary healthcare to organize the Health Care Network of SUS users with chronic musculoskeletal pain and improve clinical d