Analisis de la prescripción farmacológica en pacientes institucionalizados / Analysis of the medical prescription in institutionalised patients

Objetivos. Valorar la concordancia terapéutica de fármacos prescritos con sus diagnósticos en pacientes institucionalizados en 2 periodos de tiempo, así como las características de esta prescripción. Material y métodos. Estudio observacional, descriptivo y cuasiexperimental. Se analiza la prescripción y diagnósticos clínicos de pacientes institucionalizados y al cuidado de un mismo profesional médico en 2 periodos de tiempo y con un intervalo de un año (2010-2011), ofreciendo en ese intervalo información sobre la prescripción. Resultados. Se estudió a 81 pacientes (78% mujeres), con edad media de 84 ± 7 años y con 5 ± 2 diagnósticos por paciente. El número de fármacos distintos por paciente fue más de 8 en los 2 periodos, siendo superior en el 2011 frente al 2010. De todos los fármacos prescritos, nos encontramos que en el año 2010 el 8,88% y en el 2011 el 9,38% están incluidos en el grupo de fármacos de utilidad terapéutica baja. En el año 2010 se aprecia una concordancia del 86,71 ± 13,75 frente a 87,17 ± 14,58 en el año 2011, es decir, el 87% de los pacientes tienen fármacos acordes a sus diagnósticos, lo que supone una mejora del 0,47 de un periodo con respecto al otro. No existen diferencias estadísticamente significativas entre ambos años. Conclusiones. La prescripción en pacientes institucionalizados es muy elevada y el número de fármacos por paciente aumentó tras la información. Cuando analizamos los fármacos prescritos destaca un alto porcentaje de medicamentos incluidos en el grupo de utilidad terapéutica baja (citicolina). Un porcentaje significativo de prescripciones no se corresponden con los diagnósticos presentes en su historia clínica (AU)

Objectives. To evaluate/assess the therapeutic concordance/agreement with prescribed medication in patients institutionalized diagnoses in two periods of time as well as the characteristics of this prescription. Material and methods. Observational and descriptive study. Prescribing and clinical diagnoses of institutionalized patients were analyzed. These patients were treated by the same physicians during the period of time with a one-year interval (2010-2011), offering prescribing information in this period. Results. A total of 81 patients (78% women), mean age 84 ± 7 years, and 5 ± 2 diagnoses per patient. The number of drugs per patient was more than 8 in the 2 periods, being higher in 2011 compared to 2010. From all the prescription, we found that 8.88% in 2010 and 9.3% in 2011 are included as “limited clinical value” drugs. In 2010, it sees a concordance of 86.71 ± 13.75 against 87.17 ± 14.58 in 2011, it means, 87% of patients are treated with drugs in agreement with their diagnoses, representing an increase of 0.47 in 2011 regarding 2010. No statistically significant differences between the 2 years. Conclusions. The prescriptions in institutionalized patients are very high and the number of drugs per patient increased after information. When we analyzed prescriptions we underline a high percentage of drugs included in the group of limited clinical value (citicoline). A significant percentage of prescriptions don’t correspond with diagnoses avaiable in their clinical history (AU)

[Analysis of the medical prescription in institutionalised patients]. / Analisis de la prescripción farmacológica en pacientes institucionalizados.

OBJECTIVES: To evaluate/assess the therapeutic concordance/agreement with prescribed medication in patients institutionalized diagnoses in two periods of time as well as the characteristics of this prescription. MATERIAL AND METHODS: Observational and descriptive study. Prescribing and clinical diagnoses of institutionalized patients were analyzed. These patients were treated by the same physicians during the period of time with a one-year interval (2010-2011), offering prescribing information in this period. RESULTS: A total of 81 patients (78% women), mean age 84±7 years, and 5±2 diagnoses per patient. The number of drugs per patient was more than 8 in the 2 periods, being higher in 2011 compared to 2010. From all the prescription, we found that 8.88% in 2010 and 9.3% in 2011 are included as "limited clinical value" drugs. In 2010, it sees a concordance of 86.71±13.75 against 87.17±14.58 in 2011, it means, 87% of patients are treated with drugs in agreement with their diagnoses, representing an increase of 0.47 in 2011 regarding 2010. No statistically significant differences between the 2 years. CONCLUSIONS: The prescriptions in institutionalized patients are very high and the number of drugs per patient increased after information. When we analyzed prescriptions we underline a high percentage of drugs included in the group of limited clinical value (citicoline). A significant percentage of prescriptions don't correspond with diagnoses avaiable in their clinical history.

