[Comparing group educational intervention to individual and self-learning in COPD]. / Comparación de intervención educacional grupal frente a una individual y el autoaprendizaje en EPOC.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is considered a public health issue which affects 10.2% of Spanish population between 40 and 80 years of age. Many patients do not perform well the inhalation technique. Error rates vary between 50-80% depending on the device under study. These values haven been proven to decrease with educational interventions. OBJECTIVE: To ascertain whether a group educational intervention is superior to an individual intervention or to a conventional approach in these patients as regards quality of life measured by means of the total score of the COPD Assessment Test (CAT),of adherence to treatment, exacerbations and hospitalizations. MATERIAL AND METHODS: A multicenter, multidisciplinary cluster-randomized controlled clinical trial with three branches (conventional intervention, individual intervention and group intervention) in a cohort of COPD-patients. Sociodemographic data and risk factors were collected and several questionnaires were completed (CAT, BODEx, Barthel, Lawton y Brody). A descriptive analysis of qualitative and quantitative variables and a multiple linear regression were conducted. OUTCOMES: 149 patients of average age 69.08 (SD 1.26). Significant differences were observed in CAT in the different intervention groups according to the level of severity on BODEx. The rate of patients performing well the inhalation technique was significantly lower at the beginning of the study and the number of exacerbations was lower after the intervention. Last year's exacerbations were linearly related to post-intervention suffering. CONCLUSIONS: Better results are obtained using the traditional and individual interventions. There is a decrease in number of exacerbations, hospitalizations, CAT score and post-intervention inhalation technique.

Hipotiroidismo adulto en una zona básica de salud / Hypothyroidism in adults in a basic health area

Introducción. El objetivo del presente trabajo es estudiar la prevalencia y las características clínicas y epidemiológicas de la enfermedad hipotiroidea en el adulto, a través del registro de datos electrónicos de la historia clínica. Material y métodos. Estudio observacional, descriptivo y transversal. La población diana eran los pacientes de los centros de salud de Lucena I y II (Córdoba). Criterios de inclusión: pacientes que tuvieran 14 años o más, diagnosticados de hipotiroidismo, nacidos y con residencia en Lucena. Se seleccionaron 214 pacientes a través de un muestreo aleatorio, los cuales se sometieron a una entrevista clínica mediante un cuestionario. Resultados. La edad media de los pacientes fue de 49,71 años (DT 17,03; IC 95% 47,34-51,98), siendo el 85,5% mujeres. El 74,8% son diagnosticados de hipotiroidismo subclínico frente al 18,7% de hipotiroidismo primario y un 6,5% de hipotiroidismo secundario. El 53,7% (IC 95% 46,81-60,59) de los pacientes diagnosticados de hipotiroidismo no tienen pedidos los anticuerpos tiroideos; sin embargo, un 75,2% (IC 95% 68,89-80,86) están recibiendo tratamiento con levotiroxina. La prevalencia de hipotiroidismo fue de un 5,7% (IC 95% 5,46-5,96). Conclusiones. El hipotiroidismo subclínico es muy frecuente en las consultas de Atención Primaria. Muchos pacientes no están correctamente diagnosticados y otros están sobremedicados, por lo que sería preciso revisar el diagnóstico

Introduction. The objective of the present study is to study the prevalence, as well as the clinical and epidemiological characteristics of hypothyroid disease in adults using the computerised clinical records. Material and methods. Observational, descriptive and cross-sectional study. The target population was the patients of the health centres of Lucena I and II (Córdoba). Inclusion criteria: Patients 14 years or older, diagnosed with hypothyroidism, born and resident in Lucena. Two hundred and fourteen patients were recruited by random sampling, who then underwent a clinical interview using a questionnaire. Results. The mean age of the patients was 49.71 years (SD 17.03; 95% CI 47.34-51.98), with 85.5% women. A diagnosis of sub-clinical hypothyroidism was found in 74.8%, compared to 18.7% of primary hypothyroidism, and 6.5% of secondary hypothyroidism. The 53.7% (95% CI 46.81-60.59) of patients diagnosed with hypothyroidism did not have thyroid antibodies results. However, 75.2% (95% CI 68.89-80.86) were being treated with levothyroxine. The prevalence of hypothyroidism was 5.7% (95% CI 5.46-5.96). Conclusions. Sub-clinical hypothyroidism is very common in Primary Care clinics. Many patients are not correctly diagnosed and many are over-medicated, suggesting a need to review the diagnosis

[Hypothyroidism in adults in a basic health area]. / Hipotiroidismo adulto en una zona básica de salud.

INTRODUCTION: The objective of the present study is to study the prevalence, as well as the clinical and epidemiological characteristics of hypothyroid disease in adults using the computerised clinical records. MATERIAL AND METHODS: Observational, descriptive and cross-sectional study. The target population was the patients of the health centres of Lucena I and II (Córdoba). INCLUSION CRITERIA: Patients 14 years or older, diagnosed with hypothyroidism, born and resident in Lucena. Two hundred and fourteen patients were recruited by random sampling, who then underwent a clinical interview using a questionnaire. RESULTS: The mean age of the patients was 49.71 years (SD 17.03; 95% CI 47.34-51.98), with 85.5% women. A diagnosis of sub-clinical hypothyroidism was found in 74.8%, compared to 18.7% of primary hypothyroidism, and 6.5% of secondary hypothyroidism. The 53.7% (95% CI 46.81-60.59) of patients diagnosed with hypothyroidism did not have thyroid antibodies results. However, 75.2% (95% CI 68.89-80.86) were being treated with levothyroxine. The prevalence of hypothyroidism was 5.7% (95% CI 5.46-5.96). CONCLUSIONS: Sub-clinical hypothyroidism is very common in Primary Care clinics. Many patients are not correctly diagnosed and many are over-medicated, suggesting a need to review the diagnosis.