Gestión ineficaz de la propia salud relacionada con la prescripción por principio activo en pacientes polimedicados mayores de 65 años

Evaluar si la Prescripción por Principio Activo en pacientes polimedicados mayores de 65 años se relaciona con una Gestión Ineficaz de la Propia Salud (GIPS). - Conocer la calidad de vida relacionada con la salud, sus factores asociados y el impacto que sobre la misma produce la presencia de GIPS y la Prescripción por Principio Activo. Métodos: Estudio descriptivo transversal de una muestra representativa (n=425) desarrollado entre junio de 2011 y junio de 2012 en la provincia de Málaga. Las variables de resultado fueron el diagnóstico enfermero Gestión Ineficaz de la Propia Salud y la Calidad de Vida Relacionada con la Salud. Mediante entrevista domiciliaria se recogieron variables sociodemográficas, clínicas y relacionadas con la medicación, utilizándose el instrumento EuroQol-5D para evaluar la calidad de vida. Resultados: Se estudiaron 375 pacientes y 50 cuidadoras con una edad media de 74,68 + 5,62 años, siendo mujeres el 64,2%. La prevalencia de GIPS en la población estudiada fue del 37,4%. Los factores que se comportaron como factores de riesgo para este diagnóstico, fueron: el riesgo social, la depresión, la falta de adherencia terapéutica y el hecho de no ser capaz de identificar genéricos como iguales o con la patología para la que estaban prescritos. Por el contrario, se comportaron como factores protectores frente al mismo, el presentar un porcentaje de prescripción por principio activo superior al 75% y el no tener en el botiquín genéricos de distintas marcas. La percepción global de calidad de vida medida mediante EQ-EVA fue de 59,67±21,08, mientras que en el Índice-EQ fue de 0,66+0,19, con valores más elevados en hombres. De las 5 dimensiones del EuroQol, la ansiedad-depresión y el dolor fueron las más frecuentemente afectadas, mientras que la movilidad y el cuidado personal resultaron las más influyentes en la percepción de la calidad de vida. El análisis multivariante mostró, en ambas escalas, como factor asociado a mejor calidad de vida la independencia funcional y a peor calidad de vida el analfabetismo, el riesgo social, el consumo de más de 10 medicamentos y la depresión. Conclusiones: La Prescripción por Principio Activo no se relaciona con una Gestión Ineficaz de la Propia Salud, constituyendo, por contra, un factor protector frente a dicho diagnóstico. El nivel de calidad de vida de los pacientes de nuestro estudio es comparable al de otras poblaciones con características sociodemográficas similares, no constituyendo la prescripción por principio activo un factor que influya negativamente. Son la incapacidad funcional y los problemas sociales y psicológicos, los principales condicionantes de la misma en este tipo de población

The implications of the foot health status in Parkinson patients: A case–control study

Parkinson's disease (PD) is a neurodegenerative disorder that affects bothhealth of the feet, as to gait patterns. This study aimed to find out about footproblems and their impact on self-perceived quality of life and related to foothealth in Parkinson's patients compared to a group of healthy subjects and tomeasure it with Spanish Podiatry Health Questionnaire (PHQ-S). It is about acase–control study in a sample of Parkinson's patients n=62, healthy controlsn=62. The PHQ-S was reported, it describes perception the subject has ineach of podiatric 6 dimensions consulted, assessing appreciation of health sta-tus of interviewee's feet and a self-rated the foot health score on the visual ana-log scale (VAS). There were statistically significant differences (P< 0.05) inthe dimensions that assessed problems with walking and moving, nail trim-ming, concern feet state, and affectation of quality of life related foot health.Regarding the self-perception of state of their feet, Parkinson's patientsperceive a worse state of health of their feet than healthy subjects. The meanvalue was 4.8 (SD 2.2) for Parkinson's patients and 3.8 (SD 2.3) for healthysubjects. In conclusion, patients with PD have problems in walking or moving,foot pain, difficulties in foot hygiene and in cutting for their nails, as well asthe concern they suffer from deterioration in state of their feet affect them anddecrease their quality of life. Podiatric problems in Parkinson's patients have agreat impact in reducing quality of life related to foot health.Parkinson Association's of Malaga. Partial funding for open access charge: Universidad de Málag

