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1.
Aten. prim. (Barc., Ed. impr.) ; 52(7): 469-476, ago.-sept. 2020. tab, graf, mapas
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET5-1912

RESUMO

OBJETIVO: Describir la producción científica española de atención primaria durante 2013-2017, analizando su distribución geográfica, factor de impacto, áreas de investigación y participación de diferentes sectores institucionales. DISEÑO: Estudio observacional bibliométrico. PARTICIPANTES: Publicaciones indexadas en Medline. MEDICIONES PRINCIPALES: Revista y año de publicación, primer/último autor, centro de trabajo y comunidad autónoma. Se clasificaron los artículos según su contenido. El factor de impacto fue obtenido de la base de análisis bibliométrico Journal Citation Reports. RESULTADOS: Incluidos 980 documentos. El índice de transitoriedad fue 78,8%. La mayoría de los artículos (43,2%) procedía de centros de salud, originados en unidades o institutos de investigación, desde 14,9% en 2013 hasta 19,1% en 2017. El 63,3% se clasificaron como «aspectos clínicos». El 19,3% fueron publicados en la revista Atención Primaria, el 40,6% en revistas extranjeras y el 72,4% en revistas con factor de impacto, siendo esta proporción significativamente inferior (p < 0,001) en los procedentes de centros de salud (59,6%) o de unidades docentes/gerencias/servicios de salud (70,0%) respecto a los originados en unidades/institutos de investigación (93,1%) o en universidades (89,0%). En relación al número de habitantes (documentos/100.000 habitantes), las comunidades más productivas fueron Cataluña (4,2), Aragón (3,9) e Islas Baleares (3,3). CONCLUSIONES: En las publicaciones de atención primaria existe gran diversidad tanto en áreas de investigación como en las revistas donde se publican. La mayoría proceden de centros de salud, tratan aspectos clínicos y se publican en revistas españolas. Se observan diferencias en el volumen de producción científica entre comunidades autónomas


OBJECTIVE: To describe the Spanish scientific production of primary care during 2013-2017 and analyze their geographical distribution, impact factor, areas of research and involvement of different institutional sectors. DESIGN: Observational study bibliometric. PARTICIPANTS: The study focused on publications indexed in Medline. MAIN MEASUREMENTS: Journal and year of publication, first/last author, workplace and autonomous community. Later, articles were classified according to their content. The impact factor was obtained from the basis of bibliometric analysis Journal Citation Reports. RESULTS: Using search criteria, were selected 980 documents. The transiency rate was 78,8%. The highest proportion of articles (43.2%) came from health centers, but we observed an increase of the articles from units or research institutes (14.9% in 2013, 19.1% in 2017). Of the total, 63.3% were classified as “clinical aspects”, 19.3% were published in the journal Atención Primaria, 40.6% in foreign journals and 72.4% in journals with impact factor, being this proportion significantly lower (p <0.001) in those coming from health centers (59.6%) or teaching units/management/health services (70.0%) with respect to those originated in research units/institutes (93.1%) or in universities (89.0%). In relation to population (articles/100.000 inhab.), the most productive communities were Cataluña (4.2), Aragón (3.9), e Islas Baleares (3.3). CONCLUSIONS: In primary care publications there is great diversity in both research areas such as in journals where published. Most are from health centers, treat clinical aspects and published in Spanish journals. Differences in the volume of scientific production between regions are observed

6.
Aten Primaria ; 2019 Nov 01.
Artigo em Espanhol | MEDLINE | ID: mdl-31685282

RESUMO

OBJECTIVE: To describe the Spanish scientific production of primary care during 2013-2017 and analyze their geographical distribution, impact factor, areas of research and involvement of different institutional sectors. DESIGN: Observational study bibliometric. PARTICIPANTS: The study focused on publications indexed in Medline. MAIN MEASUREMENTS: Journal and year of publication, first/last author, workplace and autonomous community. Later, articles were classified according to their content. The impact factor was obtained from the basis of bibliometric analysis Journal Citation Reports. RESULTS: Using search criteria, were selected 980 documents. The transiency rate was 78,8%. The highest proportion of articles (43.2%) came from health centers, but we observed an increase of the articles from units or research institutes (14.9% in 2013, 19.1% in 2017). Of the total, 63.3% were classified as "clinical aspects", 19.3% were published in the journal Atención Primaria, 40.6% in foreign journals and 72.4% in journals with impact factor, being this proportion significantly lower (p <0.001) in those coming from health centers (59.6%) or teaching units/management/health services (70.0%) with respect to those originated in research units/institutes (93.1%) or in universities (89.0%). In relation to population (articles/100.000 inhab.), the most productive communities were Cataluña (4.2), Aragón (3.9), e Islas Baleares (3.3). CONCLUSIONS: In primary care publications there is great diversity in both research areas such as in journals where published. Most are from health centers, treat clinical aspects and published in Spanish journals. Differences in the volume of scientific production between regions are observed.

