[Screening and effectiveness evaluation of a brief intervention in risk drinkers seen in primary health care]. / Evaluación del cribado y la efectividad de una intervención breve en bebedores de riesgo atendidos en consultas de atención primaria.

AIMS: To evaluate the screening, the effectiveness of an antialcoholic brief intervention for risk drinkers, the acceptation level to participate in this study, and the analytical parameters evolution associated to the alcohol consumption after of the intervention. DESIGN: Longitudinal prospective intervention study of 1 year of duration. SETTING: 5 urban primary care physician's practices. PARTICIPANTS: Of an aleatory pattern of 681 patients, men and women of 18-65 years old, were selected 78 risk drinkers. Patients with exclusion criteria (n=10), didn't wanted to participate (n=24) and had suspicion of alcoholic dependence syndrome (ADS) (n=11), didn't participated in this intervention. INTERVENTIONS: Were offered antialcoholic brief counselling with written supporter and were followed with alcohol consumption rate and analytical control at 2 and 12 months. MAIN MEASURES: Was estimated the prevalence of risk drinkers, the acceptation level to participate in this study, alcohol consumption and risk drinkers decreased at 2 and 12 months, analytical parameters evolution after of the intervention. RESULTS: Prevalence of risk drinkers: 11.5% (95% confidence interval [CI], 8.3%-14.7%). Acceptation level to participate in this study: 64.7%. Significative alcohol consumption decreased at 2 and 12 months (P<.05). Risk drinkers decreased: at 2 months were 57.6% (95% CI, 50.3%-64.9%; P=.01) and at 12 months were 42.4% (95% CI; 35.9%-48.9%) (P=.003). GGT, MCV, cholesterol, and triglycerides significative decreased. CONCLUSIONS: Low prevalence of risk drinkers without suspicion of ADS in our setting; high effectiveness of antialcoholic brief counselling and high acceptation level to participate in this study; reduction of the GGT, MCV, cholesterol, and triglycerides after of the intervention.

[Evaluation of infiltrations performed in primary care]. / Evaluación de las infiltraciones realizadas en atención primaria.

OBJECTIVES: To describe the evolution of the pain and the functional impotence in the articular and periarticular pathology after to infiltrate with local corticosteroid and anaesthetic; to analize the number of discharge certificates that maybe to give in the patients with employment transitory incapacity (ETI) during the first week post-infiltration. DESIGN: Intervention without control group. SETTING: Semiurban primary care physician's practices (ABS Piera). PARTICIPANTS: Men and women elder than 18 years old, with articular and periarticular pathology. INTERVENTION: Were infiltrated with local triamcinolone acetonid and bupivacain 2% 65 patients. MAIN MEASUREMENTS: Were gathered socio-demographic factors, diagnostic, response, number of infiltrations for patient, secondary effects, and number of discharge certificates that were given in the patients in ETI situation during the first week post-infiltration. RESULTS: Were infiltrated predominantly men (57%) with 31-65 years old (67.7%), employed (70.7%) in manual works (78.4%). Rotary joint tendinitis (46.2%) and epicondylitis (27.7%) were the most common diagnostics. Mean and CI (95%) obtained in the VAS for pain were: initially, 8.8 (7.4-9.8); week, 1.4 (1-1.8); 3 months, 2.2 (1.3-3.1), and year, 2.3 (1.1-3.5). Mean and CI (95%) found for functional impotence were: initially, 8.2 (6.7-9.7); week, 0.9 (0.7-1.1); 3 months, 1.2 (0.9-1.5), and year, 1.6 (1.4-1.8). The number of infiltrations for patient was 1.6. Hadn't important secondary effects. Were given 19 discharge certificates in 25 patients with ETI in the first week post-infiltration. CONCLUSIONS: The patients diminished the pain and the functional impotence in the articular and periarticular pathology after of the infiltration, allowing to give an elevate number of discharge certificates during the first week post-infiltration.

[A multicenter primary care study on alcohol consumption]. / Estudio multicéntrico sobre el abordaje del consumo de alcohol en atención primaria.

OBJECTIVES: To find records of alcoholic drink consumption in general medical records and actions taken when at-risk drinkers were identified. DESIGN: A descriptive study using clinical auditing at 4 Health Centres. PARTICIPANTS: 399 Primary Care (PC) clinical records. MEASUREMENTS AND MAIN RESULTS: Only 24.8% of the clinical records included alcoholic drink consumption over the last two years. Only 11 (2.8%)-all for men-of the records examined fulfilled the criteria for the drinker being considered at-risk. Low recording of alcohol might be for different reasons: some related to the professionals, others to the internal organisation of the PC team, yet others due to the external support structure. Causes related to internal organisation and the professionals were considered priority, as it was harder to intervene from the team into external causes. CONCLUSIONS: The results show low recording of alcohol consumption and justify the design of specific interventions. The methodology of continual quality improvement helps us identify the causes, the possible solutions and to design the strategy for change.