Atencion primaria
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Randomized Controlled Trial Comparative Study
[The PROPRESE trial: results of a new health care organizational model in primary care for patients with chronic coronary heart disease based on a multifactorial intervention].
Comparison of the results from the EUROASPIRE I to the EUROASPIRE III, in patients with coronary heart disease, shows that the prevalence of uncontrolled risk factors remains high. The aim of the study was to evaluate the effectiveness of a new multifactorial intervention in order to improve health care for chronic coronary heart disease patients in primary care. ⋯ An intervention based on models for chronic patients focused in primary care and involving patients in medical decision making improves cardiovascular risk factors control (smoking, LDL-C and SBP). Chronic care strategies may be an efficacy tool to help clinicians to involve the patients with a diagnosis of CHD to reach better outcomes.
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Multicenter Study Observational Study
[Evaluation of satisfaction with telemedicine devices and with the results of the care received among chronic patients. The ValCrònic program].
To evaluate patient satisfaction with the ValCrònic program, telemedicine devices, and the results of the care received after a 2-year follow-up. ⋯ The ValCrònic program promotes self-care among patients.
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Multicenter Study
[Implantation of a program for polymedicated patients within the framework of the Galician Strategy for Integrated Chronic Care].
A total of 22.8% of citizens in Galicia are older than 65 years and, compared with the Spanish population as a whole, they represent a more elderly population with a higher prevalence of chronic diseases. The SERGAS 2014 strategy and the Galician Strategy for Integrated Chronic Care envision the development of a specific program to improve the health and quality of life of older polymedicated patients. ⋯ The program to improve the quality of care provided to chronic polymedicated patients in Galicia is a timely and necessary initiative, given the high percentage of the population with multiple comorbidities receiving polymediation. The program has clear benefits: the quality of prescription and patient safety improved due to the reduction in the number of medications administered and the detection of potentially inappropriate prescriptions.
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To determine the utility and viability of a chronic care program. ⋯ When assessing the utility of CRONIGICAT, we believe that progress has been made mainly in its implantation, which has acted as a catalyst for a self-directed shift to a better chronic care model and has identified areas for improvement. We believe that the CRONIGICAT is viable and sustainable, since its actions and projects are integrated within routine clinical practice.
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To explore the perception of primary care health professionals in the Basque Country (Spain) of multiple comorbidities and their influence on clinical practice and the organization of health services. ⋯ The increase in multiple comorbidities is a reality that worries primary care professionals, who express the need for adequate training, decision-making tools and support in daily clinical practice dealing with the most frequent situations and combinations of multiple comorbidities. The most effective approach to these problems requires a shift in the healthcare model toward an integrated view of the patient, a transition from a paternalist approach to a more proactive approach, and the development of healthcare integration.