RESUMO
PURPOSE: The purpose of the present study was to characterize the education that patients with type 2 diabetes mellitus receive, and to identify differences as regards the presence of insulin therapy or not. METHODS: This crossover, multicentre and descriptive study involved 1066 Spanish physicians who completed a questionnaire on Internet. RESULTS: The physicians that responded had a mean of 26.0 years of experience in healthcare, and mainly worked in a walk-in clinic in an urban area. Physicians rated the level of patient knowledge about their disease on a 5.0 point-scale. Fifty percent of them indicated that they spent between 15 and 30min in educating patients at the time of diagnosis. Previous control with HbA1c>9%, presence of microvascular complications, and a low socio-cultural level, were factors associated with spending more time in education. CONCLUSION: This is the first study designed to evaluate the education provided to patients with type 2 diabetes mellitus from Spain. The time spent and the individualization of the education are important factors associated with better long-term control of the disease, and thus with the effectiveness of the clinical management.
Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Educação de Pacientes como Assunto/métodos , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Adulto , Estudos Cross-Over , Feminino , Pesquisas sobre Atenção à Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Insulina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Espanha , Fatores de Tempo , Adulto JovemRESUMO
BACKGROUND AND OBJECTIVE: Cardiovascular diseases are the main cause of death in the Spanish population. The detection and control of cardiovascular risk factors are fundamental in the prevention of cardiovascular disease. The main objectives of this study are to analyse the attitudes and therapeutic decisions of Primary Care (PC) physicians when treating hypertension (HT) and diabetes mellitus type 2 (DM2), with the aim of establishing the situation and eventually proposing improvement strategies. MATERIAL AND METHOD: A national ecological, multicentre, cross-sectional, and descriptive study was conducted in 2013. A questionnaire was used and 1,028 PC physicians took part in the study. RESULTS: A total of 92.9% of the investigators consulted have indicated that they follow the guidelines for evaluation, treatment, and diagnosis of HT, and 91.4% in the case of diabetes. The latter is diagnosed as a casual finding, while HT is diagnosed through active investigation in patients with other risk factors. Combined therapy takes more than 6 months to take effect in patients with HT, and between 8 and 9 months in diabetic patients. The percentage of non-compliance is similar (10-40%) in both pathologies. Around half the physicians questioned considered interaction with the specialist to be good or excellent (46% HT and 57.3% DM2). CONCLUSIONS: Clinical practices in PC for HT and DM2 have some basic criteria in common. The interaction with the specialist is good, but there is a considerable margin for improvement.
Assuntos
Atitude do Pessoal de Saúde , Diabetes Mellitus Tipo 2/terapia , Hipertensão/terapia , Médicos de Atenção Primária/estatística & dados numéricos , Estudos Transversais , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Fidelidade a Diretrizes , Pesquisas sobre Atenção à Saúde , Humanos , Hipertensão/diagnóstico , Masculino , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Fatores de RiscoRESUMO
Purpose. The purpose of the present study was to characterize the education that patients with type 2 diabetes mellitus receive, and to identify differences as regards the presence of insulin therapy or not. Methods. This crossover, multicentre and descriptive study involved 1066 Spanish physicians who completed a questionnaire on Internet. Results. The physicians that responded had a mean of 26.0 years of experience in healthcare, and mainly worked in a walk-in clinic in an urban area. Physicians rated the level of patient knowledge about their disease on a 5.0 point-scale. Fifty percent of them indicated that they spent between 15 and 30min in educating patients at the time of diagnosis. Previous control with HbA1c>9%, presence of microvascular complications, and a low socio-cultural level, were factors associated with spending more time in education. Conclusion. This is the first study designed to evaluate the education provided to patients with type 2 diabetes mellitus from Spain. The time spent and the individualization of the education are important factors associated with better long-term control of the disease, and thus with the effectiveness of the clinical management (AU)
Objetivo. El objetivo del presente estudio fue caracterizar la educación que reciben los pacientes con diabetes mellitus tipo 2 e identificar las diferencias existentes en función de la presencia o ausencia de terapia insulínica. Métodos. En este estudio transversal, multicéntrico y descriptivo participaron 1.066 médicos españoles que completaron una encuesta por Internet. Resultados. Los médicos participantes tenían una experiencia media de 26 años en atención sanitaria y principalmente trabajaban en centros de atención primaria de áreas urbanas. Los médicos determinaron el grado de conocimiento de cada paciente en relación con su enfermedad empleando una escala de 5 puntos. El 50% de los médicos indicaron que habían empleado entre 15 y 30min en educar al paciente en el momento del diagnóstico. Los niveles de HbA1c>9%, la presencia de complicaciones microvasculares y un nivel sociocultural bajo fueron los factores asociados a la necesidad de dedicar un mayor tiempo a la educación. Conclusión. (AU)Este es el primer estudio diseñado para evaluar la educación proporcionada al paciente con diabetes mellitus tipo 2 en España. El tiempo dedicado y la individualización de la educación son factores asociados con un mejor control a largo plazo de la enfermedad y, consecuentemente, con una mayor eficacia en su manejo clínico (AU)
Assuntos
Humanos , Diabetes Mellitus Tipo 2/terapia , Dieta para Diabéticos , Educação de Pacientes como Assunto/métodos , Complicações do Diabetes/prevenção & controle , Autocuidado/métodos , Avaliação de Eficácia-Efetividade de Intervenções , Pesquisas sobre Atenção à Saúde/estatística & dados numéricosRESUMO
Fundamento y objetivo. Las enfermedades cardiovasculares constituyen la principal causa de muerte en la población española. La detección y control de los factores de riesgo cardiovascular es fundamental para prevenirlas. Este estudio tiene como objetivos fundamentales analizar la actitud y las decisiones terapéuticas de los médicos de Atención Primaria (AP) ante la hipertensión arterial (HTA) y la diabetes mellitus tipo 2 (DM2), con el fin de conocer la realidad y proponer estrategias de mejora para su correcto manejo. Material y método. Estudio ecológico de encuesta, descriptivo, transversal y multicéntrico, de ámbito nacional, con participación de médicos de AP, realizado en 2013. Se solicitó la participación en el estudio a 1.028 médicos. Resultados. El 92,9 y el 91,4% de los investigadores consultados sigue las guías para la evaluación, el tratamiento y el diagnóstico de HTA y DM2, respectivamente. Esta última se diagnostica sobre todo casualmente, y la HTA por búsqueda activa en pacientes con otros factores de riesgo. La terapia combinada tarda más de 6 meses en instaurarse en pacientes hipertensos y entre 8-9 meses en diabéticos. El porcentaje de incumplimiento es similar (10-40%) en ambas dolencias. Aproximadamente la mitad de los encuestados consideran buena o excelente la interacción con el especialista (46 y 57,3% en HTA y DM2, respectivamente). Conclusiones. La práctica clínica en AP en HTA y DM2 tiene criterios básicos comunes. La interacción entre la AP y el especialista es buena. No obstante, existe margen de mejora en el tratamiento de estos factores de riesgo, particularmente en lo relativo a intensificar la terapia precozmente (AU)
Background and objective. Cardiovascular diseases are the main cause of death in the Spanish population. The detection and control of cardiovascular risk factors are fundamental in the prevention of cardiovascular disease. The main objectives of this study are to analyse the attitudes and therapeutic decisions of Primary Care (PC) physicians when treating hypertension (HT) and diabetes mellitus type 2 (DM2), with the aim of establishing the situation and eventually proposing improvement strategies. Material and method. A national ecological, multicentre, cross-sectional, and descriptive study was conducted in 2013. A questionnaire was used and 1,028 PC physicians took part in the study. Results. A total of 92.9% of the investigators consulted have indicated that they follow the guidelines for evaluation, treatment, and diagnosis of HT, and 91.4% in the case of diabetes. The latter is diagnosed as a casual finding, while HT is diagnosed through active investigation in patients with other risk factors. Combined therapy takes more than 6 months to take effect in patients with HT, and between 8 and 9 months in diabetic patients. The percentage of non-compliance is similar (10-40%) in both pathologies. Around half the physicians questioned considered interaction with the specialist to be good or excellent (46% HT and 57.3% DM2). Conclusions. Clinical practices in PC for HT and DM2 have some basic criteria in common. The interaction with the specialist is good, but there is a considerable margin for improvement (AU)