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Reverté-Villarroya S, Suñer-Soler R, Zaragoza-Brunet J, Martín-Ozaeta G, Esteve-Belloch P, Payo-Froiz I, Sauras-Colón E, Lopez-Espuela F. Vascular Risk Factors in Ischemic Stroke Survivors: A Retrospective Study in Catalonia, Spain. Healthcare (Basel) 2022; 10:healthcare10112219. [PMID: 36360560 PMCID: PMC9690451 DOI: 10.3390/healthcare10112219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/29/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Background: The distribution of vascular risk factors (VRFs) and stroke management vary by geographic area. Our aim was to examine the percentage of the VRFs according to age and sex in ischemic stroke survivors in a geographical area on the Mediterranean coast of Southern Catalonia, Spain. Methods: This was a multicenter, observational, retrospective, community-based study of a cohort, the data of which we obtained from digital clinical records of the Catalan Institute of Health. The study included all patients with a confirmed diagnosis of ischemic stroke who were treated between 1 January 2011 and 31 December 2020. Patients met the following inclusion criteria: residing in the study area, age ≥ 18 years, and presenting ≥1 modifiable vascular risk factor. The exclusion criteria were as follows: death patients (non-survivors) and patients without modifiable VRFs. We collected the demographic, clinical, and VRF variables of the total of 2054 cases included, and we analyzed the data according to age groups, sex, and number of VRFs. Results: Most of the patients included were in the 55−80 age group (n = 1139; 55.45%). Of the patients, 56.48% (n = 1160) presented ≤ 2 modifiable VRFs, and the age group <55 years old (67.01%) presented more VRFs. Hypertension and (>80 years old (38.82%)) and dyslipidemia (<55 years (28.33%)) were the most prevalent VRFs. In the age group 55−80 (69.59% men), the prevalence of VRFs was higher ((3−4 VRF (42.76%) and >4 VRF (5.35%)). Conclusions: These results suggest the presence of many VRFs in people diagnosed with ischemic stroke—although with a lower percentage compared to other studies—and the need for specific individualized interventions for the control of modifiable RFs related to primary and secondary prevention of stroke.
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Affiliation(s)
- Silvia Reverté-Villarroya
- Nursing Department, Universitat Rovira Virgili, Avenue Remolins, 13-15, 43500 Tortosa, Spain
- Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500 Tortosa, Spain
| | - Rosa Suñer-Soler
- Faculty of Nursing, University of Girona, Emili Grahit, 77, 17071 Girona, Spain
- Correspondence: (R.S.-S.); (J.Z.-B.)
| | - Jose Zaragoza-Brunet
- Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500 Tortosa, Spain
- Correspondence: (R.S.-S.); (J.Z.-B.)
| | - Gisela Martín-Ozaeta
- Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500 Tortosa, Spain
| | | | - Iago Payo-Froiz
- Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500 Tortosa, Spain
| | - Esther Sauras-Colón
- Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500 Tortosa, Spain
| | - Fidel Lopez-Espuela
- Metabolic Bone Diseases Research Group, Nursing Department, Occupational Therapy College, University of Extremadura, Avenue of the University s/n, 10003 Cáceres, Spain
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Rosell-Murphy M, Rodriguez-Blanco T, Morán J, Pons-Vigués M, Elorza-Ricart JM, Rodríguez J, Pareja C, Nuin MÁ, Bolíbar B. Variability in screening prevention activities in primary care in Spain: a multilevel analysis. BMC Public Health 2015; 15:473. [PMID: 25947302 PMCID: PMC4440275 DOI: 10.1186/s12889-015-1767-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 04/21/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite evidence of the benefits of prevention activities, studies have reported only partial integration and great variability of screening in daily clinical practice. The study objectives were: 1) To describe Primary Health Care (PHC) screening for arterial hypertension, dyslipidaemia, obesity, tobacco use, and excessive alcohol consumption in 2008 in 2 regions of Spain, based on electronic health records, and 2) To assess and quantify variability in screening, and identify factors (of patient, general practitioners and PHC team) associated with being screened, that are common throughout the PHC population. METHODS Multicentre, cross-sectional study of individuals aged ≥ 16 years (N = 468,940) who visited the 426 general practitioners (GPs) in 44 PHC teams in Catalonia and Navarre in 2008. OUTCOMES screening for hypertension, dyslipidaemia, obesity, tobacco use, and