Gestión del conocimiento: perspectiva multidisciplinaria. Volumen 13

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 13 de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada, de acceso abierto a todas las áreas del conocimiento, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico. Con esta colección, se aspira contribuir con el cultivo, la comprensión, la recopilación y la apropiación social del conocimiento en cuanto a patrimonio intangible de la humanidad, con el propósito de hacer aportes con la transformación de las relaciones socioculturales que sustentan la construcción social de los saberes y su reconocimiento como bien público. El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 13, de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro cuenta con el apoyo de los grupos de investigación: Universidad Sur del Lago “Jesús María Semprúm” (UNESUR) - Zulia – Venezuela; Universidad Politécnica Territorial de Falcón Alonso Gamero (UPTFAG) - Falcón – Venezuela; Universidad Politécnica Territorial de Mérida Kléber Ramírez (UPTM) - Mérida - Venezuela; Universidad Guanajuato (UG) - Campus Celaya - Salvatierra - Cuerpo Académico de Biodesarrollo y Bioeconomía en las Organizaciones y Políticas Públicas (CABBOPP) - Guanajuato – México; Centro de Altos Estudios de Venezuela (CEALEVE) - Zulia – Venezuela, Centro Integral de Formación Educativa Especializada del Sur (CIFE - SUR) - Zulia – Venezuela; Centro de Investigaciones Internacionales SAS (CEDINTER) - Antioquia – Colombia y diferentes grupos de investigación del ámbito nacional e internacional que hoy se unen para estrechar vínculos investigativos, para que sus aportes científicos formen parte de los libros que se publiquen en formatos digital e impreso

Evaluation of Inappropriate Prescribing in Patients Older than 65 Years in Primary Health Care

To asses inappropriate prescribing and its predisposing factors in polymedicated patients over the age of 65 in primary health care. Design: cross-sectional study. Setting: Primary care centres in the Costa del Sol Health District and Northern Health Area of Malaga in southern Spain. Participants: Patients older than 65 years who use multiple medications. Data collection was conducted during 1 year in a population of 425 individuals who comprised a stratified randomized sample of the population of health care users in the study area. The data were collected by interview on a structured data collection form. Study variables. Dependent variable: Potentially inappropriate prescribing (PIP) (STOPP/START criteria). Predictor variables: Sociodemographic characteristics, clinical characteristics and medication use. A descriptive analysis of the variables was performed. Statistical inference was based on bivariate analysis (Student&rsquo;s t or Mann-Whitney U test and chi-squared test) and multivariate analysis was used to control for confounding factors. 73.6% of participants met one or more STOPP/START criteria. According to information about prescribed treatments, 48.5% of participants met at least one STOPP criterion and 43.30% of them met at least one START criterion. The largest percentage of inappropriate prescriptions was associated with cardiovascular treatments. More than three-quarters of the participants had one or more inappropriate prescriptions for medicines in primary care, according to STOPP/START criteria. In addition, PIP was directly related to the number of prescribed medications, gender and specific pathologies (diabetes)

Adherencia al tratamiento en pacientes polimedicados mayores de 65 años con prescripción por principio activo

Objetivo: Valorar el nivel de adherencia al tratamiento y los factores relacionados en polimedicados mayores de 65 con prescripción por principio activo. Diseño: Estudio observacional, descriptivo, transversal, sobre polimedicados mayores de 65 años adscritos a los centros de atención primaria del Distrito Sanitario Costa del Sol y del Área Sanitaria Norte de Málaga. Se ha realizado entre enero del 2011 y septiembre del 2012, sobre una población de 375 individuos obtenida mediante muestreo aleatorio simple a partir de las listas de pacientes proporcionadas por cada centro. Los datos se recogieron mediante entrevista, sobre hoja estructurada de recogida de datos y previa firma del consentimiento informado. Variables del estudio: Variable principal de resultado: adherencia al tratamiento (test de Morisky-Green). Variables predictoras: Prescripción por principio activo, variables sociodemográficas, clínicas y relacionadas con la medicación. Se efectuó un análisis descriptivo de las variables. La inferencia estadística se realizó mediante análisis bivariante (test de la t de Student o U de Mann Whitney y chi al cuadrado), controlándose los factores de confusión mediante análisis multivariante (regresión lineal y logística). Resultados: El cumplimiento terapéutico se sitúa en el 51,7%, no apreciándose diferencias estadísticamente significativas con respecto al sexo o la edad. Encontramos relación con residir en zona de interior (p = 0,001), vivir acompañados (p < 0,05) y no presentar riesgo de ansiedad (p = 0,046). Conclusiones: La adherencia es similar a los estudios realizados, independientemente de si la prescripción es por principio activo. El incumplimiento fue mayor en individuos que viven solos, en población costera y con riesgo de ansiedad

Use of health care services according to functional performance in community-dwelling older adults in Spain. An approach using GAMLSS models.

