Subject(s)
Humans , Primary Health Care/trends , Community Health Services , Community ParticipationSubject(s)
Humans , Coronavirus Infections/epidemiology , Pandemics , Health Systems , Primary Health Care , Economic Development , AgedABSTRACT
The objective of this study was to assess the impact of an education intervention for primary health care physicians, based on the knowledge of clinical practice guidelines and availability of rapid antigen detection test for group A streptococci (GAS), on the improvement of antibiotic prescription for patients with acute respiratory tract infections. Before and after the intervention, physicians collected data from ten consecutive patients who attended during a 3-week period. This process was performed twice a year for 6 consecutive years (2012-2017). A total of 18,001 patients were visited by 391 primary care physicians during the study period, 55.6% before intervention and 44.4% after intervention. After intervention, the antibiotic prescription decreased significantly, from 33.0 to 23.4% (p < 0.01). However, there was a statistically significant increase (p < 0.01) in the use of penicillins. This study, carried out in daily practice conditions, confirms that the educational strategy was associated with an overall reduction in the use of antibiotics and an improvement in the antibiotic prescription profile in acute respiratory tract infections.
Subject(s)
Anti-Bacterial Agents , Respiratory Tract Infections , Anti-Bacterial Agents/therapeutic use , Educational Status , Humans , Practice Patterns, Physicians' , Prescriptions , Respiratory Tract Infections/drug therapyABSTRACT
OBJECTIVE: In this pilot clinical study we investigated the effect on blood pressure (BP) of two community-based exercise training programs of high (HIT) vs. low-moderate intensity (LMIT) in hypertensive individuals receiving at least one antihypertensive drug. METHODS: The study included two phases of physical exercises based on 1-h session, 3 days/week for 12 and 16 weeks, respectively, separately by a 7-week resting period. Each phase was preceded by a four-week conditioning training period. According to the average maximal heart rate at baseline, participants were randomized to HIT (80-90%), LMIT (50-70%) or no-exercise (control). Heart rate was monitored during workout and BP profiles were registered by ambulatory BP monitoring at the beginning and end of each phase. RESULTS: Of 60 individuals randomized, 44 completed the study (HIT, n = 10; LMIT, n = 16; controls, n = 18). BP levels were significantly reduced after the second phase for both LMIT (SBP -3.1 mmHg, DBP -2.4 mmHg) and HIT (SBP -10.8 mmHg, DBP -8.3 mmHg). Similar levels of improvement were also found in daytime and night-time BP. Mean attendance of the prescribed training sessions was 87.4 ± 6.2% for HIT and 87.4 ± 5.3% for LMIT during the first phase and 84.1 ± 5.0% and 85.2 ± 5.9% during the second phase, respectively (p = 0.047). CONCLUSION: Both HIT and LMIT exercise training programs reduced BP but the HIT modality showed a lower rate of compliance with proposed training schedule. Intensity of training should be individually prescribed to improve tolerance to more high intensity exercises.
ABSTRACT
Background: Physical inactivity implies a significant individual and society health burden.Objectives: To assess the feasibility of implementing a preventive physical exercise (PE) programme for the general population and to analyse changes in fitness-related variables and quality of life.Methods: Pre-post comparison study in which general practitioners and nurses recommended PE to participants with sedentary behaviour and hypertension or dyslipidaemia attending in primary care for primary prevention of ischaemic cardiovascular disease. Eligible participants were referred to a PE programme (10 weeks, three days a week, a total of 30 sessions of one-hour duration). Data was collected for five years (2013-2017). Outcome measures were body weight, body mass index (BMI), physical condition (aerobic fitness, muscle strength, flexibility, balance), and quality of life (SF-36).Results: The PE programme was offered to 6,140 eligible subjects; 5,077 (82.7%) accepted to participate and received a recommendation; 3,656 (69.6% women) started the programme and 2,962 subjects (80.9% women) finished the programme. After 10 weeks, there were significant improvements (mean difference, 95% CI) in aerobic fitness (2.55 ml/min/kg, 2.32-2.79), muscle strength (0.62 m, 0.57 to 0.67), flexibility (2.34 cm, 2.06 to 2.63) and balance (-0.46 falls, -0.60 to -0.33) as well as significant decreases in body weight (-0.41 kg, -0.64 to -0.17) and BMI (-0.27 kg/m2, -0.34 to -0.20).Conclusion: Implementation of a government-supported PE programme for the general population recruited in the primary care setting and recommended by healthcare professionals is feasible, and was associated with health benefits, mainly improvements in physical fitness.
Subject(s)
Cardiovascular Diseases/prevention & control , Community Health Services/methods , Dyslipidemias/therapy , Exercise , General Practice , Hypertension/therapy , Primary Prevention/methods , Sedentary Behavior , Adolescent , Adult , Aged , Body Mass Index , Community Health Services/organization & administration , Feasibility Studies , Female , Heart Disease Risk Factors , Humans , Implementation Science , Male , Middle Aged , Muscle Strength , Physical Fitness , Postural Balance , Primary Prevention/organization & administration , Quality of Life , Range of Motion, Articular , Spain , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Health Behavior , Health Status , Health Promotion/methods , Life Style , Evaluation of the Efficacy-Effectiveness of InterventionsABSTRACT
No disponible