7.
Rev. clín. med. fam ; 12(3): 125-131, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-186802

RESUMO

Hasta hace poco los fármacos hipolipemiantes que habían demostrado, de manera consistente y reproducible, capacidad para prevenir la aparición de las enfermedades cardiovasculares, sobre todo de la cardiopatía isquémica, tanto en prevención primaria como secundaria, eran las estatinas. En España, hay comercializadas siete y todas tienen estudios de reducción de eventos clínicos frente a placebo y, en algunos casos de prevención secundaria, de tratamiento intensivo frente al convenciona, menos la pitavastatina que solo cuenta con un estudio que compara dosis altas con dosis bajas de la misma estatina. Tras los fracasos en la prevención cardiovascular del ácido nicotínico, actualmente no comercializado en España, la limitada utilidad de los fibratos y de los ácidos grasos omega 39, solo nos quedan como tratamiento para asociar a las estatinas las resinas de intercambio iónico, habitualmente mal toleradas, y ezetimiba, fármaco que solo tiene estudios de reducción de eventos en asociación con estatinas en pacientes con insuficiencia renal y con síndrome coronario agudo


No disponible


Assuntos
Humanos , Reguladores do Metabolismo de Lipídeos/farmacocinética , Anticolesterolemiantes/farmacocinética , Pró-Proteína Convertases/farmacocinética , Hipercolesterolemia/tratamento farmacológico , Anticorpos Monoclonais/farmacocinética , Doenças Cardiovasculares/prevenção & controle , Ezetimiba/uso terapêutico , Tolerância a Medicamentos , Resultado do Tratamento , Aprovação de Drogas/estatística & dados numéricos
8.
Rev. clín. med. fam ; 12(2): 50-60, jun. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-186256

RESUMO

Objetivo: Describir la frecuentación de los usuarios de consultas de Medicina de Familia y su relación con la calidad de vida relacionada con la salud, así como analizar los factores asociados a una mayor frecuentación. Métodos: Estudio multicéntrico observacional de carácter descriptivo realizado en 601 adultos que utilizaron las consultas de medicina de familia de cuatro Zonas Básicas de Salud de tres Áreas Sanitarias. La variable principal fue la frecuentación a consultas de medicina de familia en el último año. Otras variables fueron características sociodemográficas, problemas de salud (clasificación CIAP-2), consumo fármacos, calidad de vida (cuestionario EuroQol), características Zona Salud y visitas a medicina, enfermería y urgencias los tres años previos. Resultados: La media de visitas al médico de familia fue significativamente superior el año anterior (10,7±7,8) que los dos (8,7±7,5) y tres (8,1±7,0) previos (p<0,001). Mediante regresión lineal múltiple fueron variables asociadas a mayor frecuentación al médico de familia el año anterior: sexo femenino (B:-1,858; IC95 %:-2,743 - -0,974), pertenecer a ZBS rural (B:-2,936; IC95 %:-3,914 - -1,959), más visitas realizada a Urgencias de AP (B:0,342; IC95 %:0,127 - 0,556), más visitas a Urgencias Hospitalarias (B:1,106; IC95 %:0774 - 1,439), consumir mayor número fármacos (B:0,531; IC95 %:0,384 - 0,679), menor puntuación escala visual de EuroQol (CV) (B:-0,052; IC95 %:-0,069 - -0,034), mayor nº visitas enfermería (B:0,235; IC95 %:0,180 - 0,291), presentar patología sistema nervioso (B:1,639; IC95 %:0,380 - 2,898), patología respiratoria (B:1,298; IC95 %:0,129 - 2,467) y ansiedad (B:1,263; IC95 %:0,062 - 2,463). Conclusiones: Existe una elevada utilización de las consultas del médico de familia que se incrementa cada año. Fueron variables relacionadas con la frecuentación la calidad de vida, sexo, consumo de medicamentos, padecer determinadas enfermedades, residir en ámbito rural y el número de visitas a Urgencias y a consulta de enfermería