Percepción de los pacientes sobre la atención recibida por el personal no sanitario en los centros de salud / Patients’ perception on attention received from Health Centres non-sanitary staff

Objetivos. Conocer la percepción que tienen los usuarios sobre algunos aspectos interpersonales y técnicos relacionados con la atención que reciben del personal de atención al ciudadano cuando acuden a los centros de atención primaria. Valorar la posible utilidad de dos modos de medición de la satisfacción. Material y métodos. Estudio observacional descriptivo realizado con usuarios que utilizaron los servicios de atención al ciudadano de los centros de salud. Tras consultar con este personal, los usuarios fueron entrevistados personalmente utilizando dos tipos de preguntas que evaluaron sus opiniones y satisfacción con diferentes aspectos comunicacionales y de tipo técnico relacionados con la demanda realizada. Las preguntas abiertas fueron agrupadas en categorías en un proceso que involucró a tres investigadores de manera independiente. Se realizó un análisis descriptivo e inferencial (test de la X2, p<0,05). Resultados. Más de un 90% (360) de los usuarios encuestados declararon estar satisfechos o muy satisfechos con la atención recibida en atención al ciudadano; sin embargo, entre el 18 y el 36% hicieron sugerencias para mejorar esta atención tras su consulta. Independientemente del dominio explorado, destacaron las sugerencias referidas a la relación/comunicación, capacitación del personal para resolver los problemas, calidad y cantidad de las explicaciones y tiempo de espera. Conclusiones. Las encuestas que incorporan preguntas abiertas parecen más útiles para valorar la calidad de la atención recibida de los administrativos de los centros de salud, detectar problemas en esta atención y planificar nuevas intervenciones de mejora. Los aspectos relacionales e informativos representan un área de mejora prioritaria en este ámbito(AU)

Aims. To know patients’ perceptions about relational aspects and technical procedures when they are attended by the administrative staff in Health Centres. To assess the utility of two ways for measuring satisfaction. Material and methods. Cross-sectional study carried out in people attending the administrative sections of Health Centres for diverse reasons. Just after the interaction with the administrative they were interviewed using two different questions for assessing their opinions and satisfaction with communicational and technical aspects related with their demands. Descriptive analysis. Significant differences among mean was explored by X2 test. Open-ended questions were grouped in categories in a process involving three researchers independently. Results. Over than 90% (360) of the attendees declared to be satisfied or very satisfied with the service received from the staff personal. Nevertheless, among 18-36% gave suggestions for improving the service after their consultation. Independently the domain explored, people suggested the communicational, personal capability, quality and quantity of explanations and waiting time as the main aspects to be improved. Conclusions. Surveys with open-ended questions are more useful to assess the quality of the attention the citizens receive from no-sanitary staff in Health Centres. These type of questions are also more useful for detecting problems and planning new interventions. Relational and informative issues seem to be the most prioritary areas to improve in this section of Health Centres(AU)

[Patients' perception on attention received from Health Centres non-sanitary staff]. / Percepción de los pacientes sobre la atención recibida por el personal no sanitario en los centros de salud.

AIMS: To know patients' perceptions about relational aspects and technical procedures when they are attended by the administrative staff in Health Centres. To assess the utility of two ways for measuring satisfaction. MATERIAL AND METHODS: Cross-sectional study carried out in people attending the administrative sections of Health Centres for diverse reasons. Just after the interaction with the administrative they were interviewed using two different questions for assessing their opinions and satisfaction with communicational and technical aspects related with their demands. Descriptive analysis. Significant differences among mean was explored by χ(2) test. Open-ended questions were grouped in categories in a process involving three researchers independently. RESULTS: Over than 90% (360) of the attendees declared to be satisfied or very satisfied with the service received from the staff personal. Nevertheless, among 18-36% gave suggestions for improving the service after their consultation. Independently the domain explored, people suggested the communicational, personal capability, quality and quantity of explanations and waiting time as the main aspects to be improved. CONCLUSIONS: Surveys with open-ended questions are more useful to assess the quality of the attention the citizens receive from no-sanitary staff in Health Centres. These type of questions are also more useful for detecting problems and planning new interventions. Relational and informative issues seem to be the most prioritary areas to improve in this section of Health Centres.