[Epidemiological study on the impact of influenza vaccination on the clinical course of patients with COVID-19 and co-infection by both viruses in Gran Canaria, Spain]. / Estudio epidemiológico sobre el impacto de la vacunación antigripal en la evolución clínica de pacientes con COVID-19 y la coinfección por ambos virus en Gran Canaria, España.

OBJECTIVE: To analyze the frequency of influenza and SARS-CoV-2 co-infections, as well as the differences in the course of disease (risk of mortality, hospital and intensive care admissions) in patients infected with the SARS-CoV-2 virus in relation to flu vaccination status in the 2021-2022 season. METHODS: Population-based observational retrospective study in a cohort of 19,850 patients diagnosed with COVID-19 between June 1, 2021 and February 28, 2022 on the island of Gran Canaria. RESULTS: A total of 1,789 patients (9%) diagnosed with COVID-19 had received flu vaccinations. 13,676 people (68.9%) had a full course of COVID-19 vaccinations. In the period between June 1, 2021 and February 28, 2022, 8 cases of flu and COVID-19 coinfection were recorded. Hypertension (18.5%), asthma (12.8%) and diabetes (7.2%) were the most frequent comorbidities. There were 147 deaths (0.7%). Older patients ([OR] 1.11 95% CI 1.09-1.13) and people with cancer ([OR] 4.21 95% CI 2.58-6.89) had a higher risk of dying from COVID-19 (p<0.05). Female sex was noted as a protective factor ([OR] 0.61 95% CI 0.40-0.92). CONCLUSIONS: Old age, male sex and cancer were independent prognostic factors for mortality. Three doses of SARS-CoV-2 vaccines and influenza vaccines were highly effective in preventing COVID-19-related deaths and hospital admissions. These findings suggest that flu vaccination can help control the pandemic.

[Evaluation of the proper use of medicines in primary care. How can this be improved?]. / Evaluación del uso apropiado de medicamentos en atención primaria. Cómo se puede mejorar?

INTRODUCTION: The process of medicating a patient embraces the identification of the health problem, the doctor's prescription to treat this indication, the dispensing of the medicine and its consumption. The studies of use of medicine analyse this process in order to detect those factors that impinge on the correct use of medicines. OBJECTIVE: To evaluate the quality of the prescription of certain primary care medicines as a function of the indication for which they were prescribed, detecting those features of the patients, prescribing doctors, primary care centre and health district that affect their inappropriate use. METHOD: Prescription-indication study based on the calculation of multiple-level models with individualised data bases for the prescriptions. These include characteristics of the prescriptions, patients, doctors, health centres and the health district involved. These models are a step forward in this kind of study, in that they enable analysis of the information from different levels at the same time as calculation of the respective degrees of responsibility for inadequacies of prescription. DISCUSSION: Apart from its methodological originality, which may serve for subsequent studies, the main interest of this study lies in the pioneering nature of its massive use of population micro-data to evaluate prescription quality. These data are taken from the computerised clinical records in primary care.

[The integrated management software of primary care,a tool for analysing indicators of use]. / El software de gestión integral de la atención primaria, una herramienta de análisis de los indicadores de utilización.

OBJECTIVES: To analyse the indicators of use in the Gran Canaria Health Area. To characterise over-users so that the primary care team can take corrective measures. To design a computer tool giving appropriate useful information to the management, that can be directly put into practice in primary care. DESIGN: Retrospective descriptive study. SATTING: Gran Canaria Health Area. Hierarchical descent in the analysis of data in the base health area and family care unit, in the year 2000. PARTICIPANTS: Users of the Canaries Health Service registered on the individual health card data base. MAIN MEASUREMENTS AND RESULTS: The activity generated by 636 270 users with 2 876 394 appointments was studied. Mean frequency of attendance in the Gran Canaria Health Area was 4.52, with a 67.3% use rate. The user causing 11 or more visits per year was defined as an over-user. 13.4% of users were over-users and caused among them 52.3% of visits. 32.7% of users registered made no visit. CONCLUSIONS: A small section of the population causes over half the consultations. The characteristics of these users need to be analysed so that programmes can be worked out to decrease their frequency of use. The integrated management software for primary care enables this information to be analysed and serves as a support for the primary care teams. Special attention needs to be paid to the population that does not use the health centres.