Objective: To describe users' frequentation of Family Medicine practices and its relationship with health-related quality of life, and to analyze the factors associated with a greater frequency of visits. Methods: Multicentre, observational, descriptive study carried out in 601 adults who used the family medicine services of four Basic Health Zones in three Health Areas. The main variable was the frequency of visits to family medicine practices in the last year. Other variables were sociodemographic characteristics, health problems (CIAP-2 classification), drug use, quality of life (EuroQol-questionnaire), Health Area characteristics, and visits to medicine, nursing and emergency services within the previous three years. Results: The average number of visits to the family doctor was significantly higher in the previous year (10.7±7.8) than in the previous two (8.7±7.5) and three (8.1±7.0) years (p<0.001). Multiple linear regression showed variables associated with greater frequency of visits to the family doctor during the previous year: female sex (B:-1.858; 95 % CI, -2.743 - -0.974), reside in rural areas (B:-2.936 95 % CI, -3.914 - -1.959), more visits to Primary Care Emergency Room (B:0.342 95 % CI, 0.127 - 0.556), more visits to Hospital Emergency Room (B:1.106; 95 % CI, 0774 - 1.439), use higher number of drugs (B:0.531; 95 % CI, 0.384 - 0.679), lower EuroQol scale score (B:-0.052; 95 % CI, -0.069 - -0.034), more visits to nursing clinics (B:0.235; 95 % CI, 0.180 - 0.291) and presenting nervous system disease (B:1.639; 95 % CI, 0.380 - 2.898), respiratory disease (B:1.298; 95 % CI, 0.129 - 2.467) and anxiety (B:1.263; 95 % CI, 0.062 - 2.463). Conclusions: There is a high use of family doctor practices that increases every year. The variables related to frequentation were quality of life, sex, drug use, suffering certain diseases, residing in rural areas and the number of visits to the Emergency Department and to nursing clinics


Assuntos
Humanos , Atenção Primária à Saúde/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Utilização de Instalações e Serviços/estatística & dados numéricos , Qualidade de Vida , Acesso aos Serviços de Saúde/estatística & dados numéricos , Estudos Populacionais em Saúde Pública , Psicometria/instrumentação
10.
Rev. clín. med. fam ; 11(2): 51-60, jun. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-176081

RESUMO

Objetivo: Evaluar la prevalencia de burnout y sus componentes en profesionales sanitarios de Atención Primaria de Castilla-La Mancha, así como su relación con el estrés percibido y la satisfacción laboral. Diseño: Estudio descriptivo observacional transversal. Emplazamiento: Estudio multicéntrico realizado en equipos de Atención Primaria de seis Áreas Sanitarias de Castilla-La Mancha. Participantes: Todos los profesionales de medicina y enfermería de Atención Primaria de las Áreas Sanitarias participantes. Mediciones Principales: Incluidas las siguientes variables: características de participantes (sociodemográficas/laborales), características lugar de trabajo, estrés percibido (Perceived Stress Scale), burnout (Maslach Burnout Inventory) y satisfacción laboral (cuestionario Font-Roja). Resultados: La prevalencia de burnout fue del 20,7 % (IC 95 %: 16,6-24,7). Un 53,3 % presentó alterada al menos una subescala. El 38,9 % mostró alto grado de despersonalización, 28,2 % agotamiento emocional y 8,0 % baja realización personal. La puntuación de estrés percibido fue significativamente superior al aumentar el grado de burnout en las tres subescalas (p<0,001). Mediante regresión logística, las variables asociadas a burnout fueron: mayor puntuación escala estrés percibido (OR: 1,20; IC95 %: 1,12-1,28), menor puntuación en escala satisfacción (OR: 8,42; IC 95 %: 1,96-36,10), contar con mayor número de pacientes en cupo (OR: 1,01; IC 95 %: 1,00-1,02) y no ser tutor de residentes (OR: 2,88; IC 95 %: 1,06-8,25). Conclusiones: El burnout afecta a uno de cada cinco profesionales de Atención Primaria de nuestra Comunidad Autónoma, siendo la despersonalización la subescala más alterada. Los profesionales con burnout presentan puntuaciones superiores de estrés percibido e inferiores de satisfacción laboral. Otras variables relacionadas con el puesto de trabajo también se asocian con la presencia de burnout


Objective: To evaluate the prevalence of burnout and its components in health care providers in primary care of Castilla-La Mancha, as well as its relation with perceived stress and job satisfaction. Design: Descriptive, observational cross-sectional study. Location: Multicenter study carried out by Primary Care Teams of six health areas of Castilla-La Mancha. Participants: Every health care professional (doctors and nurses) of the six health areas of Castilla-La Mancha. Main measurements: The variables included were: features of the participants (sociodemographic/occupational), work place features, perceived stress (Perceived-Stress-Scale), burnout (Maslach-Burnout-Inventory) and job satisfaction (Font-Roja test). Results: Prevalence of burnout: 20.7 % (CI 95 %: 16.6 - 24.7). About 53.3 % had at least one altered subscale. 38.9 % showed high level of depersonalization, 28.2 % emotional exhaustion and 8.0 % low personal fulfillment. Perceived stress score was significantly higher as the level of burnout increased in all three subscales (p<0.001). By using logistic regression, burnout associated variables were: Higher score in perceived stress scale (OR: 1.20; CI 95 %: 1.12-1.28), lower score in satisfaction scale (OR: 8.42; CI 95 %: 1.96-36.10), having more patients in their quota (OR: 1.01; CI 95 %:1.00-1.02) and no resident supervision (OR: 2.88; CI 95 %: 1.06-8.25). Conclusion: Burnout affects one in five primary care providers in our Autonomous Community, being depersonalization the most altered subscale. Professionals with burnout present higher perceived stress and lower job satisfaction. Other job-related variables are also associated with the presence of burnout