excessive alcohol consumption. Other variables were considered at the individual (sociodemographics, visits, health problems), GP and PHC team (region among others). Individual and contextual factors associated with the odds of being screened and the variance attributable to each level were identified using the SAS PROC GLIMMIX macro. RESULTS The most prevalent screenings were for dyslipidaemia (64.4%) and hypertension (50.8%); the least prevalent was tobacco use (36.6%). Overall, the odds of being screened were higher for women, older patients, those with more comorbidities, more cardiovascular risk factors, and more frequent office visits, and those assigned to a female GP, a GP with a lower patient load, or a PHC team with a lower percentage of patients older than 65 years. On average, individuals in Navarre were less likely to be screened than those in Catalonia. Hypertension and dyslipidaemia screenings had the least unexplained variability between PHC teams and GPs, respectively, after adjusting for individual and contextual factors. CONCLUSIONS Of the studied screenings, those for obesity, tobacco, and alcohol use were the least prevalent. Attention to screening, especially for tobacco and alcohol, can be greatly improved in the PHC setting.
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Affiliation(s)
- Magdalena Rosell-Murphy
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Av Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain.
- Equip d'Atenció Primària Serraparera. Institut Català de la Salut, Cerdanyola del Vallès, Spain.
| | - Teresa Rodriguez-Blanco
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Av Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.
| | - Julio Morán
- Dirección Atención Primaria, Servicio Navarro de Salud - Osasunbidea, Navarra, Spain.
| | - Mariona Pons-Vigués
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Av Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.
| | - Josep M Elorza-Ricart
- SIDIAP, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
| | - Jordi Rodríguez
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Av Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain.
- SIDIAP, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
| | - Clara Pareja
- Equip d'Atenció Primària La Mina. Institut Català de la Salut, Barcelona, Spain.
| | - María Ángeles Nuin
- Dirección Atención Primaria, Servicio Navarro de Salud - Osasunbidea, Navarra, Spain.
| | - Bonaventura Bolíbar
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Av Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.
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Pérez Zamora S, Benítez Camps M, Dalfó Baqué A, Piqueras Garré M, Losada Duval G, Vila Coll MA. [Is the action taken by Catalonian primary care doctors adequate in view of the insufficient reduction in blood pressure levels in hypertensive patients? DISEHTAC-2001 study]. Aten Primaria 2008; 40:505-10. [PMID: 19054457 PMCID: PMC7659847 DOI: 10.1157/13127231] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2005] [Accepted: 02/18/2008] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To determine the attitude to therapy of primary care staff in view of the lack of reduction in blood pressure. To describe the most commonly used antihypertensives. DESIGN Descriptive, longitudinal, retrospective study during the year 2001. SETTING Primary care, Spain. PARTICIPANTS We analysed 990 hypertensive patients from 12 health centres picked from the 31 participants in the DISEHTAC-1996 study. METHODS Age, sex, weight, and height were analysed, along with blood pressure values throughout the year 2001, therapeutic attitude (increase/replacement/combination) with poor control (more than 2 consecutive visits with blood pressure>139 and/or 89 mm Hg), screening and prevalence of cardiovascular risk factors (CVRF), and drugs used. RESULTS There were 58.9% females; mean age: 65.4 (13.01) years, and 43.8% received 2 or more antihypertensives. The most common antihypertensives prescribed were diuretics (47.6%), and angiotensin-converting enzyme (ACE) inhibitors plus diuretics was the most used combination (22.1%). When there was poor control, some change in treatment was made in 76.8% (95% confidence interval [CI], 73.6-80) of cases. The most common was a combination of drugs (49.6%). The expected action was more frequent in those over 65 years and with a grade I of arterial hypertension (systolic blood pressure [SBP] between 140-150 and diastolic blood pressure [DBP] between 90-99 mm Hg (P<.001). CONCLUSIONS Combined therapy is used in almost half of hypertensive patients, with the most common action being a drug combination.
