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1.
Pharmacoepidemiol Drug Saf ; 29(4): 433-443, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31908111

RESUMO

PURPOSE: To analyze the evolution of the prevalence of polypharmacy and excessive polypharmacy in a Spanish population, and to improve the identification of patients with polypharmacy. METHODS: A descriptive, annual cross-sectional observational study was carried out. PATIENTS: individuals over 14 years of age included in a multiregional primary care database of the Spanish population (BIFAP). ANALYSIS: prescription data. Period 2005-2015. VARIABLES: proportion of patients with polypharmacy (simultaneous prescription of ≥5 drugs) and excessive polypharmacy (≥10 drugs) for at least 6 months, according to sex and age groups. A trend analysis of the studied period was performed (overall, and by sex and age groups). RESULTS: The data are reported on a comparative basis (2005 vs 2015). Number of patients analyzed: 2664743 vs 4 002 877. The prevalence of polypharmacy increased significantly (2.5% vs 8.9%, P-value for trend <0.001), being greater in females throughout the study period and in the group aged ≥80 years (P-value for trends <0.001). The prevalence of excessive polypharmacy also increased significantly (0.1% vs 1%, P-value for trend <0.001), being higher in the group aged ≥80 years (P-value for trend <0.001). The proportion of patients with no chronic treatment decreased (80.2% vs 63.1%). CONCLUSIONS: The prevalence of polypharmacy in this Spanish population has tripled in the period 2005-2015, while excessive polypharmacy has increased 10-fold. These increments are seen in both sexes and in all age groups, particularly in individuals over 80 years of age. The proportion of patients without chronic treatments has decreased.

2.
Farm. comunitarios (Internet) ; 11(4): 21-31, dic. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-186884

RESUMO

Introducción: la colaboración entre médicos y farmacéuticos es necesaria en el manejo de los síntomas menores, ya que el paciente acude a ambos profesionales sanitarios para su tratamiento. El objetivo del estudio fue elaborar protocolos de trabajo consensuados entre farmacéuticos comunitarios y médicos de atención primaria para el Servicio de Indicación Farmacéutica (SIF). Material y método: se utilizaron dos metodologías: revisión bibliográfica y grupo de expertos para el consenso. Estos protocolos se actualizaron y diseñaron a partir de un documento previo de 2008. En el grupo de expertos se incluyeron cuatro farmacéuticos comunitarios de SEFAC (2), MICOF (2) y cuatro médicos de atención primaria de semFYC (2) y SEMERGEN (2). Resultados: se consensuaron protocolos de trabajo para 31 síntomas menores distribuidos en cinco grupos: respiratorios, dolor moderado, digestivos, dermatológicos y otros. Se añadieron cinco síntomas nuevos al documento de partida. Respecto a la estructura de cada síntoma se consideró: concepto, causas más frecuentes, criterios de derivación al médico (edad, síntomas de alarma, duración de los síntomas, otros problemas de salud y/o medicamentos y situaciones especiales), recomendaciones para la prevención y tratamiento (no farmacológico y farmacológico). Conclusión: el documento desarrollado mediante colaboración entre profesionales de la medicina y la farmacia es una herramienta que contribuye a la mejora de la actuación del farmacéutico en el manejo de los síntomas menores desde la farmacia comunitaria, con énfasis en la definición de indicadores que señalan la necesidad de derivar el paciente al médico de atención primaria


Background: To increase the collaboration between community pharmacists and medical practitioners working in primary care it is critical to have collaborative protocols in place. Minor ailments could be a good example where this collaboration would benefit patient care as patients are seeking treatment in both settings. These collaborative protocols would assist in diminishing the variability of treatments in both settings. The aim of the study was to develop care protocols for minor ailments agreed between medical practitioners and pharmacists Methods: Two different methodologies were used to arrive at a consensus for the proto-cols: literature review and expert group. Some of the clinical protocols were updated from a previous document created in 2008. Expert group was composed of four community pharma-cists (SEFAC, MICOF) and four medical practitioners (SemFyC y Semergen). Results: Thirty-one protocols for minor ailments were agreed and allocated to five groups (five new minor ailments protocols were added: respiratory tract-related conditions, gastrointestinal disturbance, pain, dermatological problems and others.Protocols were structured following: definition, more frequent causes, referral criteria (pa-tient’s age, red flags, symptom’s duration, patient’s health problems and treatments and physiological situations), recommendations for management (prevention, non-pharmacological and pharmacological treatment) and references used. Conclusions: Clinical protocols agreed between health professionals of medicine and phar-macy are a tool that contribute to better management of minor ailments in community pharmacy