Assuntos
Humanos , Atenção Primária à Saúde , Esgotamento Profissional/epidemiologia , Despersonalização/epidemiologia , Psicometria/instrumentação , Estresse Psicológico/epidemiologia , Satisfação do Paciente/estatística & dados numéricos , Condições de Trabalho , Qualidade de Vida/psicologia , Estudos Transversais , Inquéritos Epidemiológicos/estatística & dados numéricos
11.
Rev. clín. med. fam ; 11(2): 107-111, jun. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-176084

RESUMO

La fiebre y el dolor lumbar representan dos de los motivos más frecuentes de las consultas de Medicina de Familia. Es importante la realización de una historia clínica minuciosa, una exploración física detallada y una reevaluación periódica de los pacientes, siendo éstas herramientas principales para el médico de familia para poder establecer un diagnóstico diferencial y detectar la presencia de datos de alarma. Presentamos el caso de un paciente con fiebre y dolor lumbar, describiendo el proceso del diagnóstico, su tratamiento y el manejo coordinado entre Medicina de Familia y Medicina Interna


Fever and low back pain are two of de most frequent reasons for Family Medicine consultation. It is important to carry out a detailed medical history, physical examination and periodic reevaluation of patients, these being main tools for the family physician to be able to establish a differential diagnosis and to detect the presence of alarm signals. We report the case of a patient with fever and low back pain, describing the diagnosis process, its treatment and the coordinated management between Family Medicine and Internal Medicine


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Discite/diagnóstico , Febre de Causa Desconhecida/etiologia , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Abiotrophia/isolamento & purificação , Atenção Primária à Saúde/estatística & dados numéricos , Dor Lombar/etiologia , Diagnóstico Diferencial , Cardiomegalia/diagnóstico por imagem
12.
Rev. clín. med. fam ; 11(1): 15-22, feb. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-171571

RESUMO

Objetivo: Determinar la adherencia a la dieta mediterránea de pacientes hipertensos en Atención Primaria y analizar sus factores asociados. Comprobar si existen diferencias entre los que muestran adecuado control de presión arterial y los que no. Diseño: Estudio observacional transversal. Emplazamiento: Consultas de medicina de familia de cinco Centros de Salud de dos Áreas Sanitarias de Castilla-La Mancha. Participantes: Seleccionados 387 sujetos adultos diagnosticados de hipertensión arterial. Mediciones Principales: Se recogieron variables sociodemográficas, problemas salud (CIAP-2), consumo fármacos, adherencia a dieta mediterránea (cuestionario Predimed Adherencia Dieta Mediterránea-MEDAS-14), actividad física (IPAQ-breve), factores riesgo cardiovascular, riesgo cardiovascular, presión arterial y su grado de control. Resultados: El nivel de cumplimiento de dieta mediterránea fue alto en 17,8 % de casos, moderado en 68,2 % y bajo en 14,0 %. Un 53 % mostro adecuado control de PA y en ellos la puntuación media de adherencia fue significativamente superior (8,94 vs. 8,41; p=0,012). Mediante regresión lineal múltiple, fueron variables asociadas a mayor adherencia a dieta mediterránea: mayor edad (B:0,042), inferior puntuación Systematic Coronary Risk Evaluation (SCORE) (B:-0,085), no sedentarismo de más de dos horas/día seguidas (B:-0,530), clase social más alta (I-V) (B:0,568), mayor nº de antihipertensivos consumidos (B:0,2012) y adecuado control presión arterial (B:0,444). Conclusiones: La mayoría de hipertensos manifestaron un cumplimiento al menos moderado de la dieta mediterránea, aunque son pocos los que indicaron una alta adherencia. Además, mostramos superior cumplimiento de la dieta en hipertensos con cifras controladas y que las variables asociadas a mayor cumplimiento de la dieta mediterránea incluyen algunas características sociodemográficas y otras relacionadas con características cardiovasculares (AU)