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Bolíbar B, Pareja C, Astier-Peña MP, Morán J, Rodríguez-Blanco T, Rosell-Murphy M, Iglesias M, Juncosa S, Mascort J, Violan C, Magallón R, Apezteguia J. Variability in the performance of preventive services and in the degree of control of identified health problems: a primary care study protocol. BMC Public Health 2008; 8:281. [PMID: 18691407 PMCID: PMC2533323 DOI: 10.1186/1471-2458-8-281] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Accepted: 08/08/2008] [Indexed: 11/18/2022] Open
Abstract
Background Preventive activities carried out in primary care have important variability that makes necessary to know which factors have an impact in order to establish future strategies for improvement. The present study has three objectives: 1) To describe the variability in the implementation of 7 preventive services (screening for smoking status, alcohol abuse, hypertension, hypercholesterolemia, obesity, influenza and tetanus immunization) and to determine their related factors; 2) To describe the degree of control of 5 identified health problems (smoking, alcohol abuse, hypertension, hypercholesterolemia and obesity); 3) To calculate intraclass correlation coefficients. Design Multi-centered cross-sectional study of a randomised sample of primary health care teams from 3 regions of Spain designed to analyse variability and related factors of 7 selected preventive services in years 2006 and 2007. At the end of 2008, we will perform a cross-sectional study of a cohort of patients attended in 2006 or 2007 to asses the degree of control of 5 identified health problems. All subjects older than16 years assigned to a randomised sample of 22 computerized primary health care teams and attended during the study period are included in each region providing a sample with more than 850.000 subjects. The main outcome measures will be implementation of 7 preventive services and control of 5 identified health problems. Furthermore, there will be 3 levels of data collection: 1) Patient level (age, gender, morbidity, preventive services, attendance); 2) Health-care professional level (professional characteristics, years working at the team, workload); 3) Team level (characteristics, electronic clinical record system). Data will be transferred from electronic clinical records to a central database with prior encryption and dissociation of subject, professional and team identity. Global and regional analysis will be performed including standard analysis for primary health care teams and health-care professional level. Linear and logistic regression multilevel analysis adjusted for individual and cluster variables will also be performed. Variability in the number of preventive services implemented will be calculated with Poisson multilevel models. Team and health-care professional will be considered random effects. Intraclass correlation coefficients, standard error and variance components for the different outcome measures will be calculated.
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Affiliation(s)
- Bonaventura Bolíbar
- Institut d'Investigació en Atenció Primària Jordi Gol, C/Gran Via de Corts Catalanes 587 àtic, 08007 Barcelona, Spain.
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Pérez Olano B, Sarmiento Cruz M, Farran Torres N. Control de los factores de riesgo vascular antes y después de experimentar un infarto agudo de miocardio o un accidente cerebrovascular. Aten Primaria 2007; 39:509-10. [DOI: 10.1157/13109505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Segura Garcia L, Gual Solé A, Montserrat Mestre O, Bueno Belmonte A, Colom Farran J. [Detection and handling of alcohol problems in primary care in Catalonia]. Aten Primaria 2006; 37:484-8. [PMID: 16756871 PMCID: PMC7668911 DOI: 10.1157/13089078] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To gain information on how well strategies for alcohol problem detection and interventions are being implemented in primary care in Catalonia, Spain. DESIGN Longitudinal pre/post study to evaluate the impact of the distribution to primary care professionals of a training programme for detecting alcohol problems and intervening in them. Descriptive analysis of the basic situation, using interviews with patients and professionals and examination of clinical histories (CH). SETTING Health districts that existed in Catalonia in 2001. PARTICIPANTS Twenty eight health districts, 973 patients, 80 professionals, and 852 clinical histories examined. MAIN MEASUREMENTS Data were collected, by means of questionnaires for professionals and patients and of ad-hoc instruments for examining clinical histories, on the levels of primary care screening for alcohol consumption and of intervention. RESULTS There was a major disparity in the data between the 3 sources. Thus the screening of consumption and counselling was recorded much less in the CHs than amounts that patients said they received and that professionals said they performed. In addition, most of the at-risk drinkers that were seen in PC were not detected. On comparing them with non-risk drinkers we found significant differences in sex, job, familiarity with the centre and having been asked or not about their alcohol consumption. CONCLUSIONS Given the deficiencies found in PC preventive activity on alcohol consumption and as alcohol consumption has such huge social and health repercussions on the general population, we think it is fully justified to introduce into PC specific training programmes on screening and brief intervention techniques for alcohol problems.
