12 research outputs found
Subsidized pharmacological treatment for smoking cessation by the Spanish public health system
INTRODUCTION Research has shown that financing drug therapy
increases smoking abstinence rates, although most of these
studies have been carried out in the private healthcare setting.
The aim of this work is to assess the effect of subsidized
pharmacological treatment on smoking cessation rates by the
Spanish public healthcare system.
METHODS A pragmatic, randomized, clinical trial was performed
by clusters. Randomization unit was the primary healthcare
center and the analysis unit was the patient. Smokers
consuming ≥10 cigarettes/day were randomly assigned to an
intervention group that received financed pharmacological
treatment or to a control group that followed usual care. The
main outcome was self-reported or CO-confirmed continuous
abstinence at 12 months. The main outcome, continuous
abstinence rates (%), were compared between groups at 12
months post-intervention. A model was adjusted using mixedeffect
logistic regression.
RESULTS A total of 1154 patients were included from 23
healthcare centers. In the intention-to-treat analysis, selfreported
abstinence after 12 months in the control and
intervention groups, respectively, was 9.6% (37/387) and
15.4% (118/767) (gender-adjusted OR=1.75; 95% CI: 1.1–
2.8); for CO-confirmed abstinence the corresponding values
were 3.1% (12/387) and 6.4% (49/767) (gender-adjusted
OR=1.72; 95% CI: 0.7–4.0). Pharmacological treatment use was
35.1% (136/387) in the control group, and 58.3% (447/767)
in the intervention group (adjusted OR=4.25; 95% CI: 1.8–9.9)
CONCLUSIONS Subsidizing pharmacological treatment for smoking
cessation increases self-reported or CO-confirmed abstinence
rates under realistic conditions in the primary care setting of
the Spanish public health systemThis trial was funded by the Fondo de Investigaciones Sanitarias
(FIS) del Instituto de Salud Carlos III (ISCIII), the European Regional
Development Fund (ERDF) under registration number 07528, as well
as the 2016 and 2017 calls for grants for translations and publishing
by the Fundación para la Investigación e Innovación Biosanitaria en
Atención Primaria (FIIBA
Knowledge, attitudes and preventive practices of primary health care professionals towards alcohol use: A national, cross-sectional study
Introduction Primary care (PC) professionals' knowledge about alcohol use has been identified as one of the barriers PC providers face in their clinic. Both PC professionals' level of training and attitude are crucial in the clinical practice regarding alcohol use. Objective To evaluate the knowledge, attitude, and preventive practices of Spanish PC physicians and nurses towards alcohol use. Design An observational, descriptive, cross-sectional, multi-center study. Methodology Location: PC centers of the Spanish National Health System (NHS). Participants: PC physicians and nurses selected randomly from health care centers, and by sending an e-mail to semFYC and SEMERGEN members. Healthcare providers completed an online survey on knowledge, attitude, and follow-up recommendations for reducing alcohol intake. A descriptive, bivariate, and multivariate statistical analysis was conducted (p<0.05). Results Participants: 1, 760 healthcare providers completed the survey (75.6% [95% CI 73.5-77.6] family physicians; 11.4% [95% CI 9.9-12.9] medical residents; and 12.5% [95% CI 10.9-14.1] nurses), with a mean age of 44.7 (SD 11.24, range: 26-64, 95% CI: 47.2-48.2). Knowledge was higher in family physicians (p<0.001), older professionals (Spearman's r = 0.11, p<0.001), and resident trainers (p<0.001). The PC professional most likely to provide advice for reducing alcohol use was: a nurse (p<0.001), female (p = 0.010), between 46 and 55 years old (p <0.001). Conclusions PC providers' knowledge and preventive practices regarding alcohol use are scarce, hence specific training strategies to increase their knowledge and improve their attitude and skills with regard to this health problem should be considered a healthcare policy priority
Grupo de expertos del PAPPS. Recomendaciones sobre el estilo de vida
Los determinantes de salud primarios y secundarios explican gran parte de la morbimortalidad observada en atención primaria. Se presentan las recomendaciones del Programa de Actividades Preventivas y Promoción de la Salud (PAPPS) de la semFyC, para la promoción de un estilo de vida saludable mediante la metodología de intervención y las actuaciones preventivas en consumo de tabaco, consumo de alcohol, alimentación saludable, actividad física en el tiempo libre, prevención de accidentes de tráfico y sistemas de retención infantil. Se señalan las pautas más comunes de prevención clínica. Se actualizan las recomendaciones, se señalan aspectos novedosos como la definición de consumo de alcohol de bajo riesgo y se pone al día la bibliografía. Para las principales recomendaciones se incluyen tablas específicas que recogen la calidad de la evidencia y la fuerza de la recomendación.
Primary and secondary health determinants explain a large part of the morbidity and mortality observed in primary care. The recommendations of the Program of Preventive Activities and Health Promotion (PAPPS) of the semFyC are presented, for the promotion of a healthy lifestyle through intervention methodology and preventive actions in tobacco consumption, alcohol consumption, healthy eating, physical activity in free time and prevention of traffic accidents and child restraint systems. The most common clinical prevention guidelines are outlined. The recommendations are updated, new aspects are pointed out, such as the definition of low-risk alcohol consumption, and the bibliography is updated. For the main recommendations, specific tables are included that show the quality of the evidence and the strength of the recommendation
Recomendaciones sobre el estilo de vida. Actualizacón PAPPS 2018 [Recommendations on lifestyle. PAPPS Update 2018]
Intervención sobre el estilo de vida
Múltiples estudios demuestran que determinados cambios en el estilo de vida son eficaces para mejorar la salud de las personas y disminuir la carga de enfermedad.
La evidencia sobre las intervenciones para el cambio de conducta (ICC) en las consultas de atención primaria (AP) ha ido aumentando en los últimos años, y las estrategias útiles son las cognitivo-conductuales. Las ICC más intensivas se asocian con mayor magnitud y duración del beneficio. Las intervenciones individuales sobre un solo factor de riesgo tienen escaso impacto en la salud de las personas y sus determinantes, por lo que se aconseja el abordaje integral de las conductas susceptibles de cambio para mejorar el estilo de vida. Aunque no han demostrado mejorar los resultados, se recomienda el uso de materiales didácticos impresos como apoyo a las intervenciones breves..