Objective: To determine adherence to the Mediterranean diet of hypertensive patients in primary care and to analyze its associated factors. To check if there are differences between those that show adequate control of blood pressure and those who do not. Design: Observational cross-sectional study. Location: Primary Care consultations of five health centers in two health areas of Castilla-La Mancha. Participants: 387 adult subjects diagnosed with hypertension were selected. Main measures: We collected information about sociodemographic variables, health problems (CIAP-2), drug consumption, adherence to the Mediterranean Diet (Questionnaire MEDAS-14), physical activity (short IPAQ), cardiovascular risk factors, cardiovascular risk, blood pressure and its degree of control. Results: The level of compliance with the Mediterranean diet was high in 17.8 % of cases, moderate in 68.2 % and low in 14.0 %. 53 % showed adequate control of BP; in these cases the average adherence score was significantly higher (8.94 vs. 8.41; p=0.012). Using multiple linear regression, variables associated with higher adherence to the Mediterranean Diet were: older age (B: 0.042), lower score in Systematic Coronary Risk Evaluation (SCORE) (B: -0.085), no physical inactivity for more than two consecutive hours/day (B: -0.530), higher social class (I-V) (B: 0.568), higher number of antihypertensive drugs consumed (B: 0.2012) and adequate control of blood pressure (B: 0.444). Conclusions: Most hypertensive patients reported at least moderate compliance to the Mediterranean diet, although only a few indicated a high adherence. In addition, we show superior diet compliance in hypertensive patients with controlled blood pressure values. We also show that the variables associated with greater compliance to the Mediterranean diet include some sociodemographic characteristics and other cardiovascular-related characteristics (AU)


Assuntos
Humanos , Dieta Mediterrânea/estatística & dados numéricos , Hipertensão/dietoterapia , Dieta Saudável/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Estudos Transversais
13.
Rev. esp. cardiol. (Ed. impr.) ; 71(1): 33-41, ene. 2018. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-170170

RESUMO

Introducción y objetivos: Intervenciones diferentes pueden mejorar el control del colesterol unido a lipoproteínas de baja densidad (cLDL). El objetivo principal era evaluar la eficacia de una intervención combinada para mejorar el control del cLDL de pacientes con hipercolesterolemia. También se evaluó su eficacia para mejorar el cumplimiento (farmacológico, dieta y ejercicio). Métodos: Ensayo clínico aleatorizado, de grupos paralelos y multicéntrico (atención primaria) que incluyó a 358 adultos diagnosticados de hipercolesterolemia con tratamiento previo farmacológico o no. Se comparó a 178 sujetos que recibieron intervención combinada (material escrito, tarjetas autocumplimentadas y mensajes al móvil) frente a 178 controles. La variable principal de resultado fue la proporción de sujetos con adecuado control del cLDL (valores recomendados en las guías europeas de dislipemias y riesgo cardiovascular) a los 24 meses. Resultados: El grupo de intervención mostró una reducción media del cLDL significativamente superior a los 24 meses respecto al control, 23,8 mg/dl (IC95%, 17,5-30,1) y 14,6 mg/dl (IC95%, 8,9-20,4), respectivamente (p = 0,034). El promedio de la reducción del cLDL fue del 13,1 ± 28,6%. La proporción de sujetos con adecuado control al año fue significativamente superior en el grupo de intervención (43,7 frente a 30,1%; p = 0,011; RR = 1,46). En el grupo de intervención, el cumplimiento farmacológico fue significativamente superior (77,2 frente a 64,1%; p = 0,029) y de la práctica de ejercicio (64,9 frente a 35,8%; p < 0,001), aunque no de la dieta. Conclusiones: La intervención combinada consigue una reducción significativa de las cifras de cLDL (superior al 13% al cabo de 2 años) y mejora el grado de control de pacientes con hipercolesterolemia al año (AU)


Introduction and objectives: Several interventions can improve low-density lipoprotein cholesterol (LDL-C) control. Our main objective was to evaluate the efficacy of a combined intervention to improve LDL-C control in patients with hypercholesterolemia. The study also assessed the efficacy of the intervention in improving adherence (pharmacological, diet, and exercise). Methods: A multicenter, parallel group, randomized clinical trial (primary care) was conducted in 358 adults diagnosed with hypercholesterolemia, whether receiving prior drug therapy or not. We compared 178 participants who received the combined intervention (written material, self-completed registration cards, and messages to mobile telephones) with 178 controls. The main outcome variable was the proportion of participants with adequate LDL-C control (target levels of the European guidelines on dyslipidemia and cardiovascular risk) at 24 months. Results: At 24 months, the mean reduction in LDL-C was significantly higher in the intervention group (23.8 mg/dL [95%CI, 17.5-30.1]) than in the control group (14.6 mg/dL [95%CI, 8.9-20.4]; P = .034). The mean LDL-C decrease was 13.1% ± 28.6%. At 1 year, the proportion of participants with adequate control was significantly higher in the intervention group than in the control group (43.7% vs 30.1%; P = .011; RR, 1.46). Adherence was significantly higher in the intervention group, both to drug therapy (77.2% vs 64.1%; P = .029) and exercise (64.9% vs 35.8; P < .001), but not to diet. Conclusions: The combined intervention significantly reduced LDL-C (by more than 13% at 2 years) and improved the degree of LDL-C control in patients with hypercholesterolemia at 1 year (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Hipercolesterolemia/tratamento farmacológico , Hipercolesterolemia/prevenção & controle , Colesterol/uso terapêutico , Anticolesterolemiantes/uso terapêutico , Lipoproteínas LDL/uso terapêutico , Atenção Primária à Saúde , Resultado do Tratamento , Adesão à Medicação , Modelos Lineares , Inquéritos e Questionários , Modelos Logísticos
14.
Rev Esp Cardiol (Engl Ed) ; 71(1): 33-41, 2018 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28652127