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Affiliation(s)
- Lidia Segura Garcia
- Organ Tècnic de Drogodependències del Departament de Salut, Generalitat de Catalunya, Barcelona, España.
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Gómez-Marcos M, García-Ortiz L, González-Elena L, Ramos-Delgado E, González-García A, Parra-Sánchez J. Efectividad de una intervención de mejora de calidad en el control de la presión arterial en Atención Primaria. Rev Clin Esp 2006. [DOI: 10.1157/13093467] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Gallego-Luis R, Ruiz-García A, Gordillo-López F, Díaz-Puente M, Esteban J, Gil de Miguel A. [Study of unmatched cases and controls: hyperhomocysteinaemia and chronic ischaemic cardiopathy]. Aten Primaria 2006; 37:325-31. [PMID: 16733005 PMCID: PMC7679868 DOI: 10.1157/13086709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the extent of the association between hyperhomocysteinaemia and chronic ischaemic heart disease. DESIGN Unmatched, case-control (1:3) study. SETTING Pintores Health Centre, Area 10, Primary Care, Madrid, Spain. PARTICIPANTS Patients of the health centre over 35 with chronic ischaemic heart disease or without it. METHOD Consecutive, non-randomized sample. Analysis of cases and controls with chi2 test and odds ratio (OR). The quantitative variables were analysed with the Student's t test. RESULTS The 76.32% (87/114) of cases had 2 or more cardiovascular risk factors versus 33.56% (99/265) in the control group (P<.0001). Average homocysteinaemia was 10.07 micromol/L (SD, 3.64) in the control group; and 12.74 (SD, 4.59) in the cases group. The difference between the averages (2.67 micromol/L; 95% CI, 1.82-3.52) was significant (P<.001). The difference (16.07%; 95% CI, 6.91-25.23) in hyperhomocysteinaemia (> or =15 micromol/L) between cases (28.95%, 33/114) and controls (12.88%, 38/295) was significant (P=.0001), with an association between hyperhomocysteinaemia and chronic ischaemic heart disease (OR=2.76; 95% CI, 1.62-4.68). This association increased (OR=3.26; 95% CI, 2.07-5.13) when hyperhomocysteinaemia was taken as > or =12 micromol/L, with a significant difference of 27% (95% CI, 16.59-37.41) (P<.0001) between cases (51.75%, 59/114) and controls (24.75%, 73/295). CONCLUSIONS The risk factor of hyperhomocysteinaemia > or =15 micromol/L was significantly associated (OR=2.76) with chronic ischaemic heart disease. This association was greater (OR=3.26) when hyperhomocysteinaemia was taken as > or =12 micromol/L.
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Affiliation(s)
- R. Gallego-Luis
- Unidad de Lípidos y Prevención Cardiovascular. Área 10 Atención Primaria IMSALUD. Madrid. España
| | - A. Ruiz-García
- Unidad de Lípidos y Prevención Cardiovascular. Área 10 Atención Primaria IMSALUD. Madrid. España
- Correspondencia: A. Ruiz-García. EAP Las Ciudades. Palestina, s/n. 28903 Getafe. Madrid. España.