Assuntos
Humanos , Relações Interprofissionais , Protocolos Clínicos , Farmácias , Atenção Primária à Saúde , Assistência Farmacêutica , Tratamento Farmacológico/métodos , Comunicação Interdisciplinar , Automedicação , Análise por Conglomerados
3.
Aten. prim. (Barc., Ed. impr.) ; 50(supl.2): 70-79, nov. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-179660

RESUMO

La creciente longevidad de la población, el aumento de la morbilidad y del consumo de medicamentos han provocado que la polimedicación sea un problema de salud prioritario por sus consecuencias en el incremento de efectos adversos, interacciones farmacológicas y favorecer el deterioro funcional del paciente. La situación clínica de los pacientes cambia a lo largo del tiempo y es preciso ajustar la medicación en cada etapa, valorando la fragilidad, el nivel de dependencia y el deterioro funcional. La labor de deprescribir es compleja y requiere una adecuada formación clínica y farmacológica. En atención primaria reside el mayor conocimiento del paciente y su entorno, y de forma compartida con el paciente y cuidadores se debe valorar qué medicamentos mantener y cuáles retirar desde una perspectiva clínica, ética y social. Existen herramientas de ayuda a la deprescripción que pueden resultar útiles para el médico de familia para facilitar este proceso y que se detallan en este artículo


The increasing longevity of the population, the increase in morbidity and the consumption of medications have caused that polypharmacy is a priority health problem due to its consequences: increase of adverse effects, pharmacological interactions and favor the functional deterioration of the patient. The clinical situation of the patients changes over time and it is necessary to adjust the medication in each stage, assessing the fragility, the level of dependence and the functional deterioration. Deprescription is complex and requires an adequate clinical and pharmacological formation. In Primary Care lies the greater knowledge of the patient and their environment, and in a shared way with the patient and caregivers, it is necessary to assess which drugs to maintain and which ones to withdraw from a clinical, ethical and social perspective. There are tools to help deprescription that can be useful for Primary Care to facilitate this process and that are detailed in this article


Assuntos
Humanos , Sobremedicalização , Prescrição Inadequada , Polimedicação
4.
Aten Primaria ; 50 Suppl 2: 70-79, 2018 11.
Artigo em Espanhol | MEDLINE | ID: mdl-30279013

RESUMO

The increasing longevity of the population, the increase in morbidity and the consumption of medications have caused that polypharmacy is a priority health problem due to its consequences: increase of adverse effects, pharmacological interactions and favor the functional deterioration of the patient. The clinical situation of the patients changes over time and it is necessary to adjust the medication in each stage, assessing the fragility, the level of dependence and the functional deterioration. Deprescription is complex and requires an adequate clinical and pharmacological formation. In Primary Care lies the greater knowledge of the patient and their environment, and in a shared way with the patient and caregivers, it is necessary to assess which drugs to maintain and which ones to withdraw from a clinical, ethical and social perspective. There are tools to help deprescription that can be useful for Primary Care to facilitate this process and that are detailed in this article.