RESUMO

INTRODUCTION AND OBJECTIVES: Several interventions can improve low-density lipoprotein cholesterol (LDL-C) control. Our main objective was to evaluate the efficacy of a combined intervention to improve LDL-C control in patients with hypercholesterolemia. The study also assessed the efficacy of the intervention in improving adherence (pharmacological, diet, and exercise). METHODS: A multicenter, parallel group, randomized clinical trial (primary care) was conducted in 358 adults diagnosed with hypercholesterolemia, whether receiving prior drug therapy or not. We compared 178 participants who received the combined intervention (written material, self-completed registration cards, and messages to mobile telephones) with 178 controls. The main outcome variable was the proportion of participants with adequate LDL-C control (target levels of the European guidelines on dyslipidemia and cardiovascular risk) at 24 months. RESULTS: At 24 months, the mean reduction in LDL-C was significantly higher in the intervention group (23.8mg/dL [95%CI, 17.5-30.1]) than in the control group (14.6mg/dL [95%CI, 8.9-20.4]; P=.034). The mean LDL-C decrease was 13.1%±28.6%. At 1 year, the proportion of participants with adequate control was significantly higher in the intervention group than in the control group (43.7% vs 30.1%; P=.011; RR, 1.46). Adherence was significantly higher in the intervention group, both to drug therapy (77.2% vs 64.1%; P=.029) and exercise (64.9% vs 35.8; P<.001), but not to diet. CONCLUSIONS: The combined intervention significantly reduced LDL-C (by more than 13% at 2 years) and improved the degree of LDL-C control in patients with hypercholesterolemia at 1 year.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Hipercolesterolemia/tratamento farmacológico , Guias de Prática Clínica como Assunto , LDL-Colesterol/sangue , LDL-Colesterol/efeitos dos fármacos , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/epidemiologia , Incidência , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia , Resultado do Tratamento
15.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 52(1): 31-34, ene.-feb. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-159274

RESUMO

Introducción. Estimar la prevalencia del consumo de ansiolíticos e hipnóticos referido por los mayores de 65 años e identificar posibles factores condicionantes del citado uso. Material y métodos. Estudio transversal. La población de estudio fue de 1.161 sujetos de ≥65 años no institucionalizados con suficiente capacidad para llevar a cabo una entrevista personal. Selección mediante muestreo aleatorizado simple del listado de tarjeta sanitaria. Las principales variables evaluadas incluyeron: consumo referido de ansiolíticos/hipnóticos y otros fármacos (según el sistema de clasificación ATC), estado anímico (GDS-VE), estado cognitivo (cuestionario Pfeiffer), valoración física-funcional sobre actividades básicas de la vida diaria (índice de Katz), problemas de salud (clasificación CIAP-2 de la WONCA) y variables sociodemográficas. Resultados. La prevalencia de uso referido de ansiolíticos/hipnóticos fue del 16,6% (IC 95%: 14,5-18,7). El 90,5% fueron benzodiacepinas (BZD), fundamentalmente lorazepam (39,4% de las BZD). Las BZD de vida media prolongada supusieron el 24,7% de todas. Los hipnóticos representaron el 27,5% de los ansiolíticos/hipnóticos. El uso de ansiolíticos/hipnóticos se asoció independientemente con consumir otros fármacos no psicotrópicos (OR: 6,8; IC 95%: 2,1-22,0), presentar depresión establecida (OR: 2,5; IC 95%: 1,0-5,9), presentar 4 o más problemas de salud (OR: 2,0; IC 95%: 1,4-2,9), ser mujer (OR: 2,1; IC 95%: 1,5-3,1) y ser dependiente para las actividades básicas de la vida diaria (OR: 1,8; IC 95%: 1,1-2,9). Conclusiones. La prevalencia de uso de ansiolíticos/hipnóticos es elevada en mayores de Albacete. Diversos factores han sido identificados como potenciales condicionantes de su utilización. Sería importante mejorar el conocimiento sobre el mal uso de estos fármacos con el fin de desarrollar estrategias de prescripción efectivas y seguras (AU)