| | - F.J. Gordillo-López
- Unidad de Lípidos y Prevención Cardiovascular. Área 10 Atención Primaria IMSALUD. Madrid. España
| | - M.V. Díaz-Puente
- Unidad de Lípidos y Prevención Cardiovascular. Área 10 Atención Primaria IMSALUD. Madrid. España
| | - J. Esteban
- Unidad de Docencia e Investigación en Medicina Preventiva y Salud Pública. Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos. Madrid. España
| | - A. Gil de Miguel
- Unidad de Docencia e Investigación en Medicina Preventiva y Salud Pública. Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos. Madrid. España
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Segura-Benedicto A. Inducción sanitaria de los cribados: impacto y consecuencias. Aspectos éticos. GACETA SANITARIA 2006; 20 Suppl 1:88-95. [PMID: 16539970 DOI: 10.1157/13086031] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The main aim of screening is to identify people with an increased probability to benefit from preventive interventions, generally from secondary prevention but also from primary prevention activities. The goal is to facilitate early diagnosis and treatment in order to modify positively the prognosis (the former case), or to recognize people exposed to risk factors which increase the incidence rate of disease, and then to prevent the disease (the latter case). Good intentions are not enough to achieve good results in terms of effectiveness, safety, efficiency or equity. It is necessary to have a systematic assessment of the consequences of screening, particularly on the impact on peoples health and on the health services. Due to the diversity of types of screenings that are done, it is very difficult to estimate the net impact caused by their implementation. Moreover, the changes in the health of a population depend on many factors other than health service interventions. Thus, it is very important to determine the effectiveness and safety of the screening methods that are most frequently applied. Unfortunately, assessment of the benefits and the harm potentially caused by preventive interventions has not been done often. In Spain only a few partial assessments have been published, and they focus on the activities and the processes themselves rather than the final outcomes. Given that screening activities are carried out in health care services, and that the populations screened are mostly healthy people, the ethical issues have great importance when health policies are designed and implemented. Thus, it is recommended that screenings activities be analyzed applying the ethical principles of autonomy, benefit, safety and justice. If any screening program cannot reasonably satisfy these principles then they should be removed from the list of public health activities that are financed by public resources. In the same sense, all screening procedures offered to the population must be subjected to a systematic evaluation of their effectiveness, safety, efficiency and equity in terms of how the procedure would be applied. Lastly, to achieve an effective implementation of the principle of autonomy as well the desired goal of empowering the population to exercise some control over their determinants of health, it is recommended to explore new ways of achieving active citizen participation to establish preventive priorities and to assess the impact of screening interventions.
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Plaza Tesías A, Guarga Rojas A, Farrés Quesada J, Zara Yanhi C. [Consensus on a process of benchmarking in primary care in Barcelona]. Aten Primaria 2005; 35:130-9. [PMID: 15737269 PMCID: PMC7684338 DOI: 10.1157/13071938] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To define the strategy, the conceptual framework, the methodology and the indicators that are needed to promote and consolidate the culture of external reference (benchmarking) as a strategy for change in Primary Care teams (PCT). DESIGN Cross-sectional, descriptive study. SETTING Primary care services of the Barcelona City Health Region. METHOD Two stages were distinguished. At the first stage, an adviser group was set up. This was divided into 4 focus groups in which the main lines, the conceptual framework, the sizes, the indicators and the methodology for comparing PCTs were agreed. The second stage, that of prioritization, was conducted by means of a questionnaire to opinion-formers. For each of the indicators proposed, they appraised the degree of agreement, the suitability and relevance of indicators, the capacity of PC to modify results and the practicality of the information for composing the indicators. RESULTS The involvement of professionals, their approach to improvement, and the transparency and dissemination of the evaluation were identified as strategic elements of benchmarking dynamics. In line with the basic principles of PC and the health system, 6 dimensions for evaluation were set: accessibility, effectiveness, capacity to resolve problems, longitudinality, cost-efficiency, and results. 43 of the 57 indicators prioritized gained the consensus of over 90% of the consultants. CONCLUSIONS Evaluation as a useful tool for managing PC quality has to generate improvements or changes in PCTs. The involvement of professionals in the design and development of evaluation may help both its acceptance and the implementation of the changes arising from it. The indicators used and the effect of benchmarking policy on the results of PC service delivery require evaluation.
