Atencion primaria
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To characterize the time in therapeutic range (TTR) and estimate the incidence rate of complications (PTIRc) in adults with warfarin protocol. ⋯ Despite new anticoagulant treatments, warfarin is useful. As follow-up time increased, control was better and the rate of occurrence of complications decreased; however, the conditions that showed lower TTR and higher rate of occurrence of complications require a thorough review of follow-up especially in patients with functional illiteracy.
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The use of drugs has undeniable benefits to the elderly, but it is not exempt from undesirable effects. Deprescription is the process of systematic medication review with the target of achieving the best risk-benefit ratio based on the best available evidence. This process is especially important for polymedicated elderly patients as well as those overtreated, frail, terminally ill and at the end of life. ⋯ In the decision-making process, it is very important to consider the patient and caregivers opinion, assessing the objectives of the treatment according to the clinical, functional and social situation of the patient. There are multiple tools to make it easier for clinicians to select which drugs to deprescribe (Beers criteria, STOPP-START…). The most susceptible to intervention pharmacological groups are: antihypertensives, antidiabetics, statins, benzodiazepines, antidepressants, anticholinergics, anticholinesterase agents, and neuroleptics.
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To identify the sociocultural roots that explain the higher frequency of diagnoses of depression and/or anxiety and the prescription of psychotropic drugs in women, in order to propose a preliminary explanatory framework for the investigation of gender inequalities in mental health and its medicalization. Qualitative study with a descriptive-interpretive design, through in-depth interviews conducted in January and February 2021. Interviews were held in various cities of the Basque Country, Barcelona and Madrid. 12 experts in gender and mental health from the clinical (Primary Care and Mental Health), academic and associative fields. ⋯ An analysis of thematic content was carried out starting from a critical-realistic epistemological perspective. The main dimensions to explain gender inequalities in diagnoses of depression or anxiety and prescription of psychoactive drugs were: 1) the material and symbolic subordination of women, 2) the role of «psi» sciences in the pathologization of the feminine identity, 3) the epistemological and androcentric biases of biomedicine, and 4) the active agency of women in medicalization processes. The reduction of gender inequalities in the diagnoses and prescription of psychotropic drugs will require joint intervention at the clinical, community and structural levels that, from a feminist perspective, manage to reverse the socioeconomic, symbolic and epistemic vulnerability of women.
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Practice Guideline
[Optimizing blood pressure control through telemedicine in Primary Care in Spain (Iniciativa Óptima): Results from a Delphi study].
Members of the working groups on hypertension or cardiovascular disease of the Spanish Societies of Primary Care Physicians (PCPs) [SEMERGEN], Family and Community Medicine [semFYC] and General and Family Physicians [SEMG], conducted a Delphi study to validate with a panel of PCPs with expertise in hypertension several recommendations to optimize teleconsultation in hypertensive patients. ⋯ Teleconsultation can complement face-to-face consultation, constituting an additional tool for the appropriate follow-up of hypertensive patients.