Introduction. To estimate the prevalence of self-reported anxiety/hypnotics use in adults 65 years and older and identify potential factors that determine the use of these drugs. Material and Methods. Cross-sectional study conducted on a study population of 1,161 non-institutionalised adults 65 years old and older with enough ability to conduct a personal interview. Participants were randomly selected from health care registers. The main outcomes of interest included consumption of anxiolytics, hypnotics and other drugs (filed by ATC classification system), mood (based on the Yesavage geriatric depression scale), cognitive status (Pfeiffer questionnaire), physical-functional assessment of basic activities of daily living (Katz index), health problems (ICPC-2 classification WONCA), and sociodemographic variables. Results. The prevalence of self-reported anxiety/hypnotics consumption was 16.6% (95% CI: 14.5 - 18.7), of which 90.5% were benzodiazepines (BZD), mainly lorazepam (39.4% of BZD). Long half-life BZD accounted for 24.7% of BZD. Hypnotics accounted for 27.5% of anxiolytics/hypnotics. The use of sedatives/hypnotics was independently associated with other drugs (non-psychotropics) consumption (OR 6.8, 95% CI: 2.1-22.0), presence of established depression (OR: 2.5; 95% CI: 1.0 -5.9), presence of 4 or more comorbidities (OR: 2.0; 95% CI: 1.4-2.9), being female (OR 2.1, 95% CI: 1.5-3.1) and being dependent for basic activities of daily living (OR: 1.8, 95% CI: 1.1-2.9). Conclusions. The prevalence of sedatives/hypnotics use in the elderly from Albacete is high. Several factors were identified as potential determinants of sedatives/hypnotics use in our study population. It will be important to evaluate the misuse of these drugs in order to develop effective, efficient and safe prescription strategies (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Ansiolíticos/administração & dosagem , Ansiolíticos/uso terapêutico , Entrevistas como Assunto , Amostragem Aleatória Simples , Transtornos Cognitivos/complicações , Transtornos Cognitivos/epidemiologia , Benzodiazepinas/uso terapêutico , Lorazepam/uso terapêutico , Estudos Transversais/métodos , Estudos Transversais , Envelhecimento Cognitivo/psicologia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos
16.
Rev Esp Geriatr Gerontol ; 52(1): 31-34, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-26923262

RESUMO

INTRODUCTION: To estimate the prevalence of self-reported anxiety/hypnotics use in adults 65 years and older and identify potential factors that determine the use of these drugs. MATERIAL AND METHODS: Cross-sectional study conducted on a study population of 1,161 non-institutionalised adults 65 years old and older with enough ability to conduct a personal interview. Participants were randomly selected from health care registers. The main outcomes of interest included consumption of anxiolytics, hypnotics and other drugs (filed by ATC classification system), mood (based on the Yesavage geriatric depression scale), cognitive status (Pfeiffer questionnaire), physical-functional assessment of basic activities of daily living (Katz index), health problems (ICPC-2 classification WONCA), and sociodemographic variables. RESULTS: The prevalence of self-reported anxiety/hypnotics consumption was 16.6% (95% CI: 14.5 - 18.7), of which 90.5% were benzodiazepines (BZD), mainly lorazepam (39.4% of BZD). Long half-life BZD accounted for 24.7% of BZD. Hypnotics accounted for 27.5% of anxiolytics/hypnotics. The use of sedatives/hypnotics was independently associated with other drugs (non-psychotropics) consumption (OR 6.8, 95% CI: 2.1-22.0), presence of established depression (OR: 2.5; 95% CI: 1.0 -5.9), presence of 4 or more comorbidities (OR: 2.0; 95% CI: 1.4-2.9), being female (OR 2.1, 95% CI: 1.5-3.1) and being dependent for basic activities of daily living (OR: 1.8, 95% CI: 1.1-2.9). CONCLUSIONS: The prevalence of sedatives/hypnotics use in the elderly from Albacete is high. Several factors were identified as potential determinants of sedatives/hypnotics use in our study population. It will be important to evaluate the misuse of these drugs in order to develop effective, efficient and safe prescription strategies.


Assuntos
Ansiolíticos/uso terapêutico , Hipnóticos e Sedativos/uso terapêutico , Idoso , Estudos Transversais , Uso de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Masculino , Autorrelato
17.
Rev. clín. med. fam ; 9(2): 91-99, jun. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-155703

RESUMO

Objetivo: Describir las características clínicas de los mayores polimedicados, conocer su comorbilidad y analizar su calidad de vida. Diseño: Estudio observacional de carácter transversal. Emplazamiento: Consultas de Atención Primaria de cuatro zonas básicas de Salud del Área Sanitaria de Albacete. Participantes: Mediante muestreo consecutivo se seleccionaron 275 sujetos ≥65 años que consumían más de cinco fármacos. Mediciones Principales: Se recogieron variables sociodemográficas, problemas de salud (clasificación CIAP-2), comorbilidad (Índice de Charlson), consumo de fármacos, riesgo cardiovascular y calidad de vida (cuestionario EuroQol). Resultados: La edad media fue de 76,5 años (DE: 6,7). El 75,3 % presentaba cinco o más problemas de salud. Los más frecuentes fueron endocrinológicos 93,8 %, cardiovasculares 92,0 % y locomotores 57,8 %. El 40 % presentó un Índice de Charlson ≥2. La puntuación media de calidad de vida mediante el cuestionario descriptivo EuroQol-5D fue 0,767 (DE: 0,179). Mediante regresión lineal múltiple, las variables asociadas a mayor calidad de vida (cuestionario descriptivo) fueron: menor edad (B:-0,004; IC 95 %:-0,006 a -0,001), sexo masculino (B:0,064; IC 95 %:0,025 a 0,104), superior clase social (B:-0,014; IC 95 %:-0,029 a -0,001), actividad física (B:-0,086; IC 95 %:-0,109 a -0,063), menor índice de Charlson (B:-0,019; IC 95 %:-0,037 a -0,002) y menos problemas locomotores (B:-0,31; IC 95 %:-0,052 a -0,010) y psicológicos (B:-0,055; IC 95 %:-0,091 a -0,018). Conclusiones. Nueve de cada diez mayores polimedicados presentan enfermedades endocrinológicas o cardiovasculares. Tres cuartos padecen cinco o más patologías crónicas. Se comprobó que las variables asociadas a mayor calidad de vida fueron menor edad, sexo masculino, clase social, actividad física, menor índice de Charlson y menos problemas locomotores y psicológicos (AU)


Objective: To describe the clinical features of polymedicated elderly patients, to know their comorbidity, and to analyze their quality of life. Design: Observational cross-sectional study. Location: Primary care clinics of four health-care districts in the Health Area of Albacete. Participants. By consecutive sampling, 275 subjects of age ≥65 who consumed more than five drugs were selected. Main measures: Socio-demographic variables, health problems (CIAP-2 classification), comorbidity (Charlson Index), consumption of drugs, cardiovascular risk and quality of life (EuroQol questionnaire) were collected. Results: The average age was 76.5 years (SD 6.7). 75.3 % had five or more health problems. The most common were endocrinological 93.8 %, cardiovascular 92.0 % and locomotive 57.8%. 40% showed a ≥2 Charlson Index. The average score for quality of life through the descriptive EuroQol-5D questionnaire was 0.767 (SD 0.179). By multiple linear regression, the variables associated with better quality of life (descriptive questionnaire) were: younger age (B=-0.004; 95% CI:-0.006 to -0.001), male gender (B=0.064; 95% CI=0.025 to 0.104), higher social class (B=- 0.014; 95% CI=-0.029 to -0.001), physical activity (B=:-0.086; 95% CI=-0.109 to -0.063), lower Charlson index (B=-0.019; 95% CI=-0.037 to -0.002), and less locomotive problems (B=-0.019; 95% CI=-0.037 to -0.002) and psychological problems (B=-0.055; 95% CI=-0.091 to -0.018). Conclusions: Nine out of ten elderly with polypharmacy present endocrine or cardiovascular diseases. Three quarters suffer from five or more chronic diseases. It was found that the variables associated with better quality of life were younger age, male gender, social class, physical activity, lower Charlson Index and less locomotive and psychological problems (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Qualidade de Vida , Polimedicação , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Comorbidade , Estudos Transversais/métodos , Estudos Transversais , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde , Inquéritos e Questionários , Análise de Variância
19.
Community Ment Health J ; 52(6): 738-45, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-25833726

RESUMO

This study sought to assess treatment satisfaction among patients on antidepressants, ascertaining whether there might be an association with depressive symptomatology and other variables. Cross-sectional study conducted on 564 adult patients taking antidepressant medication. Satisfaction with antidepressant treatment was assessed using the Assessment of Satisfaction with Antidepressant Treatment Questionnaire (ESTA/Evaluación de la Satisfacción con el Tratamiento Antidepresivo). A moderate negative correlation was observed between satisfaction and intensity of depressive symptoms, as assessed with the Montgomery-Asberg scale. A weak negative correlation was observed between greater satisfaction and less favourable views about taking medication. Satisfaction scale scores were higher among those who took antidepressant medication for 1 year or more versus shorter periods. Most patients reported being satisfied with the antidepressant treatment but the level of satisfaction was higher among those who presented with less marked depressive symptoms, received longer-term treatment and viewed drug treatments favourably. Treatment satisfaction is one of the patient-reported outcome measures that can serve to complement clinical evaluation of depressive disorders.


Assuntos
Antidepressivos/uso terapêutico , Depressão/tratamento farmacológico , Satisfação do Paciente/estatística & dados numéricos , Adolescente , Adulto , Idoso , Atitude Frente a Saúde , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Adulto Jovem
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