Functional performance in older adults is a predictor of survival and other health outcomes and its measurement is highly recommended in primary care settings. Functional performance and frailty are closely related concepts, and frailty status is associated with the use of health care services. However, there is insufficient evidence on the utilization of services profile according to the functional performance of older adults. The aim of this study was to assess the relationship between functional performance and the use of a wide range of health services in community-dwelling older adults. Generalized additive models for location, scale and shape were used to study these complex data of services utilization, from primary to hospital care. A total of 749 participants from two Spanish regions were followed up for 2 years. Of those, 276 (37%) presented low functional performance and 473 (63%) normal performance according to the Timed Up and Go test. The results showed that even after adjusting for burden of comorbidity and polypharmacy, participants with low functional performance used primary and secondary care health services more intensively, visited emergency rooms more often, and were hospitalized more frequently and for longer periods of time. A negative binomial distribution and a variant thereof were found to be the best models to describe health service utilization data. In conclusion, functionality should be considered as an important health indicator for tailoring the provision of health services for older adults

Influence of childhood overweight and obesity on foot and lower limb pain in a population of primary school children

Introduction In childhood, juvenile obesity affects the functional characteristics of the lower limb, predisposing children to pain, discomfort and musculoskeletal comorbidities. This cross-sectional descriptive study analyses the relationship between childhood overweight/obesity and foot/lower limb pain in a population of primary school children. Material and methods The study population consisted of 150 children aged 9–12 years recruited at a primary school in Malaga (Spain). None had pathologic feet. Anthropometric and demographic data were compiled by questionnaire and by personal interview. Among other variables, the foot posture index was calculated and knee alignment was measured. In the statistical analysis, the dependent variables considered were foot and lower limb pain, and the predictor variables were age, sex, body mass index, sports activity, foot posture index and knee alignment. A descriptive analysis of these variables was performed, together with an association analysis (using the 2 test) and a multivariate analysis (using binary logistic regression). Results In the study sample, 47.3% were girls, 15.3% were overweight and 12.7% obese. The overall prevalence of foot pain was 10.7% and that of lower limb pain, 27.3%. Of the study variables analyzed, the only ones significantly related to both foot pain and lower limb pain were overweight and obesity. Conclusions Overweight and obesity are the main factors related to pain in the feet and lower limbs in primary school children.Sin financiación3.318 JCR (2020) Q2, 51/169 Medicine, General & Internal1.000 SJR (2020) Q1, 553/2448 Medicine (miscellaneous)No data IDR 2019UE

Medication-related factors associated with health-related quality of life in patients older than 65 years with polypharmacy

<div><p>In the current public health framework, the importance of medication as a determinant of citizens’ health has emerged as a factor warranting special attention. Most studies investigating the relationship between medication and quality of life do so from the perspective of adherence. However, other medication-related factors identified at home visits may be associated with health-related quality of life.</p><p>Methods and design</p><p>Objective: To describe the relationship between medication-related factors and the health-related quality of life in patients older than 65 years who use multiple medications (polypharmacy).</p><p>Design: Cross-sectional descriptive study.</p><p>Setting: Primary care.</p><p>Participants: Patients older than 65 years who use multiple medications (n = 375).</p><p>Measurements: The main outcome measure was health-related quality of life according to the EuroQol-5D instrument. Sociodemographic, clinical and medication-related variables were recorded during home interviews.</p><p>Results</p><p>Mean age was 74.72 ± 5.59 years, and 65.5% of our participants were women. The global level of health-related quality of life according to the EQ-5D visual analog scale was 59.25 ± 20.92. Of the five EuroQol dimensions, anxiety/depression and pain were the most frequently reported, while mobility and self-care were the dimensions with the greatest impact on self-reported quality of life. Multivariate analysis indicated that functional independence was the factor most strongly associated (β = 14.27 p < 0.001) with better health-related quality of life, while illiteracy (β = −13.58 p < 0.001), depression (β = −10.13 p < 0.001), social risk (β = −7.23 p = 0.004) and using more than 10 medicines (β = −4.85 p = 0.009) were strongly associated with a poorer health-related quality of life.</p><p>Conclusions</p><p>Factors inherent within the patient such as functional incapacity, cognitive impairment and social and emotional problems were the main constraints to quality of life in our study population. The number of medicines taken was negatively related with quality of life.</p></div

Perceived quality of life (EQ-VAS) according to different dimensions.

<p>Perceived quality of life (EQ-VAS) according to different dimensions.</p