Assuntos
Desprescrições , Medicina de Família e Comunidade , Idoso Fragilizado , Doenças Neurodegenerativas , Assistência Terminal , Idoso , Humanos , Polimedicação , Atenção Primária à Saúde
5.
Rev. clín. med. fam ; 11(2): 116-119, jun. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-176086

RESUMO

La foliculitis por Pseudomonas aeruginosa se relaciona con el contacto de aguas contaminadas, generalmente piscinas, aguas termales o spa. Presentamos un caso en el que tras la búsqueda del foco de infección éste quedó indeterminado y en el que el tratamiento tópico fue ineficaz, requiriendo tratamiento antibiótico vía oral


Pseudomonas aeruginosa folliculitis iscaused by contact with contaminated water, generally in pools, thermal waters and spas. We present a case where, after searching, the source of infection remained unknown. The topical treatment was ineffective, requiring oral antibiotic therapy


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Foliculite/diagnóstico , Pseudomonas aeruginosa/patogenicidade , Infecções por Pseudomonas/diagnóstico , Diagnóstico Diferencial , Dermatopatias Papuloescamosas/diagnóstico , Antibacterianos/uso terapêutico , Antagonistas dos Receptores Histamínicos/uso terapêutico , Atenção Primária à Saúde/métodos
6.
Rev Esp Salud Publica ; 912017 Dec 22.
Artigo em Espanhol | MEDLINE | ID: mdl-29269726

RESUMO

OBJECTIVE: Adverse drug reactions (ADR) are one of the ten main causes of mortality in the world, as a cause of hospital admissions or prolongation hospitalizations days created an important health and economic impact. This study aimed to detect incidence and characterize ADRs that occurred during hospitalization and associated with admission in Internal Medicine service. METHODS: Observational and prospective study of intensive RAM monitoring patients admitted in Internal Medicine services in a third level hospital over a twelve months period in 2014. The assessment consisted of a complete and protocol collecting information about the patients and related to suspected ADRs during hospitalization. Statistical analysis was performed using SPSS v.20.0. RESULTS: The study included 253 patients and in 54 (21,34%) ADR were detected, the risk of experiencing an ADR was associated with the age (p=0.012). ADR-related hospitalizations incidence were 7,11%, and fatal ADR incidence were 1,97%. With regard to severity 81,2% were severe. Gastrointestinal disorders represented the most common ADRs followed by metabolism and nutrition disorders and vascular disorders. The drugs most frequently associated with ADRs were cardiovascular agents, antiinfective drugs and central nervous system agents. 72.2% of the patients who suffered ADR had polypharmacy. CONCLUSIONS: In our study incidence of adverse drug reactions in hospitalized patients was 21,34%, this data and ADR´s related to admission to hospital or fatal ADR´s are mainly suffered by pluripathology and polymedicated elderly patients with worst renal function values. In these patients a more careful prescription should be made.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Hospitalização , Polimedicação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Gastroenteropatias/induzido quimicamente , Gastroenteropatias/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Admissão do Paciente , Estudos Prospectivos , Fatores de Risco , Espanha/epidemiologia , Adulto Jovem
11.
Rev. esp. salud pública ; 91: 0-0, 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-169298

RESUMO

Fundamentos: Las reacciones adversas a medicamentos de uso humano (RAM) son una de las diez principales causas de mortalidad a nivel mundial, siendo las que causan ingreso o prolongan la estancia hospitalaria las de mayor impacto sanitario y económico. Los objetivos de este estudio fueron conocer la incidencia y las características de las RAM en pacientes hospitalizados en los servicios de Medicina Interna. Métodos: Estudio observacional y prospectivo de monitorización intensiva de RAM de los pacientes ingresados en los servicios de Medicina Interna en un hospital de tercer nivel durante el año 2014. Se protocolizó la recogida de datos relativos al paciente así como las características de las RAM. El análisis estadístico se realizó con el software SPSS v.20.0. Resultados: Se monitorizaron 253 pacientes. Se detectaron RAM en 54 pacientes (21,34%), encontrándose una asociación positiva entre la edad y la presencia de RAM (p=0.012). La incidencia de ingresos causados por una RAM fue de 7,11% y las RAM mortales fueron un 1,97%. Las RAM fueron graves en el 81,2% de los casos. Los órganos más afectados fueron el gastrointestinal, trastornos del metabolismo y de la nutrición y el vascular. Los grupos terapéuticos causantes de RAM más frecuentes fueron los agentes cardiovasculares, los antinfecciosos y los del sistema nervioso. El 72,2% de los pacientes que sufrieron RAM presentaban polimedicación. Conclusión: La incidencia de RAM en nuestro estudio se sitúa en el 21,34%. La carga de ingresos o de mortalidad derivados de una RAM la sufren, fundamentalmente, pacientes ancianos, pluripatológicos, polimedicados y con peores valores de función renal por lo que es en ellos en quien fundamentalmente se debería realizar una prescripción más cuidadosa (AU)