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Galán I, Rodríguez-Artalejo F, Tobías A, Gandarillas A, Zorrilla B. Vigilancia de los factores de riesgo de las enfermedades no transmisibles mediante encuesta telefónica: resultados de la Comunidad de Madrid en el período 1995-2003. GACETA SANITARIA 2005; 19:193-205. [PMID: 15960952 DOI: 10.1157/13075952] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To illustrate -for the first time with Spanish data- the usefulness of telephone-interview-based surveillance of non-communicable diseases risk factors for the purpose of drawing up public health policies. METHODS We analysed information from the Non-Communicable Disease Risk Factor Surveillance System (Sistema de Vigilancia de Factores de Riesgo asociados a Enfermedades No Transmisibles- SIVFRENT) for the period 1995-2003. This system is based on monthly telephone interviews covering a representative population sample, aged 18-64 years. 18,049 interviews were conducted for the whole period. Indicators of overweight and obesity, sedentary lifestyle, diet, tobacco and alcohol consumption, preventive practices, accidents and injuries, and road safety were calculated. The time trend was estimated using average annual prevalence ratios, obtained from generalised linear models with binomial family and logarithmic link. RESULTS Among men, the changes of greatest magnitude corresponded to an increase in overweight and obesity, which registered a relative annual rise of 3.7%, and a decrease in dieting (-3%), high alcohol consumption (-6.1%) and non-use of safety belts (-4%). Among women, there was a marked increase in overweight and obesity (3.3%), cessation of smoking (3.1%) and recourse to mammograms (6.4%), and a decrease in dieting (-4.1%) and non-use of safety belts (-4.5%). CONCLUSIONS Although important progress was observed in a number of indicators, such as tobacco and alcohol consumption, road safety and the undertaking of preventive practices, the situation worsened in others, i.e., fundamentally the increase in overweight and obesity.
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Affiliation(s)
- Iñaki Galán
- Servicio de Epidemiología, Instituto de Salud Pública, Consejería de Sanidad y Consumo de la Comunidad de Madrid, 28037 Madrid, España.
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Benítez Camps M, Pérez Zamora S, Dalfó Baqué A, Piqueras Garre MM, Losada Doval G, Vila Coll MA. [The DISEHTAC II study: diagnosis and follow-up of hypertension in Catalonia. comparison with 1996 data]. Aten Primaria 2005; 35:7-12. [PMID: 15691448 PMCID: PMC7669093 DOI: 10.1157/13071038] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2004] [Accepted: 07/14/2004] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the changes in the diagnosis and follow-up of hypertension, and in the evaluation of cardiovascular risk, in a population served by primary care centers in Catalonia (northeastern Spain). Management was evaluated with indicators published in the Guidelines for Hypertension for Primary Care (Guía de Hipertensión Arterial para la Atención Primaria). DESIGN Multicenter, observational, before-after design (1996-2001). SETTING Primary care. PARTICIPANTS Twelve primary care centers chosen from among the 31 centers that took part in the DISEHTAC I study (1996), with a total of 990 patient records. MAIN MEASURES We analyzed age, sex, date of diagnosis of hypertension, number of blood pressure measurements needed for diagnosis, use of the mean value of duplicate blood pressure determinations, values for all blood pressure measurements in 2001, blood pressure determinations during the preceding 6 months, screening for and diagnosis of diabetes, dyslipidemia, smoking, obesity, and left ventricular hypertrophy. RESULTS Of the 171 new cases of hypertension, 16.7% were diagnosed from at least 3 duplicate blood pressure measurements or as a result of acute episodes of hypertension. About one third (32.4%) of the patients with hypertension had blood pressure values below 140 and 90 mm Hg (25.7% in 1996), and the difference between the 2 sets of survey results was statistically significant. In three fourths (75.4%) of the patients, blood pressure had been measured during the preceding 6 months; this percentage was not significantly different in comparison to the figure found in 1996. Screening to detect cardiovascular risk factors was done in 50.4% of the patients (63.1% in 1996). CONCLUSIONS Follow-up for hypertension in Catalonia has improved notably since 1996, but there was no improvement in the diagnosis of risk factors or in the integral evaluation of cardiovascular risk.
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