Objectives: Adverse drug reactions (ADR) are one of the ten main causes of mortality in the world, as a cause of hospital admissions or prolongation hospitalizations days created an important health and economic impact. This study aimed to detect incidence and characterize ADRs that occurred during hospitalization and associated with admission in Internal Medicine service. Methods: Observational and prospective study of intensive RAM monitoring patients admitted in Internal Medicine services in a third level hospital over a twelve months period in 2014. The assessment consisted of a complete and protocol collecting information about the patients and related to suspected ADRs during hospitalization. Statistical analysis was performed using SPSS v.20.0. Results: The study included 253 patients and in 54 (21,34%) ADR were detected, the risk of experiencing an ADR was associated with the age (p=0.012). ADR-related hospitalizations incidence were 7,11%, and fatal ADR incidence were 1,97%. With regard to severity 81,2% were severe. Gastrointestinal disorders represented the most common ADRs followed by metabolism and nutrition disorders and vascular disorders. The drugs most frequently associated with ADRs were cardiovascular agents, antiinfective drugs and central nervous system agents. 72.2% of the patients who suffered ADR had polypharmacy. Conclusion: In our study incidence of adverse drug reactions in hospitalized patients was 21,34%, this data and ADR´s related to admission to hospital or fatal ADR´s are mainly suffered by pluripathology and polymedicated elderly patients with worst renal function values. In these patients a more careful prescription should be made (AU)


Assuntos
Humanos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Hospitalização/estatística & dados numéricos , Gestão da Segurança/organização & administração , Estudos Prospectivos , Dano ao Paciente/prevenção & controle , Estudos de Coortes
18.
Arch. med. deporte ; 24(120): 285-289, jul.-ago. 2007.
Artigo em Espanhol | IBECS | ID: ibc-86475

RESUMO

El médico de Atención Primaria se enfrenta día adía a variedad de patologías y de personas, cada una con circunstancias distintas. En este artículo se intenta hacer una revisión de conceptos sobre el doping en el deporte enfocada a los médicos de Atención Primaria, puesto que muchas veces acuden a consulta personas deportistas y debemos tener en cuenta todo lo que puede supone el consumo de los fármacos que recomendamos, cuáles podemos prescribir y qué debemos de hacer si es absolutamente el consumo de alguna sustancia farmacológica durante el desarrollo de una prueba deportiva. Se hace también un repaso a las causas por las que se dopan y características que nos deben poner en alerta sobre un posible dopaje, además de la conducta y consejos a tener en cuenta con los deportistas en nuestras consultas (AU)


The doctor of Primary Care faces to variety of pathologies and people, each one with different circumstances. In this article it is tried to make a revision of concepts on doping in the sport focused to the doctors of Primary Care, since often sport people go to consultation and we must consider everything what can supposes the consumption of the drugs that we recommended, which we can prescribe and what we must do if it is absolutely the consumption of some drug during the development of a sport test. It is also made a review to the causes by which they are drugged and characteristics that must put to us on the alert on a possible dopping, in addition to the conduct and advice to consider with the sportsmen in our consultations (AU)


Assuntos
Humanos , Masculino , Feminino , Doping nos Esportes/métodos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde , Estimulantes do Sistema Nervoso Central/metabolismo , Estimulantes do Sistema Nervoso Central/farmacologia , Analgésicos/metabolismo , Analgésicos/farmacologia , Esteroides/metabolismo , Esteroides/farmacologia , Diuréticos